A Matter of Hours

I was talking the other day to young, surprisingly old-school physician who bemoaned nurses “doing things” she thought properly done by duly authorized medical practitioners. (She also implied, by-the-by, that when physicians said “Go fetch,” the proper nursely response was a demure “Yes, doctor, and do you want your neck rubbed?)” Clearly, this physician thought, medicine was the senior and superior discipline, and nurses should defer at all times to their judgement, even on matters clearly within the sphere of nursing. Her basis for this line of thought was that physicians got “thousands and thousands of hours” of clinical and classroom education while nurses only had a “few hundred hours of  dubious training.”

My head almost nodded, subconsciously anyway, in agreement. Got us there. It’s a common theme, actually, when you see discussions of nursing versus medicine. Nurses just don’t have the education, it’s claimed, to make the really important decisions in patient care. But then I thought about it for a bit.

Leaving apart the obvious — that medicine and nursing are two different (if related) disciplines — in point of fact, I had 1950 clinical hours and about 2000 hours of classroom study to become a Registered Nurse — and this doesn’t include the hundreds of hours more of post-graduate education to gain speciality certification and also training for things like ACLS and TNCC. I know it doesn’t compare to the extensive/intensive training of physicians. But still, nearly four thousand hours of formal training as a minimal entry to practice is nothing to sneeze at either, and hardly the “few hundred hours of dubious training” imagined by some physicians. At any rate, it makes me wonder why, given our own expertise, education and experience, why some nurses continue to be cowed by claims of physician superiority?

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  1. #1 by TheNerdyNurse on Sunday 14 August 2011 - 1359

    Personally, it’s not superiority, it’s respect. Then again, I expect, and usually have been given the same amount of respect in return. MDs are part of the team that help me provide excellent patient care. I need them on my side!

  2. #2 by Sean on Sunday 14 August 2011 - 1550

    The gun-shy nurses who do not defend themselves or their profession when confronted with these G.O.D.-complexed physicians boils down to fear, or maybe even laziness. Some just don’t want to jump out of their comfort zone IMHO. Then again it could be that they may (dare I say) agree with them?
    While I couldn’t agree more that we both (nursing vs medicine) need each other to properly do our jobs, the ‘discussion’ still exists.

  3. #3 by Jenn Jilks on Sunday 14 August 2011 - 2053

    This is why Nurse Practitioners have been doing so well. Keep on truckin’!

  4. #4 by Susan Eller (@s_eller) on Monday 15 August 2011 - 1151

    I worry about this because when the hierarchy is so strictly adhered to – patient safety is at risk. To amplify Sean’s point – if a nurse is not going to defend themselves or their profession against the G.O.D. – how likely will they be to defend their patients? What if the same MD violates sterile technique in a line insertion? Maybe it is not the same thing – but a concern anyhow.

  5. #5 by Nicki on Monday 15 August 2011 - 1202

    This is why I didn’t and still don’t want to be a nurse. Nurses just don’t get the respect that they deserve!!! It is a ton of work, a ton of knowledge, dedication, and commitment all to be told that they don’t know better. I also get so discouraged when a nurse in the ED tells me (a basic EMT) that I have to administer the oxygen to the patient after I transfer him from the gurney to the bed because they are not authorized to do that. Or when I was visiting a friend in the hospital after having completed my ambulance shift and my friend went apneic. I told the nurse she needed to bag her because she wasn’t breathing. She replied, “I need an order to do that!” So I said, “Well, luckily for her, I don’t!” and I ventilated my friend while the nurse called a code blue. WTF? To all you docs out there, STOP PLACING STUPID RESTRICTIONS ON NURSES!!! THEY ARE BRIGHT, INTELLIGENT AND ARE BEING HELD BACK! LET THEM USE THEIR TRAINING!!!!!!!!!!!

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