Torn between Nursing and Medicine

ImThatGuy, BSN, RN · Feb 5, 2011

Consider your finances as well.
One of the docs I work with has close to 300K in student loan debt. She lives in a one bedroom, student apartment, showers in our locker room, and eats all the free food she can get. She's not married and she came from a poor background, and didn't get a lot of scholarship awards despite being a very bright gal. She's a hospitalist in part because she absolutely could not afford to buy into a practice; she didn't even consider it.
One of my closest friends is a doc in a small town. She only has 150K in student loans for med school...but she just bought a practice for about 300K. Now she owes 450K.
I don't make nearly as much as she does as a nurse...but I have more income after debt than she does. I paid for college with a few scholarships and cash. I have no student loan debt. She and her husband are paying more in her loan debt and for her malpractice insurance each month than my husband and I make each month combined. We live much better than they do. In 20 years? She might have a better lifestyle. Right now, she's working herself to the bone, trying to make ends meet. I work three days a week, take violin lessons, am training for a half marathon, and in general enjoy life.

And that right there boys and girls is why I didn't go back for o-chem, review the other stuff, take the MCAT, and apply to med school.

DNS on the go · Feb 6, 2011

I understand what you are saying, but various levels of a course and two different sets of courses are totally different things. I've Taken ENG 111 (the first college English you must take in order to move on) via an AP course/ test in high school. SO the summer after I graduated (June 2010) I took ENG 112 (the second english you must take in order to move up in Englishes) Now I am in ENG 114 (our school doesn't have an ENG 113 the next leve lup is straight to ENG 115.) This is just an example.Whether a med student, nursing student, or BIo Chem Student all will take the same A&P1, A&P 2, General Chem I & II, ENG 111, 112, 114, 115 etc./............... Many, nursing programs, especially BSN programs, require general chem I & II, bio chem, and Statistics and College Algebra. What I'm saying is, just because many nursing schools don't require their students to have 3 to 5 levels of each subject in science, it doesn't mean that medical students didn't have to take the same A&P 1 & 2, or General Chem and Bio Chem that nursing students or biology students had too. Even Pre-med students have to start at general chem and work up to the advanced chem and bio classes. Don't get it twisted.
Somebody should count the number of science courses (both basic and advanced) that Pre- medical students and nursing students have to take and then see how much the difference is. How many more science/ math courses do pre-med students take than nursing students (BSN prepared Nursing students of course) ?

I have been a nursing instructor at several colleges and universities. The science classes that are required by nursing students to take are not the same science classes that scienc/pre med majors take. To suggest that nursing students are required to take the real science classes is false and laughable.

For nursing you take a survey of HA&P with labs. This is not the HA&P that bio students take. Nursing A&P is a survey class that is set up for students who are taking a vocational degree (i.e. nursing, respiratory care, etc). Science and pre-med students take HA&P after taking general bio with labs. Same with chemistry classes. Nursing requires a year of chemistry that is a brief survey of general and organic chemistry. Science and pre-med students must take general chemistry (which requires Cal as a pre-req.) and then organic chemistry with labs.

While their are nursing students who come into nursing after completing a college degree (including a "hard" science degree-biology, chemistry, physics,etc), the majority of nursing students come ill prepared to study survey versions of hard science classes.

As a university instructor, who must try to "train" the students who enter nursing programs, I can tell you that nursing does not attract academically oriented students.

The majority have significant academic issues including poor writing skills, poor math skills, inability to synthesize information, etc. The nursing students of today are not the students of 20 or 30 years ago. Why the quality of nursing students is deteriorating is complex.

Additionally, the second degree nurses or career changing nurses are not the scholars that you may think. Yes they have a college degree (usually in a very light subject like sociology, liberal arts,marketing, art history etc). They could not make it (or make a living) in their original field and have heard romantic stories about nursing.

While some of these second degree may have taken hard science classes or even have a science degree, they have other issues that prevented then from suceeding in the job market. Employers (hospitals) by the way are leary of the second degree nurse as it is assumed they could not "make it" the first time and are the most out of touch about what nursing is about.

I have taught these students and can say they are overall better than the general nursing student but they do not understand the concept of being a "foot solider" or a "worker bee". They are so wrapped up in the perceived opportunities in nursing. It is sad, as now the opportunities are minimal and as new graduates they are having a real hard time even getting entry level positions.

If nursing is going to be a more attractive field it must seriously deal with these issues-poor caliber students entering nursing. It is sad to see a graduate level nursing students who can not write cohesively.

Nursing schools must enforce real admission standards at the entry level and at the graduate level. Nursing is one of the few soft areas that does not require a GRE to get into a master program. The schools dropped the GRE to open the door to more students (remember each student is tution money).

