Let me put a question to the readers here:
What are your experiences & feelings on Nurse / Doctor relationships in general?
Given the time & effort it takes to complete a nursing degree plus specialty training, I would suspect at the very least there should be some professional respect on both sides of any Nurse / Doctor relationship. Particularly when it comes to senior or experienced staff.
Not so, says Nurse In Australia reader Nighean, responding to a post on nursing shortages. See if you can identify with anything in this reader’s contribution:
Doctors still believing they are the bastions of all knowledge?
This retention of nurses is an interesting thing. Yes the extra pay would be welcome and an improvement in conditions also.
But for me the reason I moved out of acute nursing as an experienced Grade 2 and later in my career as ANUM was due to being completely done with doctors still believing they are the bastions of all knowledge and therefore completely within their rights to be abusive or rude to you.
I got sick of having phones hung up in my ear when calling about a patient and reporting adverse pathology or a turn in their condition. I got sick of being sneered at when I suggested a course of treatment-often in consultation with the patient. Being the ‘advocate’ of the patient caused no end of sniggers, snide remarks, blatant commentary ‘all nurses are stupid’…etc. Professional status??? I think not. Not while the AMA rules with an iron fist.
Why are NP’s so slow to take their place? Because in the AMA’s eyes we are no more advanced than the sheepish, demure nurses that pandered to doctors over inflated ego’s in the ’50’s. Sure I’ve worked with some great doctors, but regrettably they are the exception not the rule. My education? Far exceeds the time it takes to become a GP but that counts for nothing apparently.
In my opinion there needs to be an investigation into the bullying of nurses from the medical profession. When we are treated with respect we might retain some great nurses, until then they will leave once they realise that another allied health professions or other career paths not only pay better, but allows true quality of life time, respect and professional recognition.
Thoughts, anyone?
Interesting!
I’m a first year mature-aged (ish) nursing student, and one of my oldest friends is in her third year of med school in another state. She speaks highly of the nurses she encounters during her prac – particularly the mental health nurses. We’ve shared material and discussed our courses a little bit, and when I provide a joke MSE of myself, she provides a joke diagnosis.
I feel that in nursing school now, we are being taught that we are to be equal-but-different clinical professionals. It could just be my friend’s personal attitude, or it could be her training too, but it seems like she at least is approaching her future doctoring in that way.
I’m lucky enough to work in California, land of the kick-ass Nurses’ Union.
I am also lucky enough to work at a teaching hospital. Some might say it’s a setback, but I find it means that the MDs are used to working with people of all skill levels and experience.
I also find that I often know more about something than a new Intern, and therefore can ask for pretty much anything and get it
The Docs at my hospital are pretty liberal with praise, and tend to be very polite in general. Only once or twice have I seen someone get a bad dressing-down, and it was over fairly serious matters.
There is *nothing* demure about *any* of the nurses I work with!
Hi guys,
Great comments and I appreciate them very much. my experience in nursing is within Australia only so I have no other reference to speak of. Its good to hear others opinions. I too have found that junior MO’s, student doctors and interns tend to be very receptive to nursing knowledge. What wipes that is the attitudes of senior medical staff, and in the situation I referred to in the original post was the revolting attitudes of a good percentage of residents, registrars and finally the consultants themselves.
I’m very proud of being a nurse, I am exceptionally proud of the work I do and what it took for me to get to this point. I believe that it is time for nursing to be recognised for the unique body of knowledge it possesses and stops filtering that out to allied health.
Any good historical research will point out that allied health sectors evolved from nurses and nursing assessments ie exercise physiology for child polio sufferers-designed and implemented by a nurse (Elizabeth Kenny). Speech pathology/assessment for CVA patients etc. These are all now removed from nursing to the point where we (I at least and other colleagues) feel almost as if we cannot be trusted to accurately assess a swallowing deficit (for example). But it is the ingrained attitude that concerns me the most.
I think even in Kim’s post where she (he? sorry!) points out that (quote) “Only once or twice have I seen someone get a bad dressing-down, and it was over fairly serious matters” is enough of an issue for me. It implies the very same appalling attitude that I am speaking of. It is NOT the doctors position to discipline nursing staff. It is for the NUM, ANUM or DON to do so. They are supposed to be differing disciplines therefore doctors ARE NOT nursing heirarchy. Doctors may request nursing staff to perform certain tasks but why we are not their handmaidens and as far as I am concerned haven’t been for a very long time.
