Garth Rattray

I can't figure out what got into the head of the Nurses Associa-tion of Jamaica (NAJ), Edith Allwood-Anderson. I am certain that she is not acting on behalf of the NAJ when she preposterously portrays doctors as dangerously bungling, self-righteous practitioners desperately in need of constant monitoring by nurses who must save patients from their ineptitude. I wonder what rare event precipitated her discordant bluster.

Needless to say, nurses are integral to patient care and, during training, medical students are taught early on that nurses are ultimately in charge of the wards. They are not subservient to doctors (as Mrs. Allwood-Anderson suggests is the general thinking). Doctors have their responsibilities/roles and so do the nurses, pharmacists, medical technologists, physical therapists, radiology technicians, nutritionists, dieticians and the varied ancillary staff. They all work together as part of a team so I am shocked at the NAJ president for claiming that there is a 'lack of appreciation of nursing expertise'.

Unfair and inflammatory

Her statement is so outlandish, unfair and inflammatory that I suspect that there must be an ulterior motive to all of this. The traditional 'doctors' orders' are de facto instructions that cover a wide range of things from dressings to medication. President of the Jamaica Medical Doctors' Associa-tion, Dr. Myrton Smith, clearly explained (in The Sunday Gleaner - November 19, 2006), that nurses only check prescribed drugs on hospital wards where it is they who must directly dispense medications (oral or otherwise). Under those circumstances, every nurse has a moral, professional and legal responsibility to vet any drug that she/he administers. And, even under those circumstances, most prescriptions are scrutinised by the pharmacists before the nurses do their final check.

Naturally, pharmacists see far more prescription errors than nurses do because they are usually the dispensers both in the public and private setting, yet we don't hear a hue and cry from that group. As the Medical Association of Jamaica (MAJ) president, Dr. Alverston Bailey, pointed out, if Mrs. Edith Allwood-Anderson's claim that medication errors by local doctors are endangering the lives of patients, then, as a concerned member of the medical team dedicated to patient care, she should have reported the matter to the Medical Council and/or the MAJ.

Scrutinised

The Gleaner quoted Mrs. Allwood-Anderson as saying, "No doctor should hand a prescription to a patient without it being scrutinised by at least two other medical officers, including the nurse on duty". Her absurd proclamation seeks to portray doctors as a bunch of incompetents and nurses as the vanguard protectors of our vulnerable patients. It further seeks to disparage years of medical training and a hard-earned medical degree. It threatens to erode the confidence that patients have in doctors.

Since no one is perfect and since the well-being and lives of patients are at stake, there are checks and balances within the medical system. Private practitioners rely heavily on pharmacists to double-check whatever they prescribe. Pharmacists are also our well-trained professional partners, they are not our subordinates.

Within the public and private hospital system, pharmacists and (sometimes) nurses double and triple-check medications before they are dispensed or administered. As a team, our only interest is the good health of our patients. Because of the safeguards within the system, I am certain that occasional prescription errors are usually intercepted. For the sake of research and record-keeping, the Ministry of Health may wish to conduct a survey (as they have done repeatedly in the United States) but I'm certain that no crisis exists.

Dr. Garth A. Rattray is a medical doctor with a private practice.