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Interprofessional Rivalry

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Heard some ambulance staff slagging off medical grades the other day from GPs to Consultant Anaesthetists. Given the generalisations being made and demonstration of some stereotyping I attributed their frustrations to interprofessional rivalry. It interested me to think we are viewed often negatively by allied professionals.

As Doctor's do we warrant it by the way we behave? Is it an inevitability of working side by side with people from different disciplines? Does anyone have any examples?

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Seems to me like an age-long matter. It's there btw drs-nurses, psychiatrists-psychologists, office staff-managers, etc.

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psychiatrists-medics, general adult psychiatrists-psychotherapists, psychiatrists-social workers :)

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I guess one of the questions we may need to answer it also exists between nurses and social workers as well....?

in other words, why is it that psychiatrists are 'always' involved?

envy?

sense of unfairness re: pay?

our bad attitude?

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First two seem to be correct. Yes other disciplines envy us n they also think that doctors are paid more despite the fact, according to their point of view, that other disciplines do as useful job as doctors. It appears that everyone is becoming more and more vocal about it even in the presence of doctors. Surprisingly has anyone checked the pay scales for psychologists and Band 7 and 8 nurses. They earn much more than at least StRs and staff grades for a 40 hour week.

I had 'disengagement skills' training recently and the trainer, who was a nurse, was quite critical of doctors stating that it is not the job of nurses only to restrain someone and in a multidisciplinary team, doctors should be equally involved in process of restraint and they should go for 5 day restraint training. So there is a perception that doctors are not doing the jobs which they feel they should be doing. And I thought, what next. We had nurse prescribers, nurse practitioners, nurse consultants.......... and we did not say why other disciplines are taking on traditional roles of doctors. Now people like doctors to take on traditional roles of other disciplines. So they want you to restrain the patients, give them medication, probably change bedsheets and give patients bath, because you work in multidisciplinary team while nurse practitioners do the job you once used to do. And yes, you should have a pay cut as well. Because it is not happening, they dont like you.

I do not think that attitude of doctors is a problem. As a general rule, doctors are lot more accomodating than other disciplines. Having said about restraint, though I do not have 5 day restraint training, I have been voluntarily involved in restraint 3 times, just because of the reason that situation was acute and not enough nurses were around but it is not something I would like to have in my job description or people expecting me to do. Worrying things is that previously it was just nurse-doctor rivalry, now it is becoming more of other disciplines-doctors rivalry and I dont see attitude of doctors contributing to it. We are being forced into more and more submissive roles and we are adapting to it. One day, being part of multidisciplinary team, we will be cleaning the wards and will be running after cleaners to sign DOPS for us. (No offence to cleaners, they do a great job but I feel my doing that job would be a waste of my clinical training)

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We already have

Consultants, Ass Specialists, Staff grade, ST, FTST, SpR, trust grade...

Junior consultant and Sub consultant are on the way...

the way we are going now... we will have...

doctor - consultant, doctor - nurse, doctor - porter, doctor - auxillary, doctor - domestic, etc etc

From the above example... I think control and restraint is part of the nursing job...

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and within gen adult psych- between inpatient and community teams- and fights with crisis teams r the order of the day

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We already have

Consultants, [highlight]Ass Specialists[/highlight], Staff grade, ST, FTST, SpR, trust grade...

Do you mean proctologists?!?!?! :lol:

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The thing that doctors do that no-one else in the multidisciplinary team will do is: take responsibility for decisions that go outside of the protocols. Nurse prescribers/consultants/whatever will always get to a point where they say 'Lets get a doctor.' Either because the situation is not familiar, the element of risk is too high, or for some other reason. That is the reason we are paid relatively highly, and why we are trained to have a broad background in medicine, and practice as professionals.

If the allied professions were able to take on this role then we would not need doctors, but the training would need to be as comprehensive as ours has been to date.

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We already have

Consultants, [highlight]Ass Specialists[/highlight], Staff grade, ST, FTST, SpR, trust grade...

Do you mean proctologists?!?!?!  :lol:

hahaha... nice short form eh?!

An associate specialist doing Critical Appraisal...

An Ass specialist doing Cr app....

hahahahaha

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We already have

Consultants, [highlight]Ass Specialists[/highlight], Staff grade, ST, FTST, SpR, trust grade...

Do you mean proctologists?!?!?!  :lol:

hahaha... nice short form eh?!

An associate specialist doing Critical Appraisal...

An Ass specialist doing Cr app....

hahahahaha

:lol: :lol: :lol:

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sometimes I can see some nurses' point of view; they know what do to to the patient and they are generally right; they tell the doctor: prescribe this, the patient has low/high BP come and fix it, the patient doesn't need to be in hospital etc. so doctors behave in a submissive way; it is odd to be paid more or even the same isn't it?

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This is something that used to concern me. Now when faced with yet another dig I simply remind myself how much more pay I receive than them and laugh inside.

It's just envy pure and simple.

If they wanted to be paid more and given more kudos they should've applied to medical school.

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There maybe rivalry, jealousy etc.

But its they way you deal with it.

I had very difficult people in the team and at different places of work.

Just accept them and be very nice to them.

You will be surprised how things will work out.

Once had a tough manager on the ward within a few days she became a very good friend.

Just a few words of appreciation made the difference.

I got my way through.

Surely, all these rivalry exists.

Don't know when I will meet a really tough one ;).

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Doctor bashing is something that I have often come across, whether it is comments about higher incomes, job security or not having to do too many unpleasant tasks like nurses etc.

However we are a highly inteligent, highly trained group of people who have made lots of scarifices to reach where we are. and we fully deserve all the previleges that we receive. and they come with significant responsibilities too.

In my opinion, doctor's psychological profile usually makes us strive for perfection, avoid criticisms and we are not usually very good at financial profiteering or naming a price for our work, hence the discomfort when other disciplines make these comments.

We shouldnt be, we have rightly earned our place.

Recently I was in an ECG training session and one of the psychiatric nurses commented to the speaker, a medicine SPR that she should modify the talk to accommodate the non doctors. well, I am glad the nurses are trying to learn ECG but first and foremost they should learn how to appropriately take an ECG reading. by the time a demonstartion of how to take an ECG ahd come, they had left. so we have a situation where the psychiatric nurses refuse to take blood, ecg, do wound care etc, as they are not medically trained.

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I think the old saying:

&quot:lol:o as you would be done by' is useful.

99% of the time, if one is kind and friendly to people they will in turn treat you with respect also.

Gosh, am I going soft in my old age?!

:o

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An archetypal function of apes (including the naked variety) is to affiliate themselves in to a group. This has obvious survival advantages. Once in the group it is good to reinforce your position in it and a good way is to remind the other members by criticising other groups.

My point.....

If you in a group particulary one thats under treat from an other, members will slag of other groups for anything. If it is'nt money, its attitude, or apathy, or intellegence. It won't ever stop so lets just ignore it like we do the thymus gland.

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