I am an RN studying to be a Physician Assistant. I have been training in the medical model for PA school after my nursing school education. I’ve essentially sat in on the training of both MDs and RNs and can tell you stereotypes are ingrained on both sides.
Doctors are groomed to expect to have nurses “bugging” them for orders, calling them with useless and non-important updates, and causing unnecessary drama.
Nurses are equipped with armor to defend the patient, fight for patient safety, and defend themselves around the doctors. It’s almost like they are taught to fight the bullies who write things for them to do…instead of focusing on orders to be carried out for patient care.
Nurses are also blamed for patient deterioration and act defensively. Many younger nurses come out of nursing school with the mindset of notifying the physician of ANY patient changes—even though we are taught to notify MDs when patient status changes and necessitates new orders. Doctors don’t care—and are annoyed by a phone call informing them--if you just hung a new bag of IV fluids. (That is, unless the patient has fluid restrictions or is receiving a bolus).
However, if nurses don’t notify doctors about seemingly benign changes and the patient starts deteriorating, he/she is held responsible for the outcome. Nurses get blamed for everything!
Nursing needs to change because the weight of responsibility weighs heavier than that of any other profession. This pressure is insane—and is what made me get out of nursing.
But, I think both sides are wrong to perpetuate these stereotypes, prejudices, and behaviors.
As a PA with a nursing background, I will do my best to bridge communication between doctors and nurses on the same team. I hope to one day be a nursing instructor, and my main objective will be to shape our future nurses to embrace nursing as a science, especially when reporting to oncoming nurses and when updating physicians. We all care about our patients and need to understand the scope of practice of each team member. Maybe a cross-training rotation would help rectify this conflict (med students work a nursing shift--minus the administration of meds only licensed professionals can give; and nursing students shadow MDs).
What are your thoughts?
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June 10th, 2008 at 10:47 am
Just curious: why did you choose the PA path as opposed to NP?
Feel free to read my blog, A Nurse Practitioner’s View (www.npview.blogspot.com).
Good luck!
June 10th, 2008 at 12:01 pm
I just finished nursing school and I am a little green. I also will not be able to work as a nurse this year for a year due to the military. I think that the aforementioned has a little to do with this subject because I really look for ward to doing what I set out to do be a nurse. I value that and I can’t do it for the next year. Many people who (for lack of a fitting term)I will call ignorant, think that the next thing after nursing school is medical school. They don’t believe that there is life beyond the ADN or BSN, I plan to get my DNP or PhD in Nursing which ever suits me best. I think that if people want to make things better, work in the field that you chose stand by it and improve it from the inside out. I have family that are have finished med school and yea for them, but I am tired of the “what now, med school?” comments. And it makes me feel really good to tell them ‘No I plan to be a Doctor of Nursing Practice’ and see their face as if the BSN was the last stop for me. Good luck with PA school, but that only gets you a master degree at best. Not for sake of degree but for freedom and independence I choose to peruse a higher ed in Nursing and prove to myself and people that nurses are not the hand maiden of the doctor that we are a team and that our intelligence should be respected and valued.
June 12th, 2008 at 1:01 pm
Why does it seems as if the author is being attacked, she/ he had brought up an idea, will cross training and shadowing each other’s day help alleviate some of these sterotyping? Why has nobody reflected on that. Instead the focus seems to be on the professional chioce of the author which is a very personal thing for all of us and should be respected or does that make this person less of an RN?
Nurses should try to be more tolerant and accept that not being the same does not mean wrong
June 13th, 2008 at 1:00 am
i think that it would be great to have followed a doctor around for a day… to see where they go when they “disappear” from the unit… to see what kinds of things they deal with, and especially to see what kinds of information is important to pass along to a doctor… that would have been great 🙂 and vice versa… it would be great to have a few of the residents see what we do all day and how their “few orders” translate into how i spend my time that day…
June 28th, 2008 at 10:30 pm
I do like your idea of having the nursing follow md and the other way around. I Medical program in the area I work in does something like that.
We have med students with us, but only for a short time, even though it is a short time I think it is good that they expose them to what nurses do…I think this opens their eyes, of course we have some med student who already think they are better then us nurses but for the most part they are all great and very interested in what we do!!! Great idea!!!
