Volume 185 - Issue 1
The efficacy of a nurse-led preoperative cataract assessment and postoperative care clinic
Authors: Bradley J Kirkwood, Konrad Pesudovs, Paul Latimer and Douglas J Coster
Med J Aust 2006; 185 (1): 49. || doi: 10.5694/j.1326-5377.2006.tb00454.x
Published online: 3 July 2006
Published online: 3 July 2006
In reply: The points made by McKee and Gole are valid.
However, the demand for eye-care services is outstripping the ophthalmological workforce. Some task substitution is necessary. The effect of the nurse-led cataract clinic has been largely to increase patient access to outpatient appointments — it helps deal with a large hidden waiting list (time to first clinic appointment), and frees up ophthalmologists to spend more time in the operating room.
Registrars in training are not likely to cope with an increasing demand for services. The number of trainees is determined by the Royal Australian and New Zealand College of Ophthalmologists. Flinders Medical Centre sees 15 000 eye outpatients a year and does 1500 elective procedures — and has been allocated one first-year trainee. The nurse practitioner is more experienced and does not rotate to another hospital every few months.
Nurse practitioners may not be the preferred substitute for ophthalmologists. The employment conditions of nurses can be restrictive, and senior nurses are expensive to employ compared with other professionals, such as orthoptists and optometrists. Perhaps McKee and Gole are more comfortable with the use of professionals other than nurses, as they advocate the involvement of optometrists to decrease the load on outpatient clinics.