If nurses want to be doctors, who's going to be the nurse?

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montessori2md said:
I think mds who think nursing is distasteful are going to have a hard time relating to the nurses they work with -it's a lot easier to get on with your coworkers if you can put yourself in their shoes for at least a day and be able to think beyond "gosh, this sucks".

I also think that advanced practice nursing can help to solve some of the impending shortfall -if you believe there are many opportunities for advancement, and maybe even to move above the bedside running your butt off sort of day, then you might be more likely to start nursing to begin with, rather than just saying "gosh, I couldn't do this my whole life".

I've been in a career not unlike nursing -early childhood ed, which is also a lot of cleaning and caregiving, and it's great (I mean, you do get to teach kids how to read and multiply, you help their parents solve basic problems like how to get through a trip to the store without wanting to kill their child, etc), but I could not physically do this my whole life, I couldn't live on my income without my spouse, and I would mentally disintegrate. I imagine many nurses who jump into advanced practice are similiarly motivated.


Another good post and one you are completely correct on. I have talked with many nurses and this post captures their point of view that they shared with me.

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caroladybelle said:
The a&*hole factor is a lot lower, but still quite present. It really depends on the state, also or the teaching facility.

GA and FL abounds with jerks. FL has cornered the market on old jerks and jerks with bad handwriting, worse spoken English, and atrocious manners. While it may be stereotyping, I will never travel to the middle east give the way that the MDs act when they are here. In both FL and GA, I dealt with MD temper tantrums that rival a bratty two year old's, MDs that curse for no good reason, and the throwing of charts.

In regards to house officers:

Harvard MDs at BIDMC are wonderful, Cornell is great, HUP efficient and easy to deal with. TJUH - the floor MDs are cool, but the ED ones can be a royal pain. Einstein MDs are bit more snooty than most, as are Hopkins MDs but are tolerable. I have heard that Yale is one of the worst, but do not know from personal experience. Travelers avoid that facility like it has ebola.

The only time I got an intern in major hot water because he was a total jerk was at TJUH. And given the treatment that he got from the Attending and staff, he paid for it.

Hmmmmmm I have a friend who works at TGH and Bayfront Care center in the Bay Area. She's a secretary there and tells me that at TGH there are some a-hole doctors but mainly they are the new residents that she has issues with. On the other hand, she says her other job has much nicer doctors and is more fun because the doctors are not residents but all private practice doctors.

My own interaction with physicians has been the opposite scenario where I saw a lot nicer docs in the academic medicine area then the private practice physicians where I come from south of the bay area.
 
gujuDoc said:
Hmmmmmm I have a friend who works at TGH and Bayfront Care center in the Bay Area. She's a secretary there and tells me that at TGH there are some a-hole doctors but mainly they are the new residents that she has issues with. On the other hand, she says her other job has much nicer doctors and is more fun because the doctors are not residents but all private practice doctors.

My own interaction with physicians has been the opposite scenario where I saw a lot nicer docs in the academic medicine area then the private practice physicians where I come from south of the bay area.

Hi folks,
Medicine (as true with any profession/job) has a certain number of jerks. My favorite saying is: "What do you get when you send an A--H--E to medical school? You get an A--H--E with an MD/DO." It's not the school, it is the personality to begin with and no matter where you go, there is always someone who attempts to take personal satisfaction in putting down others that they perceive to be "lower". This seems to be quite pervasive in pre-meds and follows them through medical school. The truth of the matter is that no one can make you feel inferior without your permission be it academic physician or resident.

If you have poor manners and poor breading from the beginning, going to medical school is not going to change this and it just makes your job that much harder. Let the idiots go and keep on an excellent path. I tend to find myself pitying these doctors who cannot appreciate people who can help them do their jobs better. I know that I appreciate my healthcare team members and everyone benefits when we work together for the good of the patient.

njbmd :)
 
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njbmd said:
Hi folks,
Medicine (as true with any profession/job) has a certain number of jerks. My favorite saying is: "What do you get when you send an A--H--E to medical school? You get an A--H--E with an MD/DO." It's not the school, it is the personality to begin with and no matter where you go, there is always someone who attempts to take personal satisfaction in putting down others that they perceive to be "lower". This seems to be quite pervasive in pre-meds and follows them through medical school. The truth of the matter is that no one can make you feel inferior without your permission be it academic physician or resident.