February 10th, 2009 at 8:50 pm
I don’t think that being a nursing educator with a PA degree will work out very well. As someone in NP school I value that all of my instructors have graduate degrees in advanced practice nursing. I would not want a PA ,PT, RT, OT, dietician, or anyone else for that matter, teaching me NP material. While it would be nice to have an insight as to what each of the fields do, if you are a PA, you need to teach PAs, bottom line.
February 10th, 2009 at 11:55 pm
If you really want to be a nursing faculty member, being a PA is not the way to go. Choosing to be a PA means choosing to always be in a role tat conceptually and legally means that you are subservient to physicians and will learn nothing about advanced practice nursing. And academic programs (except perhaps some AD programs with severe faculty shortages) will not hire you unless you have an advanced degree in NURSING. Further, if you think being a PA will allow you to bridge the divide b/t nursing and medicine, i worry that you have a rude awakening coming. I urge you to consider becoming a NP instead-faculty jobs will open to you and you will have the opportunity in many states to work independently of physician oppression or required oversight. Also, you will be in a position to work to affect change in a very different and more credible way. Good luck no matter what!
April 2nd, 2009 at 3:02 pm
Please read some or all of Suzanne Gordon’s
books. There are as well a rich source of articles related to “Bullying” – nurse to nurse
horizontal violence and physician behavior avail.
on the net esp. if “YAHOOED.” Good nurses are life savers. We, however, must address toxic
workplaces. In fact, the Joint Commission plans to do just so – you can read about this on their
web site. I am sorry when anyone leaves nursing
but, after 30 years of bedside practice in a
variety of environments – teaching, community,
etc., in critical care units I have found we
are far from being treated as “professionals”.
You will likely find many interesting articles
about this issue in a nuring library as well esp.,those journals devoted to nursing management.
February 20th, 2010 at 10:36 am
I have been a RN for 15 years. I am finally in a good enough financial space that I can look into other jobs for a livelihood. I know the other nurses on this forum will want to get out the bazookas and shoot me, but, ‘nursing’ is not a career. Nursing is feeding a baby. There is NO “career” in nursing. What is the Hospital RN Job? Essentially, you are the Dr’s _____ – and you are accorded exactly that much respect. As hospitals have become more focused on liability mitigation, paperwork- now computerwok- has become a major drain on a nurse’s time. The patients need someone, but you have to fill out all the ever more numerous forms on paper or on screen. I see no value in playing the “Who can be the ‘Best Girl’ Game” I can hold my urine for 5 hours!!!! I can go without breaks and not complain, ever!!! I can take the most abuse from sleep-depraved Mds!!! And no administrator will ever stand up for me!! I can successfully navigate the office-politics of a bunch of bitter, hateful, back-stabbing phoney women!!! I can put up w psycho families better than anyone else!!! I can handle more critically ill patients than anyone else!!!! I can work my ass off from dawn to dusk and never complain that the equipment I use is often faulty- no problem, I will just run to another unit and grab a thermometer that works- no let the tech have his or her well-deserved break !!!
What a Joke ‘nursing’ is. The joke is on us. In these last 15 years I have only seen quality of life get WORSE for RNs. The ones that are able to go into administration, or get out.
February 26th, 2010 at 2:26 pm
Would have to agree with Lisa63 on her description of the nursing ” profession ” I have been an RN for ~ 17yrs, and have had similar experiences. Am also a male, so have probably had an extra dose of the negative experiences listed. It was hard getting the degree and license and then dealing with all the job issues mentioned has taken it’s toll. I have a pretty thick skin, but it gets old driving to work thru a “rat race” into a “dog fight” I am not sure what to do at this point, if anyone has any suggestions feel free to respond, but please no polly annish BS. I’m all for good pt care, but heard it all before, I think it is disingenuous, so please don’t bother if that is all you have to offer.
February 27th, 2010 at 12:51 pm
JD- I am going back to school- community college. Computer Programing, Culinary Arts… I’m not sure exactly what, but I am short-selling the house and looking into only PRN work coupled w ‘Starbucks’ type job to have the experience of a day at work without all the horrors of nursing. I just want to be a regular person again- I never want to hear from someone new I just met again when I tell them what I do- “You’re a Nurse! Oh I could NEVER do what you do!”
