DR FLOWER POWER DIDN’T KNOW SHE HAD ANY COMPETENCIES
In medicine, there must be thousands of competencies scattered thoroughout the various groups of specialties.
It is possible to fragment any medical or surgical activity into a series of competencies, and then subdivide each competency until you eventually have to split the atom.
Although medical skill are made up of a “basket of competencies” each competency in the basket usually can be serially subdivided until it can be protocol driven and performed by someone other than a medical graduate. Indeed, there was a time that the local barber’s shop was where many of the surgical competencies were displayed. At the present time, in the UK, it is not the custom to employ barbers in a hospital environment to perform surgical procedures. This may change however, since barbers have many competencies in common with surgeons. So also, do members of the “Embroiderer’s Guild”. Employing equal numbers of these groups might produce a more balanced male/female surgical workforce than there is at present.
However, it used to be different. Take phlebotomists for example. Dr Flower Power, a Junior House Officer of the 1960’s would have thought it inconceivable that an individual with no prior medical training would ever be allowed to enter “her” ward to take blood from “her” patients each morning. If she had been an innovative JHO, and had seriously suggested this idea to her chiefs, her career would likely have been in tatters.
In the 1960’s Dr Flower Power did her own phlebotomies. There was no doubt about that. Rarely a forward-looking ward sister might do one for her, but that was rare and it broke the rules. No-one was allowed to know about it. Ward sisters were trained to put needles into muscle and skin. They were not trained to put them into veins.
By the time Miss Flower Power became Dr Flower Power she was a very competent phlebotomist. She didn’t dwell on this. Indeed she was never ever trained.
She just learned.
And the learning was pleasant.
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