Hand injury - nurse or doctor?
Discussion
Hello. I've had a hand injury (minor) for around three weeks now, but it's not getting any better. (Odd one: woke up one morning and one finger was very painful in tension and compression, so I thought I may have sprained it by rolling awkwardly in my sleep. I can now locate a point of particular pain (handshakes are a lottery between being OK or going down like I've been in a pressure point fight with a master).) I'm thinking of going to my local surgery rather than minor injuries at the hospital as I hate feeling like I'm wasting NHS resources, thus I'm also wondering whether a hairline fracture/sprain confirmation could be done by a nurse rather than a doctor (i.e. more quickly. The chap at my surgery was great with my back problem over the phone a couple of years ago!). Any advice appreciated here, please. Like I said, I hate using medical professionals time at all as I feel like I'm either wasting money or preventing those in greater need from seeing them! Thanks in advance.
I'm fairly sure that's the sort of thing a nurse (practitioner? Unsure of the precise terminology) could handle, why not call and ask?
I agree, also, they're a hidden gem at my local practice for all sorts of not-obviously-complex stuff, I'd much rather we were all well funded enough to have GPs handling everything but as we don't, a really sorted nurse who's happy to confirm that my obvious tonsillitis is tonsillitis without waiting for yonks for a doctors' appointment is worth his or her weight in gold.
Hope yer hand isn't too borked.
I agree, also, they're a hidden gem at my local practice for all sorts of not-obviously-complex stuff, I'd much rather we were all well funded enough to have GPs handling everything but as we don't, a really sorted nurse who's happy to confirm that my obvious tonsillitis is tonsillitis without waiting for yonks for a doctors' appointment is worth his or her weight in gold.
Hope yer hand isn't too borked.
FlyingMeeces said:
I'm fairly sure that's the sort of thing a nurse (practitioner? Unsure of the precise terminology) could handle, why not call and ask?
I agree, also, they're a hidden gem at my local practice for all sorts of not-obviously-complex stuff, I'd much rather we were all well funded enough to have GPs handling everything but as we don't, a really sorted nurse who's happy to confirm that my obvious tonsillitis is tonsillitis without waiting for yonks for a doctors' appointment is worth his or her weight in gold.
Hope yer hand isn't too borked.
Thanks. Aye, I agree, I find the nursing career to be all to often unappreciated. I agree, also, they're a hidden gem at my local practice for all sorts of not-obviously-complex stuff, I'd much rather we were all well funded enough to have GPs handling everything but as we don't, a really sorted nurse who's happy to confirm that my obvious tonsillitis is tonsillitis without waiting for yonks for a doctors' appointment is worth his or her weight in gold.
Hope yer hand isn't too borked.
I'm not too worried about the hand, but thank you. If it's not a sprain it may be a hairline fracture. I just need to know now, as it's been a few weeks and I need to understand what I need to stop doing to rest it to heal.
Comedy anecdote: my daughter (3 years old) grabbed my little finger to guide me into the kitchen the other night and I crumpled to my knees in pain. She thought this was a great game and continued to try to hoist me to my feet using said finger until my wife had to get her to stop as I was nearly crying through a combination or pain and laughter becuase she had felled be so easily!
Had this with my thumb, but I know how I did it.
Asked the doctor twice and he brushed it off as something that would heal itself and kindly stop wasting my time with your whingeing and the door's over there, just be a good chap and jolly well p
s off smartly. Goodbye.
I wouldn't have bothered but this was a white-hot searing bloody pain that only reduced when when I pulled the thumb until it clicked.
Four years later, it's nearly gone.
Good luck...
Asked the doctor twice and he brushed it off as something that would heal itself and kindly stop wasting my time with your whingeing and the door's over there, just be a good chap and jolly well p
s off smartly. Goodbye.I wouldn't have bothered but this was a white-hot searing bloody pain that only reduced when when I pulled the thumb until it clicked.
Four years later, it's nearly gone.
Good luck...
ocd said:
Nurses are not trained to make diagnoses.
oh really ? next you'll be telling me that Nurses don;t request Imaging inline with IR(ME)R , make treatment decisions , or discharge patients either ...
ocd said:
See a doctor. It sounds like a flexor tendon sheath problem but needs to be investigated and sorted. Don't mess with hands because when they go wrong, they are unforgiving.
and your clinical examination determined this when ?ocd said:
Nurses are not trained to make diagnoses. See a doctor. It sounds like a flexor tendon sheath problem but needs to be investigated and sorted. Don't mess with hands because when they go wrong, they are unforgiving.
Yes, they are! There are limitations and I've got some pretty mixed feelings about the whole setup, but to stay objective: yes, they can diagnose, and they can treat, and will refer onwards when necessary.
Hi. Thanks for the feedback All. My surgery recommended that I go to Minor Injuries, so I did that. The nurse "didn't find any cause for concern with regard to major nerves or breaks" so I'm just trying to rest it where possible (ha!) and will give it another couple of weeks. If it's still not improving then I'll go to the GP for a referral.
mph1977 said:
ocd said:
Nurses are not trained to make diagnoses.
oh really ? next you'll be telling me that Nurses don;t request Imaging inline with IR(ME)R , make treatment decisions , or discharge patients either ...
ocd said:
See a doctor. It sounds like a flexor tendon sheath problem but needs to be investigated and sorted. Don't mess with hands because when they go wrong, they are unforgiving.
and your clinical examination determined this when ?ocd said:
Nurses work to protocols.
really ?ocd said:
They do not receive the same training as doctors.
