Are there examples of professional pairs where one can do the job of the other but not the reverse?

[Hektor12]

If you mean taking blood samples and giving vaccines, even though doctors might not be accustomed to it I think they still would have been trained at some point to do it.

Possible but currently its safe to say that there are some things doctors dont know how to do but nurses know.

[Tooting Carmen]

Nonsense. There are facilities that are 100% nurse-run without a doctor in sight. At least in SA. I worked at few of these myself and we were just fine without doctors.

What sort of hospital departments or services are able to operate without doctors?

[Kazimiera]

What sort of hospital departments or services are able to operate without doctors?

Midwifery services for one which are especially important in rural areas when there is no hospital nearby.

Midwives are trained to manage pregnancies from conception to birth.

There are units in less accessible areas called MOU's (Midwife Obstetrics Units) which run without doctors. I worked at one for two years.

[Tooting Carmen]

Midwifery services for one which are especially important in rural areas when there is no hospital nearby.

Midwives are trained to manage pregnancies from conception to birth.

There are units in less accessible areas called MOU's (Midwife Obstetrics Units) which run without doctors. I worked at one for two years.

Can midwives also carry out (and more importantly, interpret) ultrasounds and listen to the baby's heart?

[Kazimiera]

Can midwives also carry out (and more importantly, interpret) ultrasounds and listen to the baby's heart?

Absolutely. That is part of our training. In South Africa, at least. Listening to the fetal heart is the most basic thing a midwife does.

Plus, we are trained to perform difficult deliveries. When there is no hospital or doctor in a 40km radius, you do everything.

[Tooting Carmen]

Absolutely. That is part of our training. In South Africa, at least. Listening to the fetal heart is the most basic thing a midwife does.

Plus, we are trained to perform difficult deliveries. When there is no hospital or doctor in a 40km radius, you do everything.

As part of my interpreting work, I do a lot of medical interpreting (mostly on the phone), and much of it involves mothers and pregnant women. As a single male, I really had no idea that pregnant women and mothers had so many health visitors and midwives round all the time. But in any event, more generally it sounds like nurses are given more prestige and autonomy in SA than here, where it is still quite hierarchical in my experience. For instance, even to obtain some antibiotics for an infected toe, the nurse I saw at my local surgery had to have the prescription counter-signed by a doctor rather than just issuing it herself.

[Kazimiera]

How it works is this:

Woman skipped a period, she comes to the clinic. Midwife determines whether she is pregnant or not.

Thereafter she has a scan at 16 weeks (if I can remember correctly). Since not every MOU can afford an ultrasound machine, there is a midwife who comes around once a month to all the facilities to do the ultrasounds.

She has monthly antenatal check-ups during her pregnancy which increase the closer she comes to her due date.

The midwife performs the delivery and provides post-natal care.

The baby goes the clinic (run by nurses) to keep up to date with all vaccinations and manage any problems which the child or mother might have.

In a properly managed system there is no need to even see a doctor since we are trained to do what we do.

[Tooting Carmen]

How it works is this:

Woman skipped a period, she comes to the clinic. Midwife determines whether she is pregnant or not.

Thereafter she has a scan at 16 weeks (if I can remember correctly). Since not every MOU can afford an ultrasound machine, there is a midwife who comes around once a month to all the facilities to do the ultrasounds.

She has monthly antenatal check-ups during her pregnancy which increase the closer she comes to her due date.

The midwife performs the delivery and provides post-natal care.

The baby goes the clinic (run by nurses) to keep up to date with all vaccinations and manage any problems which the child or mother might have.

In a properly managed system there is no need to even see a doctor since we are trained to do what we do.

Sounds good. So, in SA, mothers and babies would only see a doctor if either had a really serious condition that, in many cases, would probably require surgery?

[Kazimiera]

As part of my interpreting work, I do a lot of medical interpreting (mostly on the phone), and much of it involves mothers and pregnant women. As a single male, I really had no idea that pregnant women and mothers had so many health visitors and midwives round all the time. But in any event, more generally it sounds like nurses are given more prestige and autonomy in SA than here, where it is still quite hierarchical in my experience. For instance, even to obtain some antibiotics for an infected toe, the nurse I saw at my local surgery had to have the prescription counter-signed by a doctor rather than just issuing it herself.

Here you get primary health care nurses who are allowed to prescribe medications like antibiotics, blood pressure medications etc. They can manage your day-to-day health issues. They act completely autonomously. We can do everything from ear cleaning, ECG monitoring, cutting open boils, suturing people who've been in a fight. The aim of these facilities is to take pressure off hospitals and provide accessible care for people in their communities.

The majority of clinics are only run by nurses. They might have a doctor once a week. The rest of the time you do what you're trained to do.

[Kazimiera]

Sounds good. So, in SA, mothers and babies would only see a doctor if either had a really serious condition that, in many cases, would probably require surgery?

Yes. We do pelvic assessments to determine whether she has an optimal pelvis for a natural delivery. If there is an abnormal pelvis, she is referred to the closet hospital which can perform a C-section if needed.

We do all the other normal stuff. Of course, you'll get situation where she's never been to a clinic, had assessments of any kind, but is now lying on the bed pushing. You do what you need to do to get that baby out alive.