If you have poor manners and poor breading from the beginning, going to medical school is not going to change this and it just makes your job that much harder. Let the idiots go and keep on an excellent path. I tend to find myself pitying these doctors who cannot appreciate people who can help them do their jobs better. I know that I appreciate my healthcare team members and everyone benefits when we work together for the good of the patient.

njbmd :)


Very good post. :thumbup: :thumbup:
 
TacoStand said:
Just an observation from my time volunteering in 2 ERs. Most of the ER techs are going to nursing school. It seems like this is a constant cycle. Many of them that I know are working at night, going to school in the day and have 1-2 kids. Their dedication is inspiring to me.

I think this is pretty common. Support fields such as CRNAs, ER tech, phlebotomists, etc. typically seem to be a "stepping stone" to something higher. These fields, at least in my area, have staggering turnover rates; new hires leaving after a couple years.
 
HooahDOc said:
I think this is pretty common. Support fields such as CRNAs, ER tech, phlebotomists, etc. typically seem to be a "stepping stone" to something higher. These fields, at least in my area, have staggering turnover rates; new hires leaving after a couple years.


Did you mean CNA? CRNAs are entirely different and our turnover rates are a bare minimum.
 
gujuDoc said:
Hmmmmmm I have a friend who works at TGH and Bayfront Care center in the Bay Area. She's a secretary there and tells me that at TGH there are some a-hole doctors but mainly they are the new residents that she has issues with. On the other hand, she says her other job has much nicer doctors and is more fun because the doctors are not residents but all private practice doctors.

The point of view of a nurse varies greatly from that of a secretary. There are big differences in their interactions with MDs.
 
fab4fan said:
Until nursing becomes an attractive career option, shortages will continue

Why do you think so many nurses are leaving the bedside? This has been discussed at length here; the reasons usually are centered around unreasonable patient loads and lack of respect from physicians and hospital admin.
In addition, many nurses are finding out how to use the system to their advantage - basically finding the prime jobs - leaving gaps in hospitals (county, state, community), etc that really need quality nursing. In addition, nursing schools are routinely on waiting lists to get into the program. There are tons of bright people wanting to get into the field; however, we're also short on qualified classroom and clinical instructors.

fab4fan said:
If you get sick, you should hope there's a nurse there to listen to your heart. Assessment is part of what we do; it's a lot more than soothing fevered brows and holding hands.
Amen.
 
Now on to what I really wanted to say.

I understand what the OP is trying to say, but I honestly haven't seen it where I've worked. I've also been fortunate enough to see what njbmd was talking about, in that we all have roles and understand they are all important for truly great patient care.

Where I'm working now, there is the smallest amount of MD vs RN vs LPN etc., that I have seen yet. There is a great attitude of respect here and we work very well as a team. I've known RN's and MD's to get thank-yous from patients elsewhere, but here, the thank-yous extend to radiology, lab -everyone! This is when you know your doing something right.

My point is:medicine is a team endeavor. There are different levels of responsibility, different strata of patient contact and care, but for the system to work well, we've got to work well together.
 
Vox Animo said:
I respect nurses and have nothing against there field. However there is such a shortage that some things are happening that I don't like. Up north some of my friends that are in programs are required to have a high GPA and need to get an 80% or better in every class. That school is cranking out nothing but high quality nurses who are going to improve healthcare.

However at my school in, there are some pre-nursing students that have the who gives a **** attitude i want to money, and are getting c-'s with the curve in their classes and are getting accepted into programs. It just bothers me because some of these people that i have seen are not competent and are going to hurt people in their profession, but there is such a shortage that lesser schools let them in. If i was a nursing student this would piss me off. I would not want to go to a medical school that allowed students in with c averages, thats just asking for a law suit.


