READ THIS AND MAKE UP YOUR OWN MIND!

You may think this is boring stuff, or even gobbledygook, but if you are a practicing doctor in the UK, The Witch Doctor thinks you should read this carefully.

Go on, it’s a labour of love, I know, but read it!

Very very carefully!

This month (July 2007) a document called “RCN domains and competencies for UK Advanced Nurse Practitioner practice” was approved by someone. (The Witch Doctor is not yet sure who.)

There are seven domains.

These are:

1. Management of client health status
2. The nurse-client relationship
3. The teaching-coaching function
4. Professional role
5. Managing and negotiating the health care delivery system
6. Monitoring and ensuring the quality of health care practice
7. Cultural competencies

Each domain is subdivided further.

As an example, consider the first domain.

This is subdivided into:

1a. Health promotion/health protection and disease prevention.
Under this heading there are 5 specified behaviours.
1b. Assessment and Management of patient illness.
Under this heading there are 8 specified behaviours.
The last specified behaviour in this group has four sub-headings.
1c. For health promotion /health protection and disease prevention, and management of patient illness.
Under this heading there are 19 specified behaviours.

This therefore gives a total of 32 specified behaviours for the first domain.

The other domaines follow a similar pattern.

Looking in detail at the 8 specified behaviours in section 1b of the first domain.

Here they are:

1b (1) Obtains, analyses and interprets history, presenting symptoms, physical findings, and diagnostic information to develop the appropriate differential diagnoses.

1b (2) Diagnoses and manages acute and long term conditions while attending to the patients response to the illness experience

1b (3) Prioritises health problems and intervenes appropriately, including initiation of effective emergency care

1b (4) Employs appropriate diagnostic and therapeutic interventions and regimens with attention to safety, cost, invasiveness, simplicity, acceptability, adherence, and efficacy

1b (5) Formulates an action-plan based on scientific rationale, evidence-based standards of care, and practice guidelines

1b (6) Provides guidance, counselling, advice and support regarding management of the health/illness condition

1b (7) Initiates appropriate and timely consultation and/or referral when the problem exceeds the nurse’s scope of practice and/or expertise

1b ( Assesses and intervenes to assist the patient in complex, urgent or emergency situations:
A. Rapidly assesses the patient’s unstable and complex health care problems through synthesis and prioritisation of historical and immediately-derived data.
B. Diagnoses unstable and complex health care problems using collaboration and consultation with the multi-professional health care team as indicated by setting, speciality, and individual knowledge and experience.
C. Plans and implements diagnostic strategies and therapeutic interventions to help patients with unstable and complex health care problems regain stability and restore health, in collaboration with the patient and multi-professional health care team.
D. Rapidly and continuously evaluates the patient’s changing condition and response to therapeutic interventions and modifies the plan of care for optimal patient outcome.

And how are these “Specified Behaviours” acquired?

Yes. Correct. You’ve got it!!!

By acquiring competencies.

A whole fistful of them!

These competencies are:

HWB6 L4
HWB7 L4

C3 L4
HWB3 L4
HWB5 L4
HWB6 L4
HWB7 L4

C3 L4
HWB3 L4
HWB5 L4
HWB7 L4

C5 L3
IK3 L4
HWB5 L4
HWB7 L4
HWB8 L3
HWB10 L3

HWB5 L4
HWB6 L4
HWB7 L4

CI L4
HWB1 L4
HWB3 L4
HWB5 L4

C1 L4
IK1 L3
HWB6 L4

HWB2 L4
HWB6 L4
HWB8 L4

C1 L4
IK1 L3
HWB8 L4

C1 L4
C3 L4
IK1 L3
HWB3 L4
HWB5 L4
HWB7 L4
HWB8 L4

C3 L4
HWB3 L4
HWB5 L4
HWB7 L4
HWB8 L4
HWB10 L3

These seem to be the competencies required for an MBChB degree. If you can get them by other means you don’t seem to need an MBChB any more.

And where do you find out about these, same as, but not required to pass MB ChB, skills?

That’s right. The Competency Place - “Skills for Health”

In the witching community, we witches, would want fully qualified doctors to be reponsible for all aspects of care that The Witch Doctor has highlighted in bold. But, of course, witches are much more demanding than humans because we have very complex anatomy, physiology, biochemistry and pathology. And our brains and decision making processes seem to be infinitely more advanced. We are therefore much more precious.

So, it may be OK for humans to be diagnosed and treated by competencies and a clipboard.

If that’s what humans want.

P.S. The Witch Doctor found the prose in italics amusing. That was all that was amusing!

The Witch Doctor - Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE

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