“The nurses they will also play a role in primary care, offering support and substitute to address the shortage of general practitioners. An experiment “is” underway at some Asst “and” will be evaluated. “These are the words contained exactly in a passage of the speech that the vice president and councilor for Welfare of the Lombardy Region, Letizia Moratti, pronounced yesterday speaking at a conference of Sidmi (Italian Society for the direction and management of the nursing professions). Words used to underline the “key role” of these figures “also in strengthening territorial medicine”. But they have aroused various negative reactions in the world of doctors and general medicine.
Starting with the trade unions. “Deputy nurses of family doctors?” Asks Italian Federation of General Practitioners (Fimmg) in a note, branding as “disrespectful, if confirmed, the statements of Letizia Moratti. “Disrespectful of doctors and their work”, the Fimmg enters into the merits, and “disrespectful of nurses, as if the latter were ‘little doctors’ and did not have a distinct and autonomous professionalism. Above all, however, I am disconcerting words for Lombard citizens, many of them without a family doctor, who are offered a nurse as ‘substitute’. This is no longer about task shifting, but about war or developing country policies – the union raises the bar – Of course, in a context of this type, it seems superfluous to discuss professional liability or insurance problems “.
“At this point we close the graduate schools“, thunders Guido Quici, president of the Cimo-Fesmed Federation medical union (to which Anpo-Ascoti, Cimo, Cimop and Fesmed adhere).” What we doctors are studying to do for 11 years, if then the non-specialists of the cooperatives are allowed to work in a hospital and now Lombard nurses are even allowed to be substitutes for general practitioners? But what do we want them to do in 6-year degree courses and 4-5-year graduate schools if what we learn there is not deemed necessary for our work? If the answer to the shortage of doctors is to hire anyone who can keep the patient company, without considering their training, we transform the degree course in Medicine into a three-year course and abolish specializations – this is Quici’s provocation – We would solve the staffing problems in the blink of an eye. So obviously the safety of care and the protection of citizens’ health are no longer of interest to anyone “.
Finally, a shower of questions: “The commissioner Moratti – continues Quici – has perhaps forgotten that diagnosis and prescription of therapies are up to the doctor? What should alternate nurses do? And do you really think there are nurses willing to give up their vital patient care role to take on responsibilities they are not prepared for? Would she be ready to be examined and treated by those who do not have the appropriate skills, and explain to citizens that anyone is better than anyone? And to honestly say that the situation in which Lombardy finds itself today is the result of years of incorrect planning, and not of who knows what unforeseeable disaster “?
“There is no joking about people’s health. The Cimo-Fesmed Federation – concludes Quici in the note – will continue to defend the role of doctors from every attack of this type and in every area, even if the global plan appears increasingly clear: brazenly lowering the level of public health to reach its privatization. But we are not willing to remain helpless to watch “.
The presidents of the provincial orders of doctors in the region also rise up. “The recent statements by Letizia Moratti on ‘nurses as substitute doctors for family doctors to tackle the shortage’ cannot but arouse astonishment, even if they are inserted in a context of previous utterances that denote the lack of knowledge of the real problems and the concrete daily life of local health care, but also the foundations of the various professional systems in force in our country, certainly not derogable by a councilor who, indeed, should be the guarantor “, they write in a note, recalling that” the current legislation entrusts the diagnosis and prescription of therapy to the doctor, configuring itself, alternatively, a criminally punishable offense. It is singular that a councilor does not realize the difference between the professional profile of the doctor and that of the nurse, who has not understood how the two figures cannot replace each other “, point out the presidents of the Lombard white coats, highlighting” how for years it has been said and how it is envisaged both in the so-called Dm71 and in the PNRR “that these two figures” should be integrated into a team work, to be carried out side by side and not kilometers away, as it seems instead to appear in some projects ” , and “that a better definition of the current functions of the two professional figures is useful precisely to avoid inappropriate overlaps and confusions”.
A scenario “like the one envisaged by the councilor Moratti – continues the exponents of the regional federation of medical orders (Gianluigi Spata, president of the Order of Como and of Fromceo; Pierfranco Ravizza, Lecco; Guido Marinoni, Bergamo; Ottavio Di Stefano, Brescia; Gianfranco Lima, Cremona; Massimo Vajani, Lodi; Stefano Bernardelli, Mantua; Roberto Carlo Rossi, Milan; Carlo Maria Teruzzi, Monza Brianza; Claudio Lisi, Pavia; Alessandro Innocenti, Sondrio; and Giovanna Beretta, Varese) – it would open up to infinite problems of professional responsibilityon the merits of which it seems useless to express oneself, also in consideration of the ‘summer’ characteristics of these externalizations “.
“Perhaps – they continue – it is better to consider them a communicative misunderstanding, however disturbing, when it comes from a leading exponent of a Region who insists on proposing itself as capable of producing advanced assistance models. We leave the judgment to the subjects most directly concerned, the Lombard citizens and their representatives to the mayors, who are demonstrating that they understand very well the substance of the problems “. Problems” including the shortage of nurses “, who” we therefore believe they do not have the time to propose themselves as substitutes and second choices for others. For our part, we reiterate the willingness of the Lombard Orders to collaborate in the hypotheses of reform of our Health Service, certain of being able to provide a report of competence which, in any case, is expressly provided for by law, even if, in fact, from our Region to date. completely neglected “.