I think I am "up north" and I just wanted to agree that there are some excellent nursing programs up here. My hubby is the gatekeeper for the nursing program at his school. Students must pass his courses to get into the program and his pass rate is a bit less than 50%, meaning that only half of his students pass into the next course.

Also, those who think the nursing shortage isn't real need to investigate further. My mom has been nursing for 25 years and the conditions have definitely changed.
 
I am a RN who will start med school in August. Anyway, just commenting on some of the previous posts:

There are short and long relationships with patients nurses care for, does not mean they were any less or more meaningful. Many times nurses care for the same group of patients all the days he or she works. There are "frequent flyers" such as those with CHF, COPD, etc who I will see and care for almost on a monthly basis.

In my area, there are no nursing shortages. In fact, at my UG institiution there is a very long waitlist for those trying to get in--there are only 50 seats. I read before (don't remember where) that one of the major issues contributing to the nursing shortages is the lack of Nurses with doctorates to teach, without them, nursing schools cannot increase their enrollment for those who are interested--and based on my own personal experience (where I live) there are many interested in nursing.

In regards to nurses mostly "moving things, cleaning"--I do think there was mistaken identity. Now, if it was stated, "Mostly nurses are passing meds or typing on computers"--I would have to agree. Often times, I find myself lacking in the "good charting" area in favor of giving better patient care. I am all for a qualified medical assisants to pass my patients their PO meds--but that does not exist at my hospital. I would really love to spend time with my patients caring for them, monitoring them, and educating them instead of having to worry about passing all those scheduled daily/nightly meds in addition to everything else that does not involve direct patient care. But that is just being idealistic--reality is a much different story.

On the the disrespect of nurses from some physicians. Most of this (from what I gather) is from how interns and residents can be/are mistreated by nursing staff at teaching hospitals--it can get just as ugly.
 
To anyone who thinks a nurse is "lower" than doctors-

Here in Texas, it's more difficult to get into nursing school than it is in medical school. These are very smart individuals.

I've been around long enough to see a nurse or two save a physician's a**. My own nephew would not be alive today had it not been for a nurse who argued with a surgeon to run a barium test. Thank God for that nurse and thank God for a surgeon who wasn't so stuck on himself that he listened.
 
wrong thread...deleted
 
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fang said:
Seems like many threads get into debates about the differences between MD's and nurses, PA's, etc, and every aspect of their respective roles.

My observation is that everyone seems to want to be the doctor--
1. Nurses with PhDs and some PA's want to call themseves "Doctor whatever"
2. Everyone wants to wear the white coat
3. There is a turf war going on about who can prescribe what in which state

If everyone wants to be a doctor and keeps struggling so desparately to take over doctors' roles, who is going to be the nurse?? If I were in the hospital, I'd rather have a great nurse and a competent doctor than the other way around, assuming I didn't have something unusual or hard to manage. Good nurses are there for their patients no matter what kind of smelly, embarassing, or offensive thing is going on-- someone needs to be nearby, in case they suddenly need CPR, need to vomit, need an IV, or just need to talk. The new trend seems to be to jettison all of that in search of more power, prestige, and self-importance -- they think that mimicing doctors' roles will bring all that. If I'm ever sick and need some help, God forbid I get some nurse who wants to listen to my heart all the time and make suggestions about BP meds.

We need to encourage people who want to prescribe medication and act as independant practitioners to go to medical school, and be clear about what practicing medicine and practicing nursing means-- they should not be synonymous... real nurses are too important.


there are still people who want to be nurses. My aunt is a nurse and she has never one day expressed a desire to be a doctor. she tells me she pities me and the workload of med school and i should be a physicians assistant instead....
 
Psychoanalyzed said:
there are still people who want to be nurses. My aunt is a nurse and she has never one day expressed a desire to be a doctor. she tells me she pities me and the workload of med school and i should be a physicians assistant instead....


