Posted by: Witch Doctor | January 16, 2008

The treacherous telephone consultation



Here is an extract from a job description for a Band 6 Out of Hours Triage Nurse Practitioner.

“An autonomous nurse practitioner with the ability to complete a comprehensive clinical assessment to determine appropriate pathway for client via telephone triage. This will include nursing diagnosis and advice. To communicate both with the client and appropriate professional and agencies where necessary within the NHS code of confidentiality and the Data Protection Act.”



There is not many a doctor would be able or willing to perform a “comprehensive clinical assessment” by telephone in an out of hours and therefore potentially emergency situation. This is because “a comprehensive clinical assessment” involves at least taking a case history, assessing the body language and examining the patient.

And yet somewhere, at some time, senior medical staff have been behind this practice, or it would not be accepted now.

Are they the same senior medical staff who were hell bent on introducing “HOSPITAL AT NIGHT” and now equally hell bent on extending it to “HOSPITAL 24/7”?

Are they?

And why are they doing it?

Why are they doing it when junior doctors have no jobs to go to.

Why are they doing it at all.

Whether or not junior doctors have no jobs to go to?

There was a time when the GMC would have criticised this practice.

And how!

No longer it seems.

Why not?

And now, not only are there telephone consultations but there is such a thing as a “Nursing Diagnosis”

Glory be. What the devil is a “NURSING DIAGNOSIS”

It’s high time “THE ROLE OF THE DOCTOR” is defined.

But The Witch Doctor fears The Tooke Report will be fudged!

Not because of Tooke, but because of complicit senior doctors.

Wait and see!!

N.B. And how The Witch Doctor loathes the word client in relation to illness.

Prostitutes have Clients.

Nurses now appear to want to have Clients.

Doctors have Patients!

redapple.jpg a red apple ……………………

The Witch Doctor – Link to a random page





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  1. “It’s high time “THE ROLE OF THE DOCTOR” is defined.”

    Hear, hear! and these nurses are paid more than the juniors, so it is not about cheaper than! Can you explain that Witchdoctor, it is beyond my stem cell!

    I too feel Tooke’s review will be ‘cleansed’, manipulated and watered down. Then it will be implemented, same as happened with the MMC that was in ‘ubfinished business’ and gained unanimous support across the profession .. as soon as it did, …. the rest is history .. and present but, I hope, not the future. The Tooke report got unanimous support too …

  2. Sam,

    In my Black Cat’s opinion, all of this was started off by the job-share “Pied Piper” ie Tony Blair and Alan Milburn and is very complex.

    My Black Cat thinks in their minds there will have been a clear “logic” that is still progressing.

    The key is in the Tooke Report. “Health and Education are now global commodities”

    The Witch Doctor will have to try a “Green Bottle Spell” in order to access their thinking processes way back then. What is happening now is just a continuum. I’ll put up a post when The “Green Bottle Spell” has been cast. Green Bottle Spells accessing the thoughts of the past are very difficult, it requires much more than a few competencies in this area.

  3. indeed,

    I seem to have psychically pre-empted you on this!

  4. You have indeed Garth,

    I picked this advert up from you, and have already put up a post timed to appear at the witching hour tonight that will be of interest to you!

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