Medical receptionists in general practice: Who needs a nurse?

The aim of this study was to determine the extent to which receptionists, working in general medical practices, are undertaking clinical tasks traditionally within the domain of nursing. A survey of 164 solo and principal general practitioners (GPs) practising within one division of general practice in south-east Queensland, Australia, yielded 84 responses (55%). The study found that some receptionists, while primarily employed for reception and clerical duties, were performing tasks that involved direct patient assessment, monitoring and therapy. Sixty percent of the GPs did not employ a nurse because of financial constraints and a perceived lack of need. These findings could be illustrative of the current trend in health care to appropriate the work of nurses to lesser-paid workers. Further investigation is indicated in order to determine the most appropriate non-medical staffing mix in general practice to achieve both quality care and financial viability.     

Information and support for women following the primary treatment of breast cancer

Objective To examine the need for, use of and satisfaction with information and support following primary treatment of breast cancer. Design Cross‐sectional survey. Participants Cohort of 266 surviving women diagnosed with breast cancer over a 25‐month period at a tertiary hospital, Adelaide, Australia. Time since diagnosis ranged from 6 to 30 months. Main outcome measures Need for, use of and satisfaction with information and support. Results Women reported high levels of need for information about a variety of issues following breast cancer treatment. Ninety‐four percentage reported a high level of need for information about one or more issues, particularly recognizing a recurrence, chances of cure and risk to family members of breast cancer. However, few women (2–32%) reported receiving such information. The most frequently used source of information was the surgeon followed by television, newspapers and books. The most frequently used source of support was family followed by friends and the surgeon. Few women (<7%) used formal support services or the Internet. Women were very satisfied with the information and support that they received from the surgeon and other health professionals but reported receiving decreasing amounts of information and support from them over time. Conclusions Women experience a high need for information about breast cancer related issues following primary treatment of breast cancer. These needs remain largely unmet as few women receive information about issues that concern them. The role of the surgeon and other health professionals is critical in narrowing the gap between needing and receiving information.     

Intermittent Auscultation for the Intrapartum Assessment of Fetal Well-being in Western Australia

Summary: In May 1995, in response to a decision of die Perinatal and Infant Mortality Committee of Western Australia, a survey of Western Australian hospitals was performed to ascertain what policies were in use for the monitoring of the fetal heart rate in labour and what proportion of these hospitals had access to electronic monitoring by cardiotocography. A response was received from 96% of the surveyed hospitals. More than half the births in this State (13,950 of 25,238) were monitored in labour using intermittent auscultation as the primary test; 7.5% of Western Australian births each year occurred in hospitals in which electronic monitoring was not available. Fewer than 50% of hospitals had written protocols describing the method of auscultation of the fetal heart during labour, the indications to contact a doctor or the management of fetal distress. The protocols which did exist displayed considerable variation in the recommended frequency of intermittent auscultation. The lack of standard practice in this field probably results from uncertainties in the literature. Intermittent auscultation has not been subjected to rigorous scientific evaluation as a screening tool and guidelines documenting ideal auscultatory practices need to balance the precision of electronic monitoring and freedom from intervention. Based on this compromise and existing evidence, a protocol for intermittent auscultation in normal labour is proposed.