Wow in Florida, it seems like pretty much anyone gets into the ADN programs and LPN programs. I see what you are saying, but I've both good and bad nurses and both good and bad doctors. That's how it is wherever you go. Any nurses I have had, had never been horrible, but I've also never had a bad doctor per say. However, there are quite a few people who were in my friend's lpn program who were really people who should not have been there. I guess, it comes down to the fact that there will always be people who are good doctors and people who are bad doctors, and the same can be said for nurses or pretty much any profession.
 
On a similar topic, who's gonna be medics if all medics want to be nurses. Just from my experience
 
Gatewayhoward said:
On a similar topic, who's gonna be medics if all medics want to be nurses. Just from my experience
:laugh: :laugh:
 
I agree that it isn't right for doctors to treat nurses or anyone in the medical field like trash. After all, medicine is not a one player game. That being said, I will like to point out that all nurses are not angels who deeply respect and care for everyone around them. There is no shortage of nurses mistreating or totally disrespecting residents and or physicians. A lot of residents I have talked to simply get attitudes with some of the nurses because of how they are being treated. It is unfortunate, but respect has to be demanded sometimes.
 
I agree that it is completely inappropriate for nurses to haze medical students/interns/residents, etc., but man, you should see how nurses treat their own. You guys think we're rough on you? You should see how nurses treat each other.

As far as respect, while everyone deserves respect to a degree, not because of his/her job, but as a fellow human being.
 
infiniti said:
A lot of residents I have talked to simply get attitudes with some of the nurses because of how they are being treated. It is unfortunate, but respect has to be demanded sometimes.

You don't get respect by demanding it. In fact, that's usually the last thing you want to do when you're being dissed, since it's like waving a giant hand-painted sign saying "YOU GOT TO ME!" Smile, laugh at yourself, do your job well, and if necessary start passing the same **** back to it origin. Do it in that order. As a last resort, kick the problem up the food chain. These steps apply to people problems in healthcare, firefighting, law enforcement, the military, boarding school, or any other hazing-intensive enviroment. Executed properly, they stop 90% of all hazing before you get to Step Four.
 
QuikClot said:
You don't get respect by demanding it. In fact, that's usually the last thing you want to do when you're being dissed, since it's like waving a giant hand-painted sign saying "YOU GOT TO ME!" Smile, laugh at yourself, do your job well, and if necessary start passing the same **** back to it origin. Do it in that order. As a last resort, kick the problem up the food chain. These steps apply to people problems in healthcare, firefighting, law enforcement, the military, boarding school, or any other hazing-intensive enviroment. Executed properly, they stop 90% of all hazing before you get to Step Four.


Quicklot,

May I just state I'm enjoying your posts in this thread and the "when is it to old to apply?" thread. Good responses. :thumbup: :thumbup: :thumbup: :thumbup:
 
Good response, but you have to realize everything you said is just a means to demand respect. I don't see myself screaming at anyone to give me some damn respect (this is actually counter productive). Sometimes, you simply have to step back, show more confidence or refuse to take that person seriously. Demanding respect can be as simple as avoiding insults or as you put it "kicking the problem up the food chain".
 
infiniti said:
Good response, but you have to realize everything you said is just a means to demand respect. I don't see myself screaming at anyone to give me some damn respect (this is actually counter productive). Sometimes, you simply have to step back, show more confidence or refuse to take that person seriously. Demanding respect can be as simple as avoiding insults or as you put it "kicking the problem up the food chain".

I'm glad we're thinking along the same lines. It sounded to me like you were recommending an all-out slugfest at the first sign of ill-use. Some would-be doctors are arrogant enough and inexperienced enough to think such an approach can work (a while back, there was an appalling thread about dealing with "insuboridination" from nurses). Of course, it invariably escalates the situation, and nurses especially have all kinds of ways to hurt you. So you fight bullies, but, as you say, you fight smart. :thumbup:
 
OK, now here's an example of why some nurses are mean to med students.

I work in Day Surgery. I was in a pt. room, getting the pt. ready for surgery, when I heard the med student say, somewhat loudly and petulantly, "Well, I would do the H&P, but the nurse is in there taking her time with the pt." (Heavy, persecuted sigh from MSIII.)

