Doctors and nurses: new game, same result
BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7241.1085 (Published 15 April 2000) Cite this as: BMJ 2000;320:1085All rapid responses
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This well written article is long overdue. Much of what is said could
also apply to allied professions such as my own. We now have consultant
physiotherapists and physiotherapy practitioners. In fact I am officially
one of the latter.
In an extended role, I have had to opportunity to take on some of the
duties of a junior doctor within orthopaedics. The opportunity to step
outside my profession for a time, working almost entirely within the
medical model, made me even more aware of the value of physiotherapy.
Physiotherapists may provide a useful service in orthopaedic and
rheumatology triage clinics, but our real strength is doing what we do
best, i.e. physiotherapy. I am sure this applies to nursing also.
Competing interests:
None declared
Competing interests: No competing interests
Health care is a very large basket. In it are doctors, nurses,
psychologists... so many health care professionals. We have many areas
that overlap. Aside from legislated domains imposed through power
brokering, there is interdependence amongst us no real or true hierarchy.
By ignoring or dismissing other health care professional's insight
and opinion, it is indeed the patient who suffers. My mandate as a Nurse
is to keep the public safe. That includes assessment, critique, planning
and validation with the patient as to their perception of the whole
process. This balancing of the patient’s needs and treatment is done best
in a inter professional collaborative atmosphere.
The Registered Nurse (BSN) in British Columbia, Canada has spent 4
years in University. They are not trained but educated as critical
thinkers. The culture of care is married to technical knowledge. I came
across this article while looking for research funding. It is now
September of 2007. It is a pity but true that this article could have been
written today.
I see an undermining and devaluing of Nurses and their work in this
article. In addition, I see the devaluing of a doctor’s knowledge in it as
well. Not only in this out of date article, but unfortunately, it is also
the current climate in some areas of practice.
Yes, we as Nurses do own at least part of the problem. And the
grooming/education of Nurses does not really prepare one for the
professional kick in the pants that may be around the corner.
I am not artificially elevating myself or my profession above another
profession. We are equal but not the same. We share many areas of
knowledge. Physicians may have a deeper domain in some areas and indeed in
other areas Nursing has a deeper store of knowledge.
By the way, Curing “is a complex process that is resident in the
patient. The process has many variables. You as the doctor and I as the
Nurse are only a small part of that process. Curing does not always mean
triumph over death either. Is there a battle here between doctors and
nurses like the one we hear about between life and death. Or really is
this oppositional notion of worth some other limitation in perception?
Having an artificial or limited view of the world supports the notion
that an argument has two sides only. Find the fulcrum in each doctor nurse
interaction. Celebrate the balancing in each situation. Certainly the
attitude you support in this article is not balancing
How can such an attitude serve for your continuing
professional/personal growth, connection to your patient, connection to
yourself and family or collaborative practice. Grow up and get with the
program. It is too easy for life to throw a curve ball and end up on the
receiving end of health care.
I surely do not wish it on you but, if you went from a healthy
vibrant man to someone needing care then you may regret the inflated-top-
of-the-food-chain-position you are putting forward.
Competing interests:
None declared
Competing interests: No competing interests
Thank you so much for saying what we as doctors cannot say, for fear
of being accused of special pleading or, inevitably, arrogance. Your
piece hit the nail right on the head. Many nurses, particularly those of
my wife's generation, also mourn the loss of the values which used to
underpin nursing, and which gave nurses a unique role in caring for the
sick.
I'm surprised there have been no other responses yet - you are
doubtless in for a tar and feathering from the nurse-as-sociologist
brigade, but no matter. If you need a referee when you start looking for
a new job, I'd be glad to oblige!
Competing interests: No competing interests
What should a nurse cost?
Outsider male perspective in the overwhelmingly female nursing
occupation[part-time] here. I find that nursing is based on the female way
of looking at the world. But the patient's are more along the lines of
50:50 male:female, leading to the inescapable conclusion that nursing is
not representative of the people it claims to serve. This suggest a
"closed union shop", with university education providing the smokescreen
of sophistication.
There's a good deal of fascism in nursing. All energy is poured into
the vast black hole of nursings endless identity crisis. But the crisis
could be solved if nursing stated unambiguously what nursing is.
Purely on a task basis, and so finding something which only nurses
do, nursing would seem to be the dignified management of the biological
wastes which emanate from humans during times of increased dependence. But
if you accept that definition, you then have to ask what it's worth. And
Radcliffe doesn't have the answers, only dated nonsense about the people
"loving their Angels".
Once you start putting a cost figure on things, you then introduce
outside interference in the form of auditing. People start questioning
your methods and efficiency.
Competing interests:
None declared
Competing interests: No competing interests