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Nurses and feild units

#1
Does anyone have an opinion on Registered Nurses serving in field units? Is this clinically benificial? Is it really necessary? How do we justify it professionally?
 
#2
Am I right in thinking that youve never served in a field unit? Without nurses posted to field hospitals the wards probably wouldnt be deployable.
 
#3
By all means deploy nurses with field hospitals. Why have them serve at a field unit for two years or more? depending on speciality or chosen field, this could result in a serious skills fade.
 
#4
Way back when I wore khaki I suggested that this schism between the green Field AMS and the specialist AMS would be best overcome by re-brigading the Fd Hosps into 'Hospital Regiments' and amalgamate them with thier co-located MDHU.

Then, for example, you could get a 3 yr posting to, say, 34 Hosp Regt in Strensall, where you would work half the time with the field unit (whether deployed or not) and the other half of the time in your clinical speciality at MDHU Northallerton.
 
#5
Nurseyboy1 said:
Does anyone have an opinion on Registered Nurses serving in field units? Is this clinically benificial? Is it really necessary? How do we justify it professionally?
let me guess, you joined the army from civi street, did your phase one training. Youve had three years in Uni as a uniformed civi, and youve been qualified under two years and starting to panic over your PPP

You joined the army, youre a soldier and a newly qualified nurse.

Should you meet DANS in the next few weeks, ask him what comes first - he'll tell you soldier first, nurse a very close second.

Just because you MAY end up in a Field Unit (note correct spelling) does not mean you will just be humping and dumping canvas

I would also presume that you have two tapes, and therefore think yourself capable of using them. Go to the green side and see for yourself, cos I'll bet you a days pay you cant

Contact the NMC, ask them how many days you must 'nurse' in three years to qualify you to remain on the register ! you'll be surprised
 
#6
After spending 18 months in med reg, I have not touched a single patient. This is not through lack of trying to get on clinical placements, but my unit is short of JNCO's, therefore muggins has to stag on and watch his nursing skills go down the pan. I have pointed this out to my chain of command on several occasions, as well as NEA, DANS and anyone else high ranking who will listen, but the soldier first argument comes is rolled out, almost as a reflex action.


Other nurses in my unit are suffering similiar problems, so i think that the real question should be, why are'nt doctors, dentists, physios, radiographers and vets all working full time as troopies and, 2ic's and so on. Why just nurses, surley we are not the only professionally qualified members of the AMS who can cut it in med reg's full time?

Sorry for the rant guys, but when I treat patients on tour I want to be able to do it very well, which is more important, i think, than being able to stag on or being able to march the toms around camp
 
#7
Karabiner said:
Serving in a field unit is no excuse for an individual to suffer serious skill fade. With DGAMS Operational Training Directive units and individuals are mandated to ensure that clinical skills are maintained, additionally we are obliged to maintain our competency within our area of nursing employment in order to remain on the register. There are plenty of opportunities to sort out clinical placements in MDHUs or other NHS hospitals, SO2 Trg at HQ AMD has recently produced a policy on clinical placements that has been sent out to all units via the chain of command.
I have been at my field unit foe a year now and I have enjoyed most of it. To be honest I prefer it to an MDHU but I am worried that we don't do enough clinical training. I work with a number of CMTs and their drills shock me at times. On most occasions the CMT is more concerned about getting the GPMG out to get ally phots on the ranges rather than putting the time to good use and cracking on with some job related training.

I have seen the policy and it states we should do enough hours to remain registered which I think is a load of crap. The other day someone in a clinical, registered profession asked what ephedrine was. I was gobsmacked but that just goes to show how detrimental being at a field unit can be.

In all honesty I think if you are going to be at a unit as a nurse or ODP you need to be on placement for at least 6months of the year to keep your skills in top condition.

I would feel guilty if I could not give complete and holistic care because of skill fade due to stagging on and painting boxes at a field unit. One months clinical placement in a year is no where near enough time to ensure your up to date in clinical practice. They usually have the clinical placement in one block as well rather than spreading it over a number of weeks in the year.
 
