I think that dr Crippen has the same probem I have with GPs, nursing homes and social workers. He only meets the bad ones. I'm sure that there are many competent Gps, caring nursing homes and effective social workers. The only problem is that they rarely call ambulances. If they rarely call ambulances then I rarely see them. I think that there are a great many good nurse specialists who know their subject and know their boundaries. It's just that they aren't the ones who'll ring up Dr Crippen and give a rubbish handover. So both Dr Crippen and myself have a badly skewed view of certain professions. (It's also why I've stopped posting about GPs who sit heart attacks out on the waiting room, or who have healthy patients that suddenly take a turn for the worse and need hospital treatment five minutes before the surgery closes). I think if we used the thumbscrews we'd jog his memory of the decent nurse specialists. I vaguely remember him praising his practice nurse, who *is* a specialist nurse. And to answer your main point I was also asked about things from Drs on their A&E rotation because I'd been there years and that it was often the first SHO post they had taken. Bit worrying when they asked me to take a look at a C-Spine x-ray mind... ...And I did remind them that I was a nurse at that point.