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IS THIS STILL CONTENTIOUS?
And who would win this debate in 2006 … ?
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THIS
HOUSE BELIEVES THAT WOUND HEALING IS AN
INDEPENDENT SPECIALITY WHICH SHOULD BE NURSE-LED
HARROGATE 1995
Moderator: Geoff Watts
Presenter of Medicine Now, BBC Radio, London
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| For
the motion:
Keith Harding
Wound Healing Research Unit, University of Wales
College of Medicine, Cardiff, UK |
Against
the motion:
Thomas Hunt
Department of Surgery, University of California,
San Francisco, California, USA |
In
supporting this motion, it is important to reflect on what currently
happens to patients with wounds. My experience is that nothing positive,
constructive or sympathetic happens to many patients with this clinical
problem.
Whilst remaining aware of the problems of setting up
new specialities, surely the lack of co-ordination of care
that is currently present could be overcome by enabling
someone with expertise to provide such care. I accept that issues
related to suitability of training and the need for support for any
individual prepared to undertake the role of ‘wound healer’
in a hospital or community setting need careful consideration, but
they can be overcome.
Perhaps a more contentious issue associated with this
motion is the apparently revolutionary statement that this speciality
should be nurse-led. Whilst many of my medical colleagues have a problem
with this, I personally do not, as I feel that most of the wound care
currently provided is actually delivered by nurses. So why should
they not be the recognised experts in this subject? They will require
enthusiasm and constructive support from medical colleagues if the
full range of wound care is to be offered, but what is so wrong for
a nurse to have a facilitating role in ensuring that patients obtain
optimal care from a range of specialities.
The number of patients, range of wound problems and
treatments currently available demand development of a
structured approach to care. The development of a nurseled speciality
of wound healing is an urgent priority and should be addressed by
both professional and managerial groups in health care systems throughout
the world. |
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New
opportunities to garner power and profit attracts seekers aplenty.
Medical and now Nursing ‘vulnologists’* want to specialise
and lead ‘organised wound therapy’ but this is not the
time or the right strategy.
Having nurses in charge of the many details in wound care is attractive.
Nurses could easily master most therapeutic techniques. However, really
capable ‘vulnologists’ will need medical, surgical and
diagnostic skills which are beyond the education and ‘licensable’
activities of most nurses.
I am reluctant to say this, but nursing education is less rigorous
than that in medical school. If wounds become a disease for nurses
to treat, those who organise medicine will pay less and expect less.
They clearly want to do so. They want to ‘trivialise’
the wound problem, and we should not help.
Nurses often can, should, must co-ordinate the wound
care team. Their expertise is underestimated. I welcome
comprehensive wound healing education for nurses and
perhaps even ‘specialised’ nurses. But to lead the team?
No. It is the wrong time, wrong message.
Why not deal with wounds like we deal with other common diseases?
Improving wound care is an educational, not an organisational task.
* From vulnus meaning wound (Latin). |
The
house at this meeting voted for the motion (see Editor’s
Letter).
What would the results of such a motion be in 2006?
We would be extremely pleased to receive your views by e-mail at
<oxfordwound@aol.com>
and hope to publish these
in a forthcoming issue of the ETRS Bulletin. |
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