#8
The_ODP said:
Karabiner said:
Serving in a field unit is no excuse for an individual to suffer serious skill fade. With DGAMS Operational Training Directive units and individuals are mandated to ensure that clinical skills are maintained, additionally we are obliged to maintain our competency within our area of nursing employment in order to remain on the register. There are plenty of opportunities to sort out clinical placements in MDHUs or other NHS hospitals, SO2 Trg at HQ AMD has recently produced a policy on clinical placements that has been sent out to all units via the chain of command.
I have been at my field unit foe a year now and I have enjoyed most of it. To be honest I prefer it to an MDHU but I am worried that we don't do enough clinical training. I work with a number of CMTs and their drills shock me at times. On most occasions the CMT is more concerned about getting the GPMG out to get ally phots on the ranges rather than putting the time to good use and cracking on with some job related training.

I have seen the policy and it states we should do enough hours to remain registered which I think is a load of crap. The other day someone in a clinical, registered profession asked what ephedrine was. I was gobsmacked but that just goes to show how detrimental being at a field unit can be.

In all honesty I think if you are going to be at a unit as a nurse or ODP you need to be on placement for at least 6months of the year to keep your skills in top condition.

I would feel guilty if I could not give complete and holistic care because of skill fade due to stagging on and painting boxes at a field unit. One months clinical placement in a year is no where near enough time to ensure your up to date in clinical practice. They usually have the clinical placement in one block as well rather than spreading it over a number of weeks in the year.
Cracking generalisation there. Im sure you'd agree that most ODP's want to do black serpent and make out they're SF with med troop? No? Didnt think so.... :x

*edit* While im at it, exactly how many boxes have you painted in the last 12 months? I'll hazard a guess at zero.
 
#9
Hi red_arrse,

To answer your question I have painted approx 20 Lacon boxes, 8 jerry cans, two six foot tables, 10 shovels, 5 canvas chairs and the list goes on. That was in the last couple of months.

Most ODPs do not want to do Black Serpent but the ones that do and have don't big it up. I haven't seen or heard any CMTs, Paramedics, Nurses and ODPs big themselves up for being in Med Tp and if they do it is usually in jest. They wouldn't anyway as we see them daily and they do exactly the same as us i.e. Maintain kit and med stores.
 
#10
Bedpan2zero said:
Should you meet DANS in the next few weeks, ask him what comes first - he'll tell you soldier first, nurse a very close second.
Ideologically I would agree with the sentiment, but some years ago when I had the opportunity to put this question to the then DANS, her response was, "Remember who pays you!"

I think she thought that ended the matter, but I retorted, "That's all very well, ma'am, but all the Army can do is sack me, whereas the NMC can strike me off the register and rob me of my livelihood entirely."

She did not have an answer to that observation. I'm sure some of the wags on here will have, however!
 
#11
Karabiner said:
If a clinical, registered professional has to ask what ephedrine is I would suggest that it is nothing to do with being at a field unit and more to do with basic incompetence. What clinical profession did this individual belong to? If they are a nurse or ODP then they should hang their registration up, this is basic knowledge and should not be affected by skill fade.
Skill fade is not just hands on. Knowledge can fade just as quickly and the clinical environment changes daily, this includes, policy, practice and equipment.

A prime example is drugs. You can bet money that after six months of not being in the clinical area you will see brand names change. Many times we have been in work and an anesthetist will ask for a drug by its brand name rather than the clinical name i.e. Propofol might get called Diprivan. I know that all you have to do is ask but sometimes you need to have it to hand quickly.
 
#12
I like where I am and I would gladly stay here however I think we should be in hospitals. We should be clinical 24/7 as that is the job we do. The whole soldier first thing is very important but there needs to be a balance. If a soldier comes through the doors of A&E they ain't going to give a rats arrse that you can strip your weapon blindfolded, they want you to do the job you trained to do.

When you go on tour you can tell who is in a field unit and those who have deployed from an MDHU as it takes the field unit person a little time to adjust back in to the clinical environment. I am not saying that they dont know their job but it is like trying to play the piano if you haven't touched it for some time.
 
#13
You all managed to keep yourselves current at Uni for 3 years when you have little hands on patient contact. Could it not be a bit beneath you to stag on or check the I12 you will be using on OPs, I was at 2 Fd Hosp when the "clinical" staff turned up from the BMHs with little if any field experience, I think it is time you started learning the field side of the job. If you are so worried about PREP or what ever it is now called get your head in the books, have clinical meeting use some of your energy to keep yourself current. This is what good CMTs had to do for years.
 
