The Roman statesman Cicero said, 'Nobody can give you wiser advice than yourself'. This might have gone down well in the Senate, but it would have got him into no end of trouble had he gone into healthcare and said this to a patient.
All patients are vulnerable, and the advice given by healthcare professionals should be robust throughout all stages of the so-called 'patient journey'.
But is it effective? A study carried out at London's King's College Hospital assessed healthcare professionals' knowledge of fitness to drive (FTD) regulations applicable to patients who had suffered a stroke or transient ischaemic attack (TIA). The study group comprised doctors and allied health professionals including nurses, and the authors concluded: 'Health professionals providing stroke care showed limited knowledge of FTD regulations after minor stroke or TIA.'
Given the importance of advice to drivers following a stroke or TIA, it is disappointing that 25% of doctors and 11% of AHPs mistakenly believed that no driving restrictions apply after a TIA. Especially when it is known that AHPs spend more time with stroke patients than doctors, and in some units they're the ones giving FTD advice since they're well acquainted with their patients' deficits. Responsibility for FTD advice does not rest exclusively with doctors, so AHPs such as nurses need to be better informed about FTD regulations.
However, the study was limited to a London teaching hospital, so perhaps the quality of advice offered by nurses in other areas of healthcare dealing with specific points of practice is of a higher standard.
Healthcare is increasingly influenced by evidence-based medicine, which has a clear and important role in hospital, general practice and community nursing. But nurses working in community settings seeing the same patients regularly might safely rely on experience, personal interactions and other not-quite-so-easily-measured criteria to inform the advice given to patients, and to augment hard facts – such as FTD restrictions - gained over time.
Medicine is not only a science, but an art, and all advice must be tempered with common sense.