Personal views

Doctors and nurses: new game, same result

BMJ 2000; 320 doi: http://dx.doi.org/10.1136/bmj.320.7241.1085 (Published 15 April 2000)
Cite this as: BMJ 2000;320:1085.1

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  1. Mark Radcliffe, deputy features editor
  1. Nursing Times, London

    In the beginning the relationship between doctors and nurses was clear and simple. Doctors were superior. They had the hard knowledge that made ill people better. The nurses, usually women, were good but not necessarily very knowledgeable. They were in charge of folding pillow cases and mopping brows. Nurses didn't cure patients; on the whole they still don't. They were just nice to them while they waited to get better.

    In 1967 Dr Leonard Stein first outlined the doctor-nurse game. He said that the interactions between the two were carefully managed so as not to disturb the fixed hierarchy. Nurses were bold, had initiative, and were responsible for important recommendations. While being bold, however, they had to appear passive. In short, nurses were able to make recommendations as long as they made it look as if they were initiated by doctors. So the nurse was responsible for the wellbeing of her patients and the nourishment of the doctors' sense of professional self. …

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