For current med students: what is the difference between nursing and medicine?

[rachmoninov3]

I'm nontrad who worked my way through school as CNA (8 years hospital), always knowing I wanted to become a physician. Another RN in my class recently left b/c of the difference between nursing and medicine. When asked what this is, she wasn't able to give a good answer.

The best way I can think to describe this difference is that medicine, with it's greater knowledge, is much more paternalistic than nursing.

How would you describe the difference?

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[Scottish Chap]

The first two years of medical school and the degree of autonomy at the end are the major differences.

 

[t33sg1rl]

One of you tells other what to do, and the other gets told what to do.

It sounds facetious, but it's true. There's lots of advanced nursing opportunities, where you can have signficantly more control, but in the end the physician is always going to be the one with the final say. I hate being told what to do, and so when it came down to it, I couldn't apply to nursing school. I would never be able to carry out the doctor's orders with a smile, even though I disagreed. I'm not nice enough. So it was med school for me.

If I'd known what a respiratory therapist did before med school, though, that would have been something to consider. I would have really liked that. 🙁

 

[Pauligirl]

It would probably be best to ask someone who was once an RN and is now a MD. No?

You're an RN who is currently in med school? Worked your way though nursing school as a CNA? And the RN in your class left med school because of some kind of differences in being an RN and studying to become an MD?

Just wondering 'cause I'm not clearly understanding what you wrote.

 

[packofneurons]

I have been asking this question myself.
I recently switched my major to pre-med from nursing because I felt I would regret not going into medicine in the long run.

Doctors generally specialize in something specific (pediatrics, surgery, ob/gyn, etc..), as nurses can switch to different floors freely (ICU, OR, telemetry, etc..). Nurses also get more time to spend individually with the patient. Doctors typically take more time figuring out what approach they will use to cure the patient.

Obviously money and time are two major factors that make the careers different. Nurses generally have the option to work three 12-hour shifts or five 8-hour shifts. Doctors are usually on call, etc.

I chose to be a doctor instead of a nurse because I do love science. I love figuring out a good mystery - it's very self-gratifying. Also - the idea of experiencing anatomy first hand while doing surgery is amazing.

If you want to build a family and have more time for them, I would stick to nursing. It's doable if you're a doctor, but I have an uncle who is a doctor and his wife also works fulltime. They not only had their children later (38+), but they constantly put their children in daycare throughout the summer even. Nursing even offers masters careers such as CRNA, NP and the salaries are comparable to a primary care physicians.

Good luck with whatever you choose. And sorry if my post is all over the place, I'm on my way to class 😳

 

[rachmoninov3]

My apologies for the confusing post. I'm an MS2, who worked as a CNA throughout undergrad.

I was more interested in the philosophical differences between nursing and medicine. I was curious what other RN's, LPN's, CNA's, etc thought about this difference, and if they could put the difference into words.

 

[Krisss17]

The difference between being a nurse and being a doctor is that they are following two different models of care. The medical model has more to do with the diagnosis of medical conditions and the treatments there of, while the nursing model covers the patient's response to disease and treatments. Both specialties are needed...it is the nurses' 24/7 care and observation that is going to provide the MDs/DOs with the information they need on whether a treatment is the best for that particular patient, and it is because of the medical education and training that doctors are able to provide the best treatment related to the disease process.

I actually was in a nursing program, having finished a semester, but I realized I'm more drawn to the medical model than the nursing model. There are good nurses and bad nurses, good doctors and bad doctors, but I think the good nurses and doctors realize the importance of the other and both are really dependent on each other to make sure that the patients they are caring for are getting the best possible care.

Okay, I'm off my soapbox now!

 

[MSmentor018]

I am an RN and a MS3, in a nutshell, nurses learn the mainly the macro and physicians have to know the macro as well as the micro.

 

[dancinRN1022]

hello,

I agree with alot that is being said. Nursing is wonderful and i enjoyed it greatly but it seems to focus mainly on the big picture. There is a lot of critical thinking and autonomy but the focus is very different. I am learning things in medical school that i never learned in nursing school and the bulk of it has to do with the "why" along with the what and "how to fix it " aspect of problems.

