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The establishment of training sites for consultation skills is a worthwhile development in the service.1 What we also now need is a fundamental change in our attitude to the educational needs of nursing staff in our daily encounters on ward rounds and in the outpatient clinics. To replace the stereotype of the nurse being merely a passive recipient of the doctor’s clinical wisdom, consultants (and other medical staff) should utilise each and every clinical episode to engage the attending nurse in a clinical problem solving exercise aimed at highlighting the diagnostic issues from the nurse’s perspective. To take the process one step further, nurses should be encouraged to attend the “problem solving exercise of the week”, which has become a tradition in postgraduate centres up and down the country. Each and every nurse is a potential future employee of NHS Direct. By optimising their educational opportunities we are making a future investment in the service.
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