Advanced Practice education for Nurses and Paramedics is actually at a higher standard than Medical School. ( Independent prescribing for Nurses and Pharmacists is a Masters Level qualification , rather than Ordinary Degree, very rare to find a currently offered advanced practitioner award which is still level 6 as again Nurses pre-reg is an Honours Degree rather than an Ordinary Degree )Practical skills training is at the same standards - Reasonable Practictioner test and all that ... never mind all the Nurses ( and Midwives, ODPs, Paramedics and other HCPC professionals) teaching these practical skills ...
ocd said:
They might well be able to order a limited range of investigations.
aside from IR(ME)R that's a preceptorship / foundation gateway outcome for Nurses in many places ocd said:
So what? If you want to do what doctors do, go to med school. Re the putative diagnosis of flexor tendon problem, read my advice. How would I have had an opportunity to examine him? I guess that you are not a doctor.
you made a diagnosis remotely without examination ... i'm guessing you aren't a Health professional, wiher that or you are stuck in some 'The Royal' time warp where ODPs are glorified porters for much of their time mph1977 said:
ocd said:
Nurses work to protocols.
really ?ocd said:
They do not receive the same training as doctors.
Advanced Practice education for Nurses and Paramedics is actually at a higher standard than Medical School. ( Independent prescribing for Nurses and Pharmacists is a Masters Level qualification , rather than Ordinary Degree, very rare to find a currently offered advanced practitioner award which is still level 6 as again Nurses pre-reg is an Honours Degree rather than an Ordinary Degree )Practical skills training is at the same standards - Reasonable Practictioner test and all that ... never mind all the Nurses ( and Midwives, ODPs, Paramedics and other HCPC professionals) teaching these practical skills ...
ocd said:
They might well be able to order a limited range of investigations.
aside from IR(ME)R that's a preceptorship / foundation gateway outcome for Nurses in many places ocd said:
So what? If you want to do what doctors do, go to med school. Re the putative diagnosis of flexor tendon problem, read my advice. How would I have had an opportunity to examine him? I guess that you are not a doctor.
you made a diagnosis remotely without examination ... i'm guessing you aren't a Health professional, wiher that or you are stuck in some 'The Royal' time warp where ODPs are glorified porters for much of their time The NHS can't afford doctors so it gets AHPs and nurses to believe that they can do everything that doctors do, and do it better. Knock yourselves out. I know where I'd go for a diagnosis if it were more than just a graze.
mph1977 said:
you made a diagnosis remotely without examination ... i'm guessing you aren't a Health professional, wiher that or you are stuck in some 'The Royal' time warp where ODPs are glorified porters for much of their time
Sorry to say but you're wasting your time. We all know doctors also work to protocols. Some people will only be happy if a trauma surgeon stops operating to have a look at their stubbed toe. ocd said:
The NHS can't afford doctors so it gets AHPs and nurses to believe that they can do everything that doctors do, and do it better. Knock yourselves out. I know where I'd go for a diagnosis if it were more than just a graze.
All other things being equal, you'd be right.But they aren't. An overworked doctor, or even a lazy one, is a liability and you are better off with a good nurse. I once watched a (French) doctor attempt to dress a friend's thumb following a minor injury. It was crap, finished up looking like he's lashed a duvet to his hand. I had to remake it afterwards. Doctors don't know everything and very few of them learn how to make dressings. In addition it may be 20 years since a GP has been in an A&E dept.
battered said:
ocd said:
The NHS can't afford doctors so it gets AHPs and nurses to believe that they can do everything that doctors do, and do it better. Knock yourselves out. I know where I'd go for a diagnosis if it were more than just a graze.
All other things being equal, you'd be right.But they aren't. An overworked doctor, or even a lazy one, is a liability and you are better off with a good nurse. I once watched a (French) doctor attempt to dress a friend's thumb following a minor injury. It was crap, finished up looking like he's lashed a duvet to his hand. I had to remake it afterwards. Doctors don't know everything and very few of them learn how to make dressings. In addition it may be 20 years since a GP has been in an A&E dept.
In terms of the management of the patient in the Emergency Department / Urgent care I would be interested as to what exactly the benefit ocd percieves there to be; Especially if you compare an experienced ENP /ECP with 5 or 10 years in the speciality against a core trainee on their second 4 or 6 months stint in Emergency Care or even a foundation doc with a whole zero to 4 months experience in speciality. As unless especially well timed or well staffed staffed a Higher specialist trainee or Career grade Doctor isn;t liklely to be seeing many minor injuries vs managing patients who required 'resusicative' care and/;or managing the patient flow in concert with the Nurse in managerial charge of the dept.
zeDuffMan said:
mph1977 said:
you made a diagnosis remotely without examination ... i'm guessing you aren't a Health professional, wiher that or you are stuck in some 'The Royal' time warp where ODPs are glorified porters for much of their time
Sorry to say but you're wasting your time. We all know doctors also work to protocols. Some people will only be happy if a trauma surgeon stops operating to have a look at their stubbed toe. Nurse practitioners are great, once they move on from Flowchart Medicine to experiential practice. But the job role has a low ceiling, and that doesn't satisfy many, whereas the equivalent doctor would move up.
OK, you can drop off your tenterhooks now. I went to the GP as it's still uncomfortable. He's recommended two weeks on Nurofen to see if it will heal on its own, but with anti-inflammatories. This seems like an awfully long time to be taking the full 400 mg, three times per day; am I wrong? He thinks it could be tendon related.
It's beginning to piss me off now. I thought at the time that it could be a hairline fracture, but I guess it'll be too late to diagnose or treat that now, unless it were to give way to a full fracture?
It's beginning to piss me off now. I thought at the time that it could be a hairline fracture, but I guess it'll be too late to diagnose or treat that now, unless it were to give way to a full fracture?
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