I can vividly remember in a facility meeting participating in a discussion with my fellow instructors about how can admissions staff let some of these students in the door of the school.

As our department head said, our paycheck come from these students tution money. We are told do what you can to compensate. As an instructor, I have been told we are training beside nurses not societial leaders. Our job is to given the students the basic skills to function at the entry level with their fuure employers being the one to refine them to the workplace. This was not the situation 20 or 30 years ago.

As an aside, data shows that second degree students are no happier ( or successful) in their nursing career as they were in the first career. Past performance is an indicator ability, appitude and emotional intelligence.

netglow, ASN, RN · Feb 6, 2011

DNS, do you have a solid measure of your worth? I mean to prove that you really have what it takes. Or, is it just nursing school instruction for you. Has anyone counted on you when the chips are down - lay all responsibility on you and bet millions on the knowledge that you will succeed? No. I can't see you ever having that kind of responsibility. I have. Both millions and now lives.

I have had a very successful first degree and career of 20+ years, climbing the ladder to owning my own very successful business having clients in big healthcare R&D, aviation, and finance, soley secured and sustained.

I'll have you know that my research papers are used as the gold standard by two of my professors. More of my research will be published in a book written by yet another professor.

I think you would be intimidated if I were a student at your college, and, I would be keenly aware that I intimidate you. But, alas people like me hold more cards than you think.

PatMac10,RN, RN · Feb 6, 2011

I have been a nursing instructor at several colleges and universities. The science classes that are required by nursing students to take are not the same science classes that scienc/pre med majors take. To suggest that nursing students are required to take the real science classes is false and laughable.
For nursing you take a survey of HA&P with labs. This is not the HA&P that bio students take. Nursing A&P is a survey class that is set up for students who are taking a vocational degree (i.e. nursing, respiratory care, etc). Science and pre-med students take HA&P after taking general bio with labs. Same with chemistry classes. Nursing requires a year of chemistry that is a brief survey of general and organic chemistry. Science and pre-med students must take general chemistry (which requires Cal as a pre-req.) and then organic chemistry with labs.
While their are nursing students who come into nursing after completing a college degree (including a "hard" science degree-biology, chemistry, physics,etc), the majority of nursing students come ill prepared to study survey versions of hard science classes.
As a university instructor, who must try to "train" the students who enter nursing programs, I can tell you that nursing does not attract academically oriented students.
The majority have significant academic issues including poor writing skills, poor math skills, inability to synthesize information, etc. The nursing students of today are not the students of 20 or 30 years ago. Why the quality of nursing students is deteriorating is complex.
Additionally, the second degree nurses or career changing nurses are not the scholars that you may think. Yes they have a college degree (usually in a very light subject like sociology, liberal arts,marketing, art history etc). They could not make it (or make a living) in their original field and have heard romantic stories about nursing.
While some of these second degree may have taken hard science classes or even have a science degree, they have other issues that prevented then from suceeding in the job market. Employers (hospitals) by the way are leary of the second degree nurse as it is assumed they could not "make it" the first time and are the most out of touch about what nursing is about.
I have taught these students and can say they are overall better than the general nursing student but they do not understand the concept of being a "foot solider" or a "worker bee". They are so wrapped up in the perceived opportunities in nursing. It is sad, as now the opportunities are minimal and as new graduates they are having a real hard time even getting entry level positions.
If nursing is going to be a more attractive field it must seriously deal with these issues-poor caliber students entering nursing. It is sad to see a graduate level nursing students who can not write cohesively.
Nursing schools must enforce real admission standards at the entry level and at the graduate level. Nursing is one of the few soft areas that does not require a GRE to get into a master program. The schools dropped the GRE to open the door to more students (remember each student is tution money).
I can vividly remember in a facility meeting participating in a discussion with my fellow instructors about how can admissions staff let some of these students in the door of the school.
As our department head said, our paycheck come from these students tution money. We are told do what you can to compensate. As an instructor, I have been told we are training beside nurses not societial leaders. Our job is to given the students the basic skills to function at the entry level with their fuure employers being the one to refine them to the workplace. This was not the situation 20 or 30 years ago.
As an aside, data shows that second degree students are no happier ( or successful) in their nursing career as they were in the first career. Past performance is an indicator ability, appitude and emotional intelligence.

Well, that may very well be true where you live, but I honestly have never seen or heard of such a preposterous thing (Now that's something to laugh at) here in NC, not saying it doesn't exist. IF there are schools around here doing it, somebody better tell these poor people that are getting University transfer degrees at CCs, for various reasons, that there Bios and Maths won't be accepted if they transfer and decide to do pre-med.

