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I had a couple of hospital appointments recently and once they were over I had a bit of a think. I’d had three investigative procedures done – one by an endoscopist, one by an ultrasonographer and one by a radiographer. All three had particular discipline backgrounds (none were medicine), but I began to wonder whether their discipline backgrounds were actually a pre-requisite for doing those jobs.

Their expertise was about knowing in detail about a very specific process, the skill and dexterity that comes from constant practice and performance, the experience that makes the difference between a competent novice and a real expert. I felt in the hands of a real expert each time – but it wasn’t obvious – or important to me – that I was in the hands of a nurse, or a radiographer, or a technician. Their very obvious competence, ability to put me at ease, confidence in explaining to me what they were able to see, and professional reassurance made me feel very safe indeed. These were clearly intelligent people who were experts in their field and knew what I was anxious about, recognised that, and responded to it, as well as ‘doing the job’.

So I began to muse about the importance of the expert practitioner in a generic sense. And whether, with the right preparation, a nurse, radiographer, physio or OT, or any other graduate health professional, could be an endoscopist, or an anaesthetic practitioner, or a rehab therapist, or a nutritionist, or a caregiver. And I began to muse about whether we need to think harder about how we deal with the needs of people for expert procedures or advice. Should it only be nurses who become ‘nurse endoscopists’? why isn’t the role just ‘endoscopist’ and any graduate professional could perform it (after suitable preparation of course)?

Should our post graduate employment be only discipline specific, or should it sometimes be specialty specific but generic in from where it draws it’s practitioners? Why should long term condition advice and expertise almost invariably be the Specialist Nurse? Why couldn’t the Diabetes Specialist have a physio background, or an OT or whatever, but have the postgraduate specialist knowledge to undertake the whole function? Would this help break down the plethora of single discipline specialist roles that overlap but don’t seem to integrate?

These are not fully formed ideas, just musings and questions, not views or beliefs. But I’d be interested in other constructive musings on this theme. But please don’t muse if you interpret this as specialist nurse bashing, or that I want to do away with all disciplines, or just want a rant. My musings are just musings – floating out there to see if they register with anyone.

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