Wow! well said Nighean. I came upon your site entirely by accident – a lucky one I would say. I agree with your comments regarding nurse/doctor politics and relationships. Many doctors are nice and easy going until you disagree with them and that is when the ingrained arrogance of medical training becomes apparent, not to mention the imblance of authority to be heard and acted upon. I am not just talking about individuals but the organic whole that is the medical profession.
You are very perceptive in reading the dynamic from Kim’s post. Doctoring and nursing have overlaps but they are very different disciplines and I am somewhat tired of nurses pandering to doctors as if for acceptance and doctors assuming they have authority over nurses.
We do not need medical acceptance and respect as much as we need to recognise and accept our nursing pprofession as unique in itself and respect ourselves for the body of knowledge that we hold and practice. The medical profession have their own vested interest in trying to dominate health systems and generally speaking that is about income. Despite the fact that the Garling Report pointed out that we have more practicing doctors than recommended by WHO they have co-opted the nurses complaint of not enough staff and totally overshadowed the real problem with general nursing in the hospital system – a lack of nurses. Yay there are not enough doctors in the unpopular remote and country areas but that is because they are on so many suburban street corners, sometimes I feel like I am tripping over doctors practices.
I am a mental health nurse and I have left the public health system because of its strong orientation towards doctoring and its exploitation of nursing. I wont go into my exploration in trying to set up under MHNIP and my abandonment of that system as another means to tying nursing to doctoring but think exploitive practices where doctors receive $5K – $10K to set up the system from the Fed Govt and then charge nurses a percentage of their income from their work because the payment is funneled through the eligible organisation that is the doctors practice.
I have a lot of respect for Florence Nightingale but we seem to forget that before she introduced standardised and professional education within the hospital system there were actually nurses working in private practice and not just as midwives. It seems that we took that turn to initiate and formalise an educational process, making a place for nursing within hospitals (indeed hospitals were nursing not doctoring spaces). Nightingale acknowledged nursing was at the mercy of the medical profession for its continuance. Nursing is the true first female profession and at the beginning we had to be careful of being crushed my doctors and society generally who did not approve of women working – I say this with some hesitation as women have always worked in a variety of jobs and careers but this was the first true profession for women – where women could leave home at a youngish age, train and work independently of fathers, brothers and husbands and receive a (pathetically) livable wage.
My point here (long winded I know!) is that we need to get out into private practice and away from medical practices. We need to start nursing clinics in the community and online, places and spaces that are nursing – get back to the baby health centres which were sites of excellence (but closed down so that GP’s could take over the work); places where nurses can practice wound care, counselling, medication management, mental illness recovery work and generally being the hub of the health system and which is commonsense – we are the profession where the patient/client/consumer is the centre and focus of attention – not the disease or the disease agent. We look wholistically and see what needs to be done and we do it either ourselves or we educate/facilitate/advocate or be a resource and referral source.
wow … we are nurses – I am proud to be a nurse and I recognise and acknowledge a long line of nursing healers some of whom were midwives and others who used herbal remedies in caring for people.
cheers
I am an Allied Health Professional (not a nurse).
I stumbled across this site by accident.
I can understand the sentiment that you share here. I personally would not like to work as a nurse for the very reasons that you state.
Being an allied health professional is still rungs below the ‘doctors’, but at least i am given a medicare provider number and have established my own private practice. i personally have not yet experienced a rude doctor.
Indeed, my course at uni was full of ex-nurses whom had had enough of what you so describe in your post. I fully support better conditions for nurses, and de-centralisation in care from the almighty GP.
The only way to obtain better conditions in health care, is to organise and unionise. – Just like the AMA has done for years.
I would propose a combined “nursing and allied health union”. – By collectively organising together, we might stand a chance against the powerful AMA.
What say you all ???
Wow, Lynn great post. So liberating to see and (hear?) passionate nurses discuss what is the central components of nursing.
I think you raise a number of really interesting and relevant points-particularly regarding independent practice. I had hoped that the commencement of Nurse Practitioners would start to pave the way for a fantastic autonomous nurse clinician, sadly I do not yet see any evidence of that with the AMA successfully stalling any real meaning within that role.
To Allied Health Professional-thankyou for your input, it was a very supportive post when I fear my original post may have come across as Allied Health bashing . Not so, I have always respected the input of AH very much but I do admit to feeling somewhat dismayed that generally speaking an allied health undergraduate degree is between 3-4 years. Same with Registered Nursing, AH are able as you say to obtain a medicare number and legally establish a practice independently with I dare say at least a few years of experience and possibly a further year in postgraduate studies.
Lets compare that with a registered nurse with a view to becoming an NP: 3-4 year Bachelor, at least 2 years post registration work experience (generally) prior to being accepted into a I year fulltime Postgraduate Diploma in the area of their choice. At this point they could concievably articulate into a Masters Degree ( a further 2 years) or be required to wait and work in the area of specialty for another couple of years prior to commencing Nurse Practitioner Candidature. it doesn’t take much to figure out that time, money, effort, sacrifice are being poured into a program that (as yet) to my mind has not demonstrated any real benefit for the RN concerned or nursing in general. There is still no autonomy, still a fundamental lack of respect, recompense and recognition.
I overheard doctors discussing the NP candidate at the hospital I used to work in last year. It was their opinion that it was a total shame-”She should have gone and done medicine-what a waste” they commented. A waste???? “Should have done medicine???” WHY?????? She LOVES nursing!!! In the intial stages of the NP-prospective NP’s were required (I understand) to present before a board of doctors to essentially demonstrate to their satisfaction their knowledge. I’m sorry? What? Again I fing myself asking why? This is nursing knowledge not medicine.
I will admit however at this stage of my tireless soapboxing
that I would be extremely pleased if their was someone out there with an altogether far more positive experience to share regarding the NP program. But I like AH’s idea of a collaborative union between Nursing and AH. Being the largest proportion of workers in the sector I can imagine that there would have to be some clout available. For me I would be so happy to see Nurses in Primary Care Practices and within their own private practices. We know so much, we understand so much about the human condition in all its kaleidescope, everywhere between optimum health and frailty-I reckon I’d give the combined union a crack-who knows maybe by making a radical change, we would start to make some real progress in nursing.
hi, i´m Nurse from ARG i was reading the post, and I cant stop to say the same, when a was a student ( I have ten years in my profesion) our teacher said ” never leave that the doctors, disrespect yours, because you´re professional how them too” and even who they are? GOD? if they think that they have proud because read two or three books than you, this is are wrong, here we have many respet each either, just in my first years how student, i saw that: and never let, that trample.
Hi guys, Great comments and I appreciate them very much. my experience in nursing is within Australia only so I have no other reference to speak of. Its good to hear others opinions. I too have found that junior MO’s, student doctors and interns tend to be very receptive to nursing knowledge. What wipes that is the attitudes of senior medical staff, and in the situation I referred to in the original post was the revolting attitudes of a good percentage of residents, registrars and finally the consultants themselves. I’m very proud of being a nurse, I am exceptionally proud of the work I do and what it took for me to get to this point. I believe that it is time for nursing to be recognised for the unique body of knowledge it possesses and stops filtering that out to allied health. Any good historical research will point out that allied health sectors evolved from nurses and nursing assessments ie exercise physiology for child polio sufferers-designed and implemented by a nurse (Elizabeth Kenny). Speech pathology/assessment for CVA patients etc. These are all now removed from nursing to the point where we (I at least and other colleagues) feel almost as if we cannot be trusted to accurately assess a swallowing deficit (for example). But it is the ingrained attitude that concerns me the most. I think even in Kim’s post where she (he? sorry!) points out that (quote) “Only once or twice have I seen someone get a bad dressing-down, and it was over fairly serious matters” is enough of an issue for me. It implies the very same appalling attitude that I am speaking of. It is NOT the doctors position to discipline nursing staff. It is for the NUM, ANUM or DON to do so. They are supposed to be differing disciplines therefore doctors ARE NOT nursing heirarchy. Doctors may request nursing staff to perform certain tasks but why we are not their handmaidens and as far as I am concerned haven’t been for a very long time.