Nursing school teaches what the problem is, how to recognize it and how to fix it...but it doesn't focus on the small aspects of the situation. It doesn't focus on the small parts of why am i doing this? what is the specific science behind it.... Granted i have only been in medical school for 6 weeks but this seems to be a trend.

You can not have one without the other. Also, if u r a good nurse, you will rarely have to do what a doctor says and just smile. A good nurse has a wonderful relationship with the physician on his/her team and you work together to figure out solutions.

If there is absolutely something that the physician feels needs to be done that u don't agree with...you don't have to do it.

good luck in school

 

[teddybear]

One of you tells other what to do, and the other gets told what to do.

It sounds facetious, but it's true. There's lots of advanced nursing opportunities, where you can have signficantly more control, but in the end the physician is always going to be the one with the final say. I hate being told what to do, and so when it came down to it, I couldn't apply to nursing school. I would never be able to carry out the doctor's orders with a smile, even though I disagreed. I'm not nice enough. So it was med school for me.

Your attendings will tell you what to do.

 

[unsung]

I'm nontrad who worked my way through school as CNA (8 years hospital), always knowing I wanted to become a physician. Another RN in my class recently left b/c of the difference between nursing and medicine. When asked what this is, she wasn't able to give a good answer.

The best way I can think to describe this difference is that medicine, with it's greater knowledge, is much more paternalistic than nursing.

How would you describe the difference?

From my understanding, medicine is concerned with *understanding* the actual pathology of illness, whereas nursing teaches heuristics "give X for Y condition" without going into detail on the "why".

There are certainly a lot more differences than that (i.e. autonomy, prescription rights, treatment vs. caring/maintaining status, etc.). But to me, that difference is the most significant one, and the reason I never considered nursing. I'm the type of person who is always asking "why?" I get a huge kick out of understanding A causes B causes C, which results in D. Memorizing a bunch of give X for Y, give A for B might make one *sound* smart to the uninitiated... but at the heart of it, there's no real understanding there.

Whether or not you know why give X for Y might not make a difference to the patient if he really does just need to receive X... anyone who gives him X in that situation is helping him. So from that perspective, if you just want to HELP the patient, nursing is plenty enough to accomplish that. But if you're also motivated by wanting to understand pathology and interested in reasoning out complex diagnoses or complications that go beyond the standard heuristics, then medicine is the way to go.

 

[squiggle]

The difference between being a nurse and being a doctor is that they are following two different models of care. The medical model has more to do with the diagnosis of medical conditions and the treatments there of, while the nursing model covers the patient's response to disease and treatments. Both specialties are needed...it is the nurses' 24/7 care and observation that is going to provide the MDs/DOs with the information they need on whether a treatment is the best for that particular patient, and it is because of the medical education and training that doctors are able to provide the best treatment related to the disease process.

I actually was in a nursing program, having finished a semester, but I realized I'm more drawn to the medical model than the nursing model. There are good nurses and bad nurses, good doctors and bad doctors, but I think the good nurses and doctors realize the importance of the other and both are really dependent on each other to make sure that the patients they are caring for are getting the best possible care.

Okay, I'm off my soapbox now!

well put. i am finishing my 4th year of a nursing degree. i do not think MD's could operate in a hospital without the observations of a nurse. or without the family support (holistic care) that nurses give.

 

[JordanMaria]

The difference between being a nurse and being a doctor is that they are following two different models of care. The medical model has more to do with the diagnosis of medical conditions and the treatments there of, while the nursing model covers the patient's response to disease and treatments. Both specialties are needed...it is the nurses' 24/7 care and observation that is going to provide the MDs/DOs with the information they need on whether a treatment is the best for that particular patient, and it is because of the medical education and training that doctors are able to provide the best treatment related to the disease process.

I actually was in a nursing program, having finished a semester, but I realized I'm more drawn to the medical model than the nursing model. There are good nurses and bad nurses, good doctors and bad doctors, but I think the good nurses and doctors realize the importance of the other and both are really dependent on each other to make sure that the patients they are caring for are getting the best possible care.

Okay, I'm off my soapbox now!

Perfect response. I was going to argue with some previous posts which were...well let's just say suboptimal. But then I saw this and was comforted.