Funny how when I was enrolled in summer college courses at a local public University pre-college program (both at a CC and a University) that a Pre-med student was enrolled in the same class. I looked up the requirements for pre-med and nursing in my area and none of the curriculum mention anything about their being two different types of one science class, one for those majoring and nursing and the other pre-med. Science is science no matter what your major is. I do agree that some of those who switch to nursing as second degree may not always be any happier. The point I am trying to clarify, is that in my part of NC, there is no such thing as science classes just for pre-med and science classes just for nursing majors.

Now at MY CC you can take Survey of Mathematics to get an AA in General Ed, but to pursue a BSN at most of the Universities around here you need to take Statistics, College Algebra, 3 levels of Chem, and some histories (which I have the histories because of dual enrollment during high school ). I am a current pre-nursing student and I don't take survey of A&P anything. I take straight up A&P I then A&P II and straight up Microbiology. All of these would transfer to any university in NC and many online program that I've researched, whether I kept my major as nursing or pre-med. I know some pre-med programs are required to take III and IV levels or more of A&P, but as far as the I and II level courses, that I and many other pre-nursing students have/ are taking, they are the same courses I would have taken at a UNC school for a BSN or pre-med degree. But, like I stated earlier, I am aware that most pre-med students, if not all, take way more science courses than a nursing major ever will, but the science that they do take, that are required for nursing as well, are the same and they are taught on the same level.

Oh and I never implied that I think that second degree nurses are "scholars", or at least I didn't mean to if I did. Any field, even medicine, can attract people who have poor writing or communication ability and some of the other things you listed, that why Medicine is a SCIENCE dominated field, so those people don't have to deal, as much, with the liberal arts and humanities. Anyone can be intelligent and challenge themselves regardless of what degree, major, or job title they have or are trying to pursue. I agree that many people are as dedicated to their field of study or work as they used to be, in part because the economy pushes people into the healthcare field as a "secure" field. And I only know of few APN programs that don't Require the GRE or the MAT, both test have been reported academically challenging on some level, or they wouldn't use them. It seems that the MAT is more difficult for people who are more science oriented and the GRE more difficult for those who are more liberal studies oriented.

BrookeeLou_RN · Feb 6, 2011

Dear Nursing instructor,

You seem so disgusted with the quality of students going into nursing, be it first time or as 2nd degree, why would you lower yourself to even consider instructing such students? How did you survive to get to the level of instructor? Are you a tenured Professor at an elite University?

I am amazed at the tone of your post.

I feel it is obvious on this site that many posters feel the "Conspiracy" of the nursing shortage could account for some students wanting to become nurses and not always having the grades to back it up..But back in the day when I went to college, those nurses were weeded out through the programs and if all else failed through the State Boards. And sometimes even those who struggled at first, did get with the program and succeeded to graduate and pass NCLEX and went on to be fine nurses!

I believe no one is born knowing it all!! Thank Goodness or there would be no need for instructors!

BluegrassRN · Feb 6, 2011

My university did not offer different classes for different majors. There was only one 100 level chemistry class that we all had to take. Same with anatomy and physiology (separate classes, each with their own lab). The only difference was that declared premed majors had preference in the actual cadaver lab, with nonpremed majors mostly having to take an observation lab that typically involved watching someone dissect, or examining, for example, a hand that had already been dissected, as well as many different synthetic models. For example, the skull we had to purchase was a detailed plastic model, but my friends who were med students had to purchase the real deal. Space in cadaver lab was limited by the fact that cadavers are apparently expensive and limited in number.

I have a difficult time believing that DNS is what he/she says she is. Much of he information in the post is so uninformed and absolutely untrue, I can't imagine that he/she has actually taught at "several universities and colleges".

ImThatGuy, BSN, RN · Feb 6, 2011

Here, at my program, nursing requires chemistry in one of two forms. If you're in the ADN program you must have had chemistry within five years. High school chemistry will suffice, and the VAST majority of ADN students are kids a couple of years out of high school. If you're in the BSN program, you have to have take a course my university (which is also my alma mater) calls "general chemistry." At this school, general chemistry leads no where. Science majors cannot/shall not/will not take it. The science course is called "university chemistry." After that one can take organic, physical, quant., etc.

The human anatomy and physiology courses (I & II) would equate to eight semester credit hours after completion. A biology major may take BOTH courses as electives but receive no more than FOUR credit hours. If they only took one course in the sequence they'd get nothing for credit.