March 2nd, 2010 at 2:40 pm
Short reply to Lisa63, I have been doing the prn thing for a few yrs. It has it’s pros and cons. Which I won’t go into detail on. I am just frustrated that the profession we chose to enter winds up being such a lousy experience for alot of people. You should’nt have to go into another line of work just because health care is in the shape it is in. We should be able to make it better as a group rather than letting other people exploit us, especially someone who has done absolutely no pt care and never intends to. Why do we allow so few to ride our coat tails and in return make us feel like they are doing us a favor by allowing us do all the work and taking on all the responsibilty, while making huge profits. Nurses are intelligent and capable people, but are pretty short sighted to allow this to continue by the constant infighting, etc, that we participate in. Pretty classic examples of devide and conquer, keep ’em fighting amongst themselves while we pull the wool over their eyes . Sorry, this was meant to be a short reply and not a political rant, but I call ’em like I see ’em, and welcome debate if someone can convince me otherwise. Nurses could be the health care version of the Teamsters if they would apply the same principles. Anywho, Good luck with everything L63
March 3rd, 2010 at 1:35 am
Although I do agree with some of the surreal facets of this post, I do have a problem with the whole PA being an advocate for RNs.
I don’t believe you sell the farm to plant more crops, its basically impossible. What that means, I don’t think you can be an advocate for nurses when you yourself no longer want to be one.
Believe me, I understand a lot of people’s reasons for wanting to leave nursing, and of course being a PA is a very interesting profession to enter into. But you also have to consider the logistics of RNs and PAs. Maintaining a PA job can be hard to do, for a man or a woman. RNs are pretty much always in demand and advanced practice RNs ranging from NPs, to Administrators, to Educators will always be in demand. Most PA’s do not make much more than a NP (in some cases less) and basically have similar responsibilities, so again why not stick with advanced practice nursing?
Nicki seemed to comeback at other posters about “attacking” the author’s choice of profession and overlooking the ideas they bring up. But the author’s ideas and choice of profession don’t seem to coincide, so that seems a very valid argument to focus on. If I wanted to be an advocate for nurses, I would do advanced practice nursing (which I am) and not something that stereotypically some people equate to being superior to the nursing profession, simply because it has the word Physician in it.
Nurses are always nurses no matter what level of education they complete within the scope of nursing practice. Anything else…is just a healthcare professional.
March 10th, 2010 at 7:08 pm
I think that if someone chooses to enter another area of work, it is their business. If you want to be a PA rather than NP and if your willing to complete the training then go for it.
I think JR inadvertently hit the nail on the head though when he mentioned that a nurse are always nurses regardless of their level of education, or thats how I took it. Nonetheless, there in lies a big problem for the profession, this perception by those, in and out of it, that believe that we are all ” just nurses ” and should be able and willing to do it all. This includes being our own secretary, CNA, IT staff, house keeper, waiter, etc, in combination with providing the advanced pt care required, and are responsible for, in acute care now a days. We give the impression that anyone can do these jobs because we are all just ” nurses ” No disrespect to anyone, but it is, at the very least, just good business practice to use staff to their fullest capabilities according to their education and training. It would result in more effective pt tx, and we would be much more efficient practitioners than being ” jacks of all trades ” With the current trends in health care I think people are going to expect more for their money. Sure we can do the work of the support staff, but wouldn’t we be of much better use providing the advanced pt procedures that we are trained to do and having the time to do it. By focusing on this we can become more valuable, both in our professional expertise and by generating capital “for the bottom line “. After all lets not kid ourselves, the bottom line is what most of the health care business is all about. By saying we are professional RNs and that it makes more sense to use us in this capacity rather than pile on time consuming tasks that impede work we are trained to do, we can provide more effective pt care, which equals better consumer satisfaction, and be more valuable in the work place. I think this is where we are lacking compared to other professions. You usually don’t see engineers pushing wheel barrels, or IT staff spending their time at copying machines, and speaking for myself I think I worked just as hard, if not harder, for my degree as they did. They generally get used for what they are trained for and where they are most effective and useful. And it’s not just about making more money, but I’m not an RN,CNA,secretary,IT,house keeper, waiter, gofer, maintenance man, etc. That’s just spreading me way too thin, and expecting way too much. If it’s so easy let adminstration come down and show us how it’s done. Hope this doesn’t sounds like a rambling diatribe, but I want to try and make a sensible, understandable, and valid case. It seems pretty clear to me, and welcome any further input on these issues for or against.