The philosophies behind the fields of nursing and medicine are very different, though both are dynamic and intersect at many points. The definitions given by Kriss are pretty close to text book so I'm not going to repeat her. A real-life example would be this: if you ask a doctor and a nurse about diagnoses and treatments for a specific disease, pharmacology, or other in-depth medical things the doctor will have more knowledge. But if you ask a doctor and a nurse about pressure ulcers, hospital acquired infections, therapeutic communication, transferring a patient, patient teaching, or how to work an IV pump, the nurse will know more. The point is that there are certain things each will focus on in real life, things that are extremely important for patient care and patient outcomes, but the focus is different.

 

[montessori2md]

Obviously for both MDs and RNs there is a lot of variety in what you can do. I will say, in the hospital, the social structure makes for a different environment. MDs tend to operate independently more than the RNs, who are typically working as part of a team -that is, on the floor, patient assignments are shuffled to match the needs of each nurse, and they regularly swap shifts or stay over for each other. The nurses I've worked with also tend to have been together for years, and they chit chat about each other's personal lives, latest stupid hospital policies, etc. I don't think our attendings are as personal with each other, or spend nearly as much time with each other.

What I'm trying to say is, part of the choice could relate to what sort of work environment you want. I'm not saying there aren't MDs who are super-social at work, or that there aren't RNs who work basically independently and don't have a social work environment. It's just that I think it's more possible to operate that way as an RN than an MD, and I do think that's relevant when you are considering careers.

Also, from a day-to-day life perspective, I think RNs are more likely to take the brunt of the high maintenance patient than an MD in a hospital setting, b/c the RN is spending more time dealing with the pt directly. On the other hand, RNs can use the "Your MD said no" line. In outpatient care, I'm not sure there's much difference, if anything, the MD is worse off, especially if on call.

RNs also, by and large, don't have to contend with the financial aspects of insurance/billing/cost structure, though administrators may have RNs alter their routines due to those factors.

 

[janalex]

Im also a nurse and am applying to med school this upcoming round, and I wanted to ask if nursing school and the experience of being a nurse has helped you...in medical school courses, understanding the material, or in clincials as a med student ?

 

[gonj]

The difference between being a nurse and being a doctor is that they are following two different models of care. The medical model has more to do with the diagnosis of medical conditions and the treatments there of, while the nursing model covers the patient's response to disease and treatments.

^ yeah that.

The doctor's focus will be to figure out what the disease is based on symptoms, diagnostic tests, etc, and then prescribe treatments for it - meds, surgery, therapy, etc. Eg, figuring out that symptoms and labs point to pneumonia, then treating it accordingly.

The nurse on the ,OTOH, will focus on things like whether the pt can breathe, can get enough O2, presence of secretions, whether pt is getting adequate nutrition, has fever, is not tolerant to activity, monitoring side fx of meds, etc, and then tending to those thing.

I'm a pre-med nursing student btw.

 

[Tori's dad]

Im also a nurse and am applying to med school this upcoming round, and I wanted to ask if nursing school and the experience of being a nurse has helped you...in medical school courses, understanding the material, or in clincials as a med student ?

I'm not a nurse so I can't speak to that, but I do know many students in my class that had no clinical experience whatsoever and get honors in almost every rotation. I suppose that nursing experience can't hurt you, but in the end the two fields are different enough that you will be on a level playing field with your classmates. Good luck in med school.

 

[Law2Doc]

^ yeah that.

The doctor's focus will be to figure out what the disease is based on symptoms, diagnostic tests, etc, and then prescribe treatments for it - meds, surgery, therapy, etc. Eg, figuring out that symptoms and labs point to pneumonia, then treating it accordingly.

The nurse on the ,OTOH, will focus on things like whether the pt can breathe, can get enough O2, presence of secretions, whether pt is getting adequate nutrition, has fever, is not tolerant to activity, monitoring side fx of meds, etc, and then tending to those thing.

I'm a pre-med nursing student btw.

Agreed. Usually docs and nurses work together as a team, but the philosophies don't always line up.The difference tends to most often get highlighted when a physician/med student is following a patient on the wards and wants to limit the patient's PRN meds so as not to mask symptoms and make diagnosis difficult, while the nurse, acting under a different model, calls the doctor every hour asking if they can PLEASE give the patient more tylenol or pain meds because the patient is uncomfortable/febrile, etc.