#14
My point ODP was that your statement that most CMT's want to look good on the range with a GPMG rather than do a bit of clinical training is complete crap. As the subject topic "Nurses and field units" the fact that you had a pop at CMT's with no relevance to the thread annoys me and it seems your just talking from your arrse. If you dont have a valid response to the thread then why post?
 
#15
I managed to avoid working on a ward for seven years - and managed to work in training, and specialist areas - but when I moved to Grimley dark and went back to the wards it was a bit of a shocker having to work for a living again, but my nursing skills didnt take much dusting down.

Utilise the CoC in your units - there is usually a fair amount of flex in a Med regt, even if it is only doing med cover on exercise (still vital, and hands on) or the local med centre for a few days a month
 
#16
cbgramc said:
You all managed to keep yourselves current at Uni for 3 years when you have little hands on patient contact. Could it not be a bit beneath you to stag on or check the I12 you will be using on OPs, I was at 2 Fd Hosp when the "clinical" staff turned up from the BMHs with little if any field experience, I think it is time you started learning the field side of the job. If you are so worried about PREP or what ever it is now called get your head in the books, have clinical meeting use some of your energy to keep yourself current. This is what good CMTs had to do for years.
I take it your not a clinical person as all members of the health care profession spend most of their time in the clinical environment during their course. University is only a small part of the course. The assignments were done during the evening or on weekends and sometimes we were given study periods during the week but for the majority of the time it was clinical. Most of university was spent doing the exams or attending lectures that taught us what we needed to be learning in the clinical area.

I don't think stagging on is beneath me and I have done my fair share but on tour I was on stag and had to be taken off duty for a mass casulaty incident, that sort of identifies what our job is and what we are needed for. If I was in the UK I wouldn't have any drama with duty and sometimes I prefer it over the day to day business at camp.

To clear up what you said about soldiering. I spent a number of years in the infantry environment and am a class 1 Infantryman. Now after 4 years my skills have faded but I still remember all the basics that were drummed into us to make us basic infantryman.

Sorry for upsetting you red_arrse and your probaly right. There are a fair share of walt nurses and ODPs but I was only trying to make a point..which wasn't the best way of explaining it.

We can all have our opinions and I think mine is valid after being at an MDHU, being deployed and working at a field unit. I don't think we get enough clinical time at a field unit. I also feel that CMTs don't either. More time should be spent in those areas: CMTs (ambulance/A&E), ODPs (Theatres/A&E) and Nurses in their specific place of practice. I think we should spend half of our year in the clinical area and the other in the basic soldering capacity (not to infantry standards).
 
#17
Bedpan2zero said:
I managed to avoid working on a ward for seven years - and managed to work in training, and specialist areas - but when I moved to Grimley dark and went back to the wards it was a bit of a shocker having to work for a living again, but my nursing skills didnt take much dusting down.

Utilise the CoC in your units - there is usually a fair amount of flex in a Med regt, even if it is only doing med cover on exercise (still vital, and hands on) or the local med centre for a few days a month
I am an ODP and they sent me to Kenya to do Primary Health Care. When I asked if I could go on clinical placement instead, like many of the Nurses and ODPs who asked we were told that it would be a good experience (not arguing that) but rather than sorting out coughs, colds and vaccines I could have been practicing my job. We also pointed out that it was not in our scope of practice and that if anything went wrong we could be held accountable but they still took us to hand out multi-vitamins and anti-biotics. If their was a surgical element to the exercise I would have been happy.
 
#18
Karabiner said:
If a clinical, registered professional has to ask what ephedrine is I would suggest that it is nothing to do with being at a field unit and more to do with basic incompetence. What clinical profession did this individual belong to? If they are a nurse or ODP then they should hang their registration up, this is basic knowledge and should not be affected by skill fade.
Ephedrine is a drug I am commonly asked about by clinical professionals and I am always happy to answer such questions rather than tut tut about the lack of knowledge. At least they asked!

Far scarier is the person who doesn't ask and who then mixes it up with epinephrine.................... Common error. Much better to encourage folks to question stuff than deride them for not knowing something.

Jez
 
#20
Don't forget there is a world of difference between so called 'field units', I have worked in both Med Regts and Fd Hosps, while nurses tend to do OK in Fd Hosps, they can often struggle with the Regimental side of life. I believe that we should select personnel more objectively to ensure that they can function in the environment they are sent to.