Dr Anna Galazka: Commentary on venous disease

Hello and welcome, my name is Anna Golaska and I am a lecturer at Cardiff Business School. In this short presentation I would like us all to think a bit more about the interview that Ellie Lindsay conducted with Anne. And in this interview Anne was speaking of how long it took her to get a diagnosis of her condition. Anne said that her GP wasn't initially very interested in her condition, that the consultant that she went to see at the time wasn't able to recommend a treatment that would work, recommending Vaseline instead. It was not until Anne went to see an expert that she finally got her diagnosis. And Anne also spoke about similar experiences that other people went through. told us about stories of other patients who also needed to go through a rather lengthy process of referrals before they got their diagnosis. She also spoke about the importance of increasing the overall level of understanding and awareness of wounds and wound care. What strikes me as somebody who looked at wounds and wound care through a sociological lens is the development of wound care as a specialism, as a profession and the implications of this professionalization for the presence of basic wound care skills amongst non-specialists. Unpacking this relationship needs a little look back to the 1970s and 1980s. In the 1970s wound care was part of general nursing curriculum but since then of course both nursing and wound care have progressed, have developed, have gone through their own professionalization projects. This has been an important step of course because both wound care and nursing have developed and it has been an important step because there is definitely still a need to improve the understanding of wounds and wound healing in patients to raise the standards of wound care provision to show that wounds are an important part of the clinical problems and an important clinical problem that has a very strong place in clinical practice. In sociology of health and illness in the 1970s and 1980s there was a lot of talk about professionalization through clinical jurisdiction. Healthcare professionals aiming for the status over a medical profession having unique control over a particular field of healthcare and expertise in this particular field of healthcare, almost an autonomy to practice this particular type of healthcare provision. But of course there is a risk that professionalization, which is based on competition rather than collaboration, can exclude healthcare professionals who are not specialists from having a good general level of knowledge, understanding and basic skills in a field. I have included on this slide a quote from a research nurse. It's from an interview that I conducted as part of my doctoral research into the relationship between clinicians and patients in wound care and I wanted to include it because I think it encapsulates that problem of professionalization based on clinical exclusive jurisdiction and the ways out of it. The research nurse says here that she had a lecturer once who said I don't like specialist nurses because they take knowledge away from generalist nurses and I said I am NOT a specialist nurse I am a research nurse in wound healing. At At the time, I was, one, a bit annoyed about what she said, and two, a bit taken aback that she should think so. I now know what she meant. The generic nurse who is so busy doing so many different things in primary care or secondary care, but I understand that having specialist nurses makes the generic nurses rely more on the specialist nurse, but I also think that specialist nurses can roll out education just by being there. You don't take over. You have to bring the generic nurse in with you to do something. Show them what to do, what they need to do. Fortunately, there have been significant changes in the medical profession's work since the 1970s, since the 1980s. It's necessary to ensure that part of the move towards improved diagnosis and improved treatment and improved aftercare of which both Anne and Ellie spoke comes with a multidisciplinary collaboration, the creation of educational pathways for all so that all sorts of clinicians, all types of clinicians, GPs included of course, have got a strong level of basic wound care to improve wound care practice for patients. Thank you.