Gap in education between MDs and RNs

Nurses Activism

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Specializes in Surgical Specialty Clinic - Ambulatory Care.

Okay, so I'm a total advocate for MDs being MDs and RNs being RNs and that there really shouldn't be any nurse who mistakenly thinks of his/her profession like he/she is a doctor. However, it does seem to me, after 4 years of nursing that MDs and hospitals expect RNs to take on more responsibility and have more medical education than my 2 years of nursing education prepaired me for. (I have a BSN but the first 2 years of the 4 years I was being schooled was on general classes...not medicine.)

Frankly I despise my school and feel totally jipped for the education I got compaired to the amount of money I paied...but I guess that's another topic.

I bring this up because I recently had to take a NIH stroke scale class online. It was provided by the American Heart Association and designed for MDs and RNs (like our education should even be in the same catagory). Overall I found the class mostly understandable, but there were times when the vocabulary was way over my head...even after I went and looked it up I still didn't understand the concept. I felt like I do when my poor patients are having to listen to their doctor explain their diagnosis then I have to go look up the diagnosis myself and try to understand it so I can re-explain it to my patients.

I know that when I do this I'm probably missing some important aspects of their diagnosis, but I don't know becuase the diagnosis may be a disease that I'm not very familar with and thus have limited experience with.

Does anyone else feel like they didn't get enough medical knowledge in school to be a very good go between for the patients and the doctor?

Does anyone else feel like the hospitals and MDs expect us to have more knowledge than we graduated with?

I understand the concept of continuing to learn and grow after graduation....but I always feel like I'm only understanding half of what is happening (and I take 20 CEUs a year eventhough my stated does not require me to).

If a doctor goes to school for a minimum of 8 years and has a residency for a minimum of 3 years then shouldn't nursing school be more like this?

Like nursing school should be 4 years of education and 1.5 years of residency (note I did not say preceptorship because an MD's residency is all inclusive).

An MDs residency involves rotations in various settings (medical surgical, surgical, L & D, women's health, etc.) over a 3 year period AND THEN if they want to specialize they go into a fellowship program for another 3ish years.

Nursing education these days is VERY VERY poor and I fear being treated by a new nurse far more than being treated by a new doctor.

What do you think?

0 Votes
Specializes in ED.

I would have loved the 1.5 year nurse residency. Being a new grad was about as much fun as being hit in the head repeatedly with a hammer. Having some time to be a real nurse and still have someone to go to for more than six weeks would have been beyond helpful. I saw a lot of nurses go down in flames during their probation periods when they were no longer being precepted. At my first job we were given six weeks of precepting then we were on our own, while still on probation for 90 days and could be terminated for any reason. Two I can think of were fired within a month of being on their own. I wonder how it works with a physician residency? If they royally screw up one time are they remediated or are they fired to make room for someone else? I suppose it depends on the program and facility?

T

0 Votes
Specializes in Critical Care, Education.

I agree with the OP - nursing education is at a disadvantage when compared to physician education. There are many reasons for this, but the biggest is FUNDING. There are Federal subsidies for "medical" education and this is what makes those residencies possible. Hospitals receive $ for providing a home to medical residencies. This funding has been drastically cut over the last decade or so, but it is still enough to make it very worthwhile for the hospital.

Outside of the few remaining diploma programs, there is NO subsidy for economic advantage for hospitals to provide clinical training for nurses. Even for diploma programs, they don't actually get any money.... just gets folded into their CMS cost report that is used as a basis for reimbursement.

In actuality, medical school may become much shorter in the future. In the near term, this will come about by eliminating a lot of the redundancy... some courses are actually pretty much duplicated in the traditional style of curricula. There are pilot programs that have already reduced med school to 3 years. Progressive medical educators have also expressed admiration (srsly) of nursing academia for being open to trying new approaches for nursing education - and said that medical education should do the same. (shock, right?) http://www.ama-assn.org/ama1/pub/upload/mm/16/itme_final_rpt.pdf UT to Shorten Road to Medical School: Austinist

There are two other important considerations. First, we are not talking about the same type of numbers here... at any given time, nursing school enrollments are huge compared to medical schools. The financial burden of trying to arrange internships or residencies for that many students??? Secondly, the type of student is very different. Med students are far more academically advanced than the average pre-licensure nursing student but they are much younger. The average nursing student needs to get out and begin earning a living as quickly as possible.

I encourage everyone to get involved with ANA & your state nursing org & become familiar with these issues... and help us fight for needed change!

0 Votes
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Okay, so I'm a total advocate for MDs being MDs and RNs being RNs and that there really shouldn't be any nurse who mistakenly thinks of his/her profession like he/she is a doctor. However, it does seem to me, after 4 years of nursing that MDs and hospitals expect RNs to take on more responsibility and have more medical education than my 2 years of nursing education prepaired (prepared) me for. (I have a BSN but the first 2 years of the 4 years I was being schooled was on general classes...not medicine.)

Frankly I despise my school and feel totally jipped(gipped) for the education I got compaired (compared)to the amount of money I paied(paid)...but I guess that's another topic.

I bring this up because I recently had to take a NIH stroke scale class online. It was provided by the American Heart Association and designed for MDs and RNs (like our education should even be in the same catagory). Overall I found the class mostly understandable, but there were times when the vocabulary was way over my head...even after I went and looked it up I still didn't understand the concept. I felt like I do when my poor patients are having to listen to their doctor explain their diagnosis then I have to go look up the diagnosis myself and try to understand it so I can re-explain it to my patients.

I know that when I do this I'm probably missing some important aspects of their diagnosis, but I don't know becuase (because)the diagnosis may be a disease that I'm not very familar (familiar) with and thus have limited experience with.

Does anyone else feel like they didn't get enough medical knowledge in school to be a very good go between for the patients and the doctor?

Does anyone else feel like the hospitals and MDs expect us to have more knowledge than we graduated with?

I understand the concept of continuing to learn and grow after graduation....but I always feel like I'm only understanding half of what is happening (and I take 20 CEUs a year eventhough (even though) my stated (state) does not require me to).

If a doctor goes to school for a minimum of 8 years and has a residency for a minimum of 3 years then shouldn't nursing school be more like this?

Like nursing school should be 4 years of education and 1.5 years of residency (note I did not say preceptorship because an MD's residency is all inclusive).

An MDs residency involves rotations in various settings (medical surgical, surgical, L & D, women's health, etc.) over a 3 year period AND THEN if they want to specialize they go into a fellowship program for another 3ish years.

Nursing education these days is VERY VERY poor and I fear being treated by a new nurse far more than being treated by a new doctor.

What do you think?

I guess I was never under the illusion that my college education prepared me in any way for being a nurse. My instructors made it clear to us that passing the boards (NCLEX) was making sure we were safe....not "All knowing", I knew that I would have to look up and learn all kinds of things once I was working and that the rest of my education would be my responsibility.

But I do agree that nursing has gotten away from teaching "nursing" and seem to have forgotten the clinical aspects so much that nurses graduate and pass boards and cannot perform the most basic of nursing functions. Unlike today, hospitals were interested in our education post graduation and gave us "orientation" for 3 months. But we also waited 3 months for our results and worked as "new grads" with another nurse.

Like everything else these days......the money they collect is more important than the education of those paying for it and as long as their pockets are full......you are on your own......sad really.

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