Three nurses qualify to take on surgeons' work

10:13am Friday 6th August 2004

THREE of the district's most experienced nurses are now operating on patients at Wycombe Hospital.

Geraldine Hannaway, Fiona Charlton and Glynis Howat, all theatre nurses, are learning how to remove lumps and bumps, repair hernias, remove varicose veins and carry out gall bladder removals using keyhole surgery.

By next February, after a year's academic and practical work, they will become surgical practitioners.

As theatre nurses they have been helping surgeons for years, watching them cutting, tying, and finally closing wounds, and thought, "I could do that". So when the chance came they jumped at it.

Bucks Hospitals' Trust put in a bid for cash to start the training scheme along with 82 other trusts. It was one of eight to be successful and received a grant of £91,000.

The three women are among 14 from the South East attached to Imperial College in London and taking courses at St Mary's Hospital in Paddington one week in six.

At Wycombe they are in the care of consultant surgeons Shaun Appleby, Marwin Farouk and Andy Northeast who are always close at hand.

Mr Northeast is Bucks Hospital's Trust's clinical director of surgery. Even before the NHS scheme started he thought it was about time the theatre nurses used their experience more widely. The UK lagged behind places like the US and the continent, he said, where nurses did all kinds of things including giving anaesthetics.

"About two years ago I took three nurses and took them though wound closures in varicose vein ops. They were good at it and have done a huge number. It is not earth shattering."

The nurses went on a rota to help one of the surgeons who was working alone. The result was that an operation that normally took 50 minutes, took 40. That was better for the patients, and better for the surgeon because he could get through more work, said Mr Northeast.

Two of the nurses then took the basic surgical skills course, which senior house officers have to take. One came top and beat the doctors.

To become surgical practitioners nurses have to have had at least five years' experience afteR qualifying Geraldine from Loudwater, who has been a theatre nurse for 20 years, is doing cyst removal and hernia repair with Mr Appleby Fiona, from Marlow, qualified in 1990 and worked in theatre for eight years. Would she have liked, with the benefit of hindsight, to have trained as a doctor from the start?

She said she preferred the whole patient approach that a nurse could give; seeing the patients at the start, assessing what they needed, explaining it and following up their progress personally afterwards.

"Surgeons can't do that. They are too busy," said Geraldine.

Mr Northeast said: "Junior doctors push off and do something else, but nurses tend to stay three or four years in the same post."

The new jobs for nurses should help with the European Working Time Directive which says doctors in training must not work more than 56 hours a week. The trust is just fulfilling the directive.

Mr Northeast said: "Because of the directive we need people to help with some of the patients. We already have nurse practitioners putting in catheters and doing other supervised work. I think it is a good idea. A good nurse can be better than a doctor."

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