I would say that no one else in my BSN program is scientifically oriented and few of them could survive well in general zoology. It's sad but true. I taught high school biology (as well as earth sci., chem., and A&P) for a year and a half before moving on to what I called bigger and better things. That, I fell into and needed to get a job with my purportedly useless science degree so I took it.

With my second degree I've approached it much more from consumer perspective than that of a student. I do not feel at all like we're being educated but rather "trained" like DNS said.

I may not be a scholar. My first degree's GPA was only 3.45, but like many college kids I never read nor studied. Listening to lectures got me by. Since that time I've taken an active interest in re-reading my bio, zoo, botany, physio, and genetics books. I've learned as much as I could about pathophysiology and pharmacoloy MOA as one could learn about in a hobby-related, spare time fashion. I went to paramedic school basically to learn something interesting, to make extra money while I was teaching (read: pad my savings lol), and stay busy by working weekends, and other off days. Did I do well in the workplace with my real career? You bet. I just wanted a change recently. I'm finding that nursing, or at least nursing school, isn't what I wanted. Healthcare and the medical arena interests me, but as I stated I don't think I'm being eduated in this area. Instead, I feel as if I'm being indoctrinated into "thinking like a nurse" which, more often than not, doesn't involve critical thinking. I'm taking a course in pathophysiology this semester and as I sit at home and read the book I finish chapters realizing that I've already learned or at least read what's printed in that book. During the lectures I often wish I were standing up front teaching it.

To summarize, I point all of this out not to suggest I'm an outstanding student or highly knowledgeable about the field. I am trying to point out though that I don't think nursing school is all that detailed. I wish it were. I'm sure some programs are, and I'm sure others are less so than mine. Honestly, I think my paramedic program was rigorous. The tests were certainly more difficult. Perhaps though it's that experience that makes me think nursing school isn't that bad.

I don't mean to step on any toes or offend anyone. I just read and hear so much about the profession trying to establish more of a professional identity, and I think solidifying the field's scientific foundation is the way to go about that.

If I had never taken an interest in the life and medical sciences, nor briefly taught the subject giving me a stronger grasp of the basics, I too might find difficulty with some of the content. To me, this simply suggests that those that are having difficulty with tying together the A&P, patho, pharm, and nursing-specific knowledge perhaps lack the scientific understanding needed to do so, and that scientific grounding would do inifinitely more to promote the profession of "nursing science" rather than psychology-mirroring theories about caring and socialization and the "are you strong enough to care" campaign.

RNbrent · Feb 6, 2011

I have not read all these comments yet.
I would say, since you are young, if you can get into medical school, do it. I personally really, really would not encourage someone with intelligence and excellent grades to go into nursing.

Yeah..... I don't like that comment. Not one bit.

Doctors will never understand the sense of reward that comes from being a nurse. Doctors act like God, but nurses are God. Intelligence has nothing to do with it. When it comes down to it, it's your personality. It's takes a special kind of person to be a nurse, but it only takes someone with resources, a bit of intelligence, and a boasting level of confidence to be a doctor.

CCL RN, RN · Feb 6, 2011

I was originally going for a biology degree when I changed to nursing. The bio degree pre-reqs at my CC were the same for pre-med.

It was 5 semesters of chemistry. Five. At the CC level.

I changed my mind after completing my first 2 years of pre-med prereqs and switched to nursing. It required 2 semesters of basic chemistry. I didn't even have to take them because my other chemistry classes were more advanced than the nursing ones.

Yes, there are different classes for both programs. And the difference is huge. I won't even get into the math and physics part. Especially since most nuring programs require neither. Well, my nursing program required intermediate algebra. I'm pretty sure that was something I learned in my sophomore year-->in high school!

OP: you're young. Go to med school...

RNbrent · Feb 6, 2011

DNS on the go,

Sounds like to me the problem isn't the student, but the teacher. Why don't you step up your game? You say these students are unintellectual? Do you even know what intelligence compromises? Do you understand that the ability to write a coherent sentence doesn't indicate your success later in life? Do you know what Dale Carnegie a successful steel giant? Not his knowledge of steel, because he had people who worked under him that knew tons more about steel then he did. It was his ability to deal with people, and to motivate them.

DNS, although your comments may be true, to some extent, they are very negative stereotypes that you place on the nursing field as a whole.

CCL RN, RN · Feb 6, 2011

Yeah..... I don't like that comment. Not one bit.
Doctors will never understand the sense of reward that comes from being a nurse. Doctors act like God, but nurses are God. Intelligence has nothing to do with it. When it comes down to it, it's your personality. It's takes a special kind of person to be a nurse, but it only takes someone with resources, a bit of intelligence, and a boasting