Other initiatives have been implemented, which are hailed as the way forward. The students meanwhile are denied regular hands on experience but offered instead several classroom based phlebotomy sessions with a teaching video. It is ironic that the cash strapped hospital trust, which previously had a willing workforce of medical students to provide the phlebotomy service without payment, now employs a team of technicians. Split shifts, cross firm cover, and night duty frustrate any meaningful progressive teaching contact or continuity of shared patient care. Consultants are increasingly embarrassed to admit that they no longer got to know their house staff or the names of who is covering their patients. Sadly, the same is becoming true with regard to consultants and their house staff. Few members of the consultant staff or specialist registrars ever get to know the students individually. They face an increasingly complex timetable of formal lectures and multiple brief attachments to ever more specialised units.
#Hands off policy plus#
In the John Radcliffe Hospital a hundred plus students each year embark on their clinical course. He was too modest to say that the experience might make him a better doctor one day. Again, the motivation was partly financial, but he said that he enjoyed carrying out basic tasks for patients as it provided a valuable insight into what it was like to be on the receiving end of medical and surgical care and it improved his interpersonal skills. He told me that he was also employed periodically as an auxiliary nurse.
He said that the job also helped to improve his confidence dealing with patients, especially the elderly sick, who often needed some persuading to submit to yet another jab. A first year clinical student from St Mary’s Hospital, he explained that a holiday job of a couple of weeks as a phlebotomist raised some much needed cash. What a delight it was when one morning a phlebotomist was someone I knew and who was keen to talk. This was a sterile contact-swift, efficient, and with no time for the niceties of social interaction. Each morning a succession of phlebotomists came to my bedside. I was motivated to write this while I was a patient in the John Radcliffe Hospital. Patients who were in hospital for more than a few days came to know their students by name and shared their hopes and fears with these, the most approachable and least intimidating members of the team. Students realised quickly that they were contributing in a positive way to the team effort and that they were valued. All biochemistry request cards written out by the house staff were shared out among the available students. A major collective responsibility of the firm students was the phlebotomy service. The dressers also served for a short time as nursing auxiliaries. The book makes public for the first time a set of 30 newly declassified Transition Memoranda that were prepared by President Bush’s National Security Council staff for the incoming Obama administration to outline the key foreign policy challenges it would face.Medics learnt important lessons by the bedsides In a postscript to each memorandum, these same experts now in hindsight take a remarkably self-critical look at that Bush foreign policy legacy after more than a dozen years of watching subsequent administrations attempt to deal with the same vexing agenda of threats and opportunities- China, Russia, Iran, the Middle East, terrorism, proliferation, cyber, pandemics, and climate change-an agenda that still dominates America’s national security and foreign policy. Thirty of these Transition Memoranda, newly declassified and here made public for the first time, provide a detailed, comprehensive, and first-hand look at the foreign policy the Bush administration turned over to President Obama. Hand-Off details the Bush administration’s national security and foreign policy as described at the time in then-classified Transition Memoranda prepared by the National Security Council experts who advised President Bush. In this episode, former United States National Security Adviser Stephen Hadley joins the podcast to discuss his new book, “Hand-Off: The Foreign Policy George W.
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