I was with the pt., and no, I was not lolligagging around; I was putting in her IV. (OR kinda gets put out if we send people over for surgery without an IV...go figure.)

Now, I'm no genius, but it seems like Mr. MSIII could have come in the room and at least started asking some questions to get the H&P started while I finished up the IV. Besides, it only took me all of three minutes to get the IV in; it's not like I was in there for an hour.

When he finally does complete the H&P (the majority of which I filled out for him, e.g. cc, medical hx, surgical hx, meds, vitals, etc.) does he put the chart back where it belongs? Noooooooo. That would be far too much to ask.

Did I say anything to him? Was I mean to him in return? No. I let it go...for the moment. But if he acts like that tomorrow, we will have a "come to Jesus" meeting, rest assured. I won't be unkind, I won't be vindictive, but he will know how things work IRL (or at least in my dept.).
 
Yeah, I don't really get that "one person at a time" thing you see in hospitals sometimes. Just get 'ur done, for goodness sake.
 
We don't even have that rule; anesthesia often comes in while I'm with a pt., and vv. Docs don't bat an eye at us coming in when they're with a pt., unless it's a really unusual situation, and then they'll usually let us know they want to talk to the pt. privately. I don't know what this guy's problem was, other than being a garden variety jerk.

Whatever his problem is, he's definitely on my radar now. I'll give him the benefit of the doubt for today; if it continues, I'll have no problem doing a little remedial education.
 
Briefly, I'm a tele nurse (1.5 years) having changed careers in my 30's from engineering.

I concur entirely with the POV's describing the need for Dr.'s, RN's, RT's, CNA's, etc to all work together as a team. As a nurse, I can only represent things from my point of view.

Personally, I've seen all sides react negatively and harshly to the other. The most blatant negativity, however, came from 2 of my nursing school educators! From comments such as "We do all of the work anyways while the docs couldn't find their way around the floor" and "you'll understand how much more important you are every year around July when the new meat comes in not knowing lopressor from an enema" to other derogatory comments along the same vein. I blew it off at the time, thinking it was just the prof's way of building up the student nurses to have the courage to stand up to a physician and his/her order as a nurse if he/she truly felt it was wrong. Thinking back, I believe they performed a disservice to the students preparing to interact on the floor with physicians, establishing a confrontational attitude from the outset.

QuikClot asked earlier if the new physicians were showing more respect. Honestly, in the 2 classes of interns I have experience with (approx 14), only 1 was negative on a regular basis. And he was denied an ortho residency spot the next year, so it wasn't just the nursing staff he had problems with. Further, I have had extremely positive interactions/relationships with nearly all of the other interns.

In the end, it comes down to respect and that respect must flow in both directions if we're going to work together as a team.

Quick example- About 6 months ago, I called one of our interns to the floor at 3am because a pt of mine exprienced flash pulmonary edema. While dealing with this, another nurse on our floor needed him because a pt of hers had chest pain. An EKG and enzymes led him to dx the second pt with an evolving MI. At the same time, yet another pt on our floor developed chest pain. We all conferred and developed a plan of attack for the three patients. Over the course of the next 2 hours, all three patients stabilized. Quick note- I only gave a half dose of one of the IV meds he ordered for my CHF patient because her pressure dropped significantly during the course of a very slow push- I informed him of this later and he thanked me, acknowledging that I made the right clinical decision. Before he left the floor that morning, I made it a point to congratulate him on his handling of the patients and his leadership of the "team". That night and ever since, there has been a shared level of respect in all of our interactions.
 
Until nursing becomes an attractive career option, shortages will continue.

Why do you think so many nurses are leaving the bedside? This has been discussed at length here; the reasons usually are centered around unreasonable patient loads and lack of respect from physicians and hospital admin.

If you get sick, you should hope there's a nurse there to listen to your heart. Assessment is part of what we do; it's a lot more than soothing fevered brows and holding hands.
I totally agree :)
 
I totally agree :)

Yoda voice:The necrobump is strong with this one...

Resurrecting an 8 year old thread with one of your first three post. Impressive
 
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