Nursing Model vs Medical Model

  1. On another site someone posted this:
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    Reality is that there is "nursing" model is just a stupid catch phrase that nurses use to try and claim that they provide "different" and "better" care than doctors.

    Its used as a ploy to increase nurses scope of practice. They try to claim that doctors have no say over what they do because they operate under a "nursing" model whereas doctors are on a "medical" model.

    Its all a bunch of BS pandering and propaganda.


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    As an outsider, I don't quite comphrehend the Doc vs Nurses battle. I always asummed that it was medical team that was working together. Sort of a technician working in conjunction with an engineer. Or in perhaps another naive way I thought that nurses monitored/assessed patient health and Doc's worked on diagnosis and treatment.

    So with that bieng said what is the differnce between the two models?
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  2. 19 Comments

  3. by   RN4NICU
    Quote from Salus69
    On another site someone posted this:
    ----------------------------------------------------------------------------------------------------------------------------------------------------
    Reality is that there is "nursing" model is just a stupid catch phrase that nurses use to try and claim that they provide "different" and "better" care than doctors.

    Its used as a ploy to increase nurses scope of practice. They try to claim that doctors have no say over what they do because they operate under a "nursing" model whereas doctors are on a "medical" model.

    Its all a bunch of BS pandering and propaganda.


    --------------------------------------------------------------------------
    --------------------------------------------------------------------------


    As an outsider, I don't quite comphrehend the Doc vs Nurses battle. I always asummed that it was medical team that was working together. Sort of a technician working in conjunction with an engineer. Or in perhaps another naive way I thought that nurses monitored/assessed patient health and Doc's worked on diagnosis and treatment.

    So with that bieng said what is the differnce between the two models?
    Nursing is holistic and focused on health whereas medicine is problem-based and focused on illness. Nurses are also charged with protecting the patient (if need be) from medical incompetence. No longer can a nurse have "MD orders" to fall back on - there is a responsibility to know and understand whether what is ordered will benefit or harm the patient. That is why nurses are EDUCATED and not TRAINED. That is why we are PROFESSIONALS and not TECHNICIANS.
    Docs do not like this. They like to feel all-powerful. They expect to write an order and have nurses falling all over themselves to carry it out. They get defensive and pouty when nurses question their almighty wisdom (even if they are not as wise as they like to think they are). Not all docs are like this, of course - the best of them welcome input from nursing and value the professional nurse's assessment and opinion - but many docs do not like to admit that nursing even has a scope of practice, much less that nurses can exercise independent judgement about what is best for the patient: hence- the medicine vs. nursing battleground.
  4. by   angel337
    i read that posting from a doctor website and they post very insulting things about nurses so i am not surprised that they feel that way. i agree with the above poster that alot of doctors do not want to acknowledge nurses as actually having brains, just mere order followers but if you screw up an order they get the chance to say "its the nurses license, not mine". i feel blessed to work with such a great team of physicians that welcome my input and my knowledge. nurses are educated differently than doctors and vice versa. if i wanted to be a doctor i would have went to medical school. i am really tired of the medical profession beating each other up about who is smarter, more advanced etc..., its getting very old. the bottom line is that one can't function without the other.
  5. by   purplemania
    Having worked closely with surgeons many years I can empathize with them when they complain about nurses sabotaging their medical plan. But I know this is an exception to the rule, as most nurses are patient advocates. So the complaints run both ways and depend solely on the individual's personality. There are good MD's and good nurses and bad MD/nurses. Heck, I don't always agree with other nurses about care plans or interventions!
  6. by   chris_at_lucas_RN
    Good nurses won't sabotage a doctor's "medical plan," their care facilitates it.

    The difference between nurses and doctors is that doctors deal with the disease process, and nurses deal with how that process affects the person.

    There is no reason for there to be this sort of competitive attitude, we are not in the same race, as it were.

    On the other hand, after centuries of having nurses as toadies, I can see how the doctors would be upset with the changing relationship. Kind of like slave owners who really, really didn't like emancipation.

    I kinda like that metaphor..... Good thread, thanks for posting it.
  7. by   leslie :-D
    chris, love your avatar....have you lost weight?
  8. by   chris_at_lucas_RN
    I wish. That's the thin person trying to get out.
  9. by   Jailhouse RN
    I work with doctors that expect RNs to be able to assess problems before calling. If the problem requires a doctor (NP/PA). Be ready to answer the their questions. Don't be afraid to make suggestions or request things. We all play on the same page. We just write with a different pen. The real deal for today's RN is the RN stands for prevention and therapy, the doctor facilitates with a Dx and treatment.
  10. by   leslie :-D
    Quote from Jailhouse RN
    I work with doctors that expect RNs to be able to assess problems before calling. If the problem requires a doctor (NP/PA). Be ready to answer the their questions. Don't be afraid to make suggestions or request things. We all play on the same page. We just write with a different pen. The real deal for today's RN is the RN stands for prevention and therapy, the doctor facilitates with a Dx and treatment.
    you know jailhouse, it is such a reasonable expectation yet there are nurses that just don't call the md/np/pa prepared. we indeed should be loaded with all the vital info in order for a dx to be facilitated. labs, vs, loc, appetite, ms, pt c/o,....you'd be surprised the nurses i've worked with that didn't have that info readily available...
  11. by   Salus
    Again, as an outsider, the terms seem more political to me than a great divide of different paradigms. As I mentioned earlier to me it seems like the models are not different per se but different parts of of the whole. Nurses monitored/assessed patient health and Doc's worked on diagnosis and treatment.

    What interests me in the field is I like the idea of helping people achieve health. I see doctors and nurses on the same team.
  12. by   Salus
    Again, as an outsider, the terms seem more political to me than a great divide of different paradigms. As I mentioned earlier to me it seems like the models are not different per se but different parts of of the whole. Nurses monitored/assessed patient health and Doc's worked on diagnosis and treatment.

    What interests me in the field is I like the idea of helping people achieve health. I see doctors and nurses on the same team with the same goal just different jobs.
  13. by   Salus
    What are some analogies that you might give been the two professions?
  14. by   PA-C in Texas
    Quote from RN4NICU
    Nursing is holistic and focused on health whereas medicine is problem-based and focused on illness. Nurses are also charged with protecting the patient (if need be) from medical incompetence. No longer can a nurse have "MD orders" to fall back on - there is a responsibility to know and understand whether what is ordered will benefit or harm the patient. That is why nurses are EDUCATED and not TRAINED. That is why we are PROFESSIONALS and not TECHNICIANS.
    Docs do not like this. They like to feel all-powerful. They expect to write an order and have nurses falling all over themselves to carry it out. They get defensive and pouty when nurses question their almighty wisdom (even if they are not as wise as they like to think they are). Not all docs are like this, of course - the best of them welcome input from nursing and value the professional nurse's assessment and opinion - but many docs do not like to admit that nursing even has a scope of practice, much less that nurses can exercise independent judgement about what is best for the patient: hence- the medicine vs. nursing battleground.
    The above paragraph is so loaded that it is hard to figure where to begin. There is obviously an inferiority complex underlying this issue, otherwise nobody would feel the need to make statements such as the one above.

    I believe that is the reason for the development of the nursing vs. medicine debate. In the traditional health model, nurses are below physicians, but "nursing theory" has evolved in order to give nurses a rationale for claiming that there is no subordination, just a difference. Rather than physicians being better educated and more advanced, the two are just different. This gives rise to semantical arguments such as "education" vs. "training", and "professional" vs. "technician", in an attempt to derive some superiority over other professions while simultaneously claiming to be on par with physicians in that both are educated professionals. People claim that nurses and physicians shouldn't be compared because they are different, but then they go and compare nursing to other professions to show that they are better. You can't have it both ways.

    I believe this stems from years of maltreatment of nurses by physicians. Nurses got tired of going to school to be dumped on, and so they made a move away from medicine. Doctors make claims to knowledge, so nurses frequently make claims to "caring about the whole person", and some try to imply that the diagnosis and treatment of disease precludes a hollistic approach. I believe that the nursing model has developed in response to the conflict with medicine as opposed to any great ideological divide, or a legitemate historical claim to nurses using a different approach, and as such, the difference is once again semantics over substance. The Medicine/Nursing relationship has moved from one that was authoritative to one that is widely considered to be collaborative.

    I think that "collaborative" is a good word to describe the relationship. Most nurses do not work for doctors. Both professions work together to provide care. Nurses have the duty and the obligation not to be complicit in providing treatment that would harm a patient. However, I think the burden on any nurse who decides not to execute a physician's order is fairly high. Refusing to provide treatment for a patient based on a physician's order because the nurse doesn't feel that is the best treatment is not a valid reason. That is a medical decision, and if you want to make those sorts of decisions, it is time to go to medical school. In order to withold prescribed care, the treatment must likely be harmful to a patient.

    I am, quite frankly, worried that the practice of medicine will largely grow to be contingent on nurses giving their stamp of approval to every treatment before they carry it out, or else they will just refuse to do it. The intrinsic problem with this is that doctors and nurses are not on the same level with regard to education, even if they are both professionals. A physician's knowledge may make him comfortable with a treatment, while a nurse would not be comfortable because of a knowledge gap. You might say, "just let them do it themselves", but if you say that too many times, you quickly argue your profession out of the rationale for its existence- to implement prescribed treatments. I would support regulations that would release nurses from the burden of having to determine if a treatment is medically appropriate, since so many of you seem to be concerned about liability issues.

    Let the flaming begin...

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