This is a tired topic on this forum. Sorry...I couldn't resist.
PowerMD weighs in on the topic (previous post):
Originally Posted by powermd
"I love responses from midlevels that attempt to compare the experience of training as a physician to the experience of training as a nurse- as if the two were in any way equal. Physicians are trained from the beginning as decisionmakers who will eventually have to assume total responsibility for patient care. Add to that the fact that competition for med school admission keeps the bar set very high in terms of brains and dedication. Nurses are trained as care-givers with the knowledge that there will always be someone to back them up. I rarely, if ever see the same cavelier attitude from fellow physicians that I see in nurses who think they can do it all. From what I've seen, the bar for admission to the nursing profession is set very, very low. My hospital suposedly has some of the best nursing care in the state. Everytime I hear about this I have to laugh because of what I see on the floors. My god are these people dumb! Perhaps 10% of the nurses I deal with daily know what they're doing and are effective providers of nursing care. The rest are an embarassment to the profession. ICU nurses tend to be brighter and more able, but they still approach patient care from a nursing perspective (care-giving vs. decisionmaking)."
My take on this:
The difference is very difficult to conceptualize from the point-of-view of mid-levels and nurses, especially since many MDs are humble about their academic accomplishments and intellectual prowess. To even think about medical school, one has to go EXTREMELY well in undergraduate college (physics, calc, bio, orgo, gChem etc). The MCAT is the next hurdle...see the pre-med forums on this topic, as it speaks for itself. Yet, this oftentimes still isn't enough for admission to medical school--the 3.95, the 37 on the MCAT, the published study--I personally know someone with these stats that didn't get in from my lab in undergrad (which is usual but not unheard of). Medical school is graduate school of the biomedical sciences basic to medicine for the first two (grueling) years, followed by high-level clinical training in the third and fourth year. Let's not forget that Step 1 and 2 (CK, CS) are required to be taken (and passed) before graduation. After this, the newly minted MDs, prepared to enter ANY specialities residency's training program, need to embark in post-graduate residency training, working with other physicians with expert knowledge in the field (from a decision-maker's perspective, a physician's perspective). To compare a CA resident's training to CNRA training is laughable when one considers what is entails to become a physician (versus CNRA...RNs do NOT have to graduate even undergrad to take the RN exam, and many CNRA programs do not require even a bachelor's degree for admission). It is no wonder that Florida had better outcomes when an anesthesiologist was directly involved with anesthesia. So, let's give physicians the credit that is their due for limiting their college fun, giving up the twenties, and living on loans in the lowest tax bracket until they can actually make some cash...in their 30s-40s.
A glimpse in this enigmatic topic is provided by Mike327:
Originally Posted by Mike327
"I'm unique, I think. At least I am here. I'm an ICU nurse with six years on the job. I'm also a third year med student. I see it from both sides now. More than once I've worked in the day as a med student and the night as a nurse in "the unit". A few observations, please read them all before you get all uptight, there's something here for everybody:
#1: NURSES HAD TO FIGHT LONG AND HARD FOR RESPECT
Don't forget where nursing as a 'career' came from. Young doctors would do well to ask that 30+ year nurse what the job was like in the 60's. Nursing was considered by docs to be a small step up from maid work (nursemaid, look it up) Nurses were expected to stand when the Docs entered the room. If the nurse was using the chart, the doc grabbed it. There was a giant class difference between the well-to-do doctor and the poor nurse that had to work because she couldn't get married. As feminism changed American culture, nursing changed with it.
Nurses had to fight like mad to be considered an important part of medicine. Today nurses tend to be better paid, more men (like me) are nurses, and nurses have much more of a voice. But, respect is a very sensitive issue for nurses. And the 'bad' years out number the 'good' years by a fair margin.
#2: NURSES ARE NOT DOCTORS
Nope, not even close. I'm so so sorry fellow nurses, for what I'm about to say, but nursing school was REALLY REALLY EASY. It is nothing compared to medical school. I went into 3rd year thinking it would be a snap, I've done critical care medicine for six years right? WRONG!!!!! The complexity is beyond compare. All that experience with 'nursing diagnosis' doesn't do jack-S**T when you need to find an antibiotic that works and won't kill their kidneys. Yes, I've watched 100's of central line placements, I could probably do it with minimal supervision. But I was wrong to think that that was all there is to this job. Sure, 'physician extenders' can be trained, in a narrow scope, to do pieces of the physicians job. But ONLY a doctor has the training to put it all together. I never understood, as an ICU nurse, the weight of responsibility that goes into being a doctor. You are the one patients look to to make the decisions. And, try as you might to listen to the nurses around you, patients will blame the doctor for the outcomes, not the nurse.
I feel it now, when I have 10+ patients to round on with a resident breathing down my neck, grading me... Deciding if I'm honors material... I need honors, I have 120,000$ in student loans, I want anesthesia and it's getting competitive...AND THAT F***ING NURSE DIDN'T TOTAL UP THE I&Os!!! Now I'm behind while I chase them down to get the numbers. Now I look disorganized... honors is slipping away...
#3: DOCTORS ARE NOT NURSES
So my GI Bleeding, Parkinsons patient needs a bowel prep for colonoscopy, and I write 'Prep for colonoscopy' and sign the preprinted order sheet. I come in the next day and, as if by magic, the patients ready to go. Ok... DOCTORS have no clue what that involves. None... Sorry fellow med students, but you need to stand there and watch this happen. Just once do a bowel prep on an immobilized Parkinsons patient. Thread that NG tube while they swear at you, then spend the next 10 GO***MN hours shoving fluid up that tube while you clean up those foal smelling BMs that are so big they run off the bed. Then try not to strangle that F**KING med student that comes in at 6am and complains that your other patients DON'T HAVE ANY I&OS CHARTED!!! And, DA**IT that parkinsons patient still isn't clear for the scope!!!
Doctors and Nurses are an odd combination: same patients, different problems. So, generally its best to stay off your high horse, 'cause you really don't have it so bad."
