Gone are the days when the physician could act as God, the orthopaedic
surgeon as the Lord God and the nurses as minister- ing angels. The
concept of a team approach with each discipline supplying special yet
overlapping skills is accepted in principle, although not always in
practice. Physiotherapists and occupational therapists resist
integration of their training among the hierarchy; however, on the
ground, these remedial therapists often do each other's jobs with
remarkable amity. Elsewhere I have discussed whether we need
multipurpose professionals or multiprofessional persons (Wright 1982).
At Leeds the close collaboration that exists between rheumatol- ogists
and non-medically qualified professionals has resulted in a productive
Bioengineering Group for the Study of Human Joints, a Clinical
Pharmacology Unit of international renown and a Rehabilitation Unit that
consistently produces bricks without straw. One aspect of this combined
approach to patient care has been the development of the discipline of
clinical nurse metrology (Bird et al. 1980). Skilled nursing sisters
have worked in this capacity for a decade in Leeds. Their contribution
has not only enhanced the reliability of the results of clinical trials
in which they have been engaged, but it has been highly s;ost effective
and greatly appreciated by patients. It has also measurably improved our
patient education programme. Moreover, the posts have provided
considerable job satisfaction. This book arises from the expertise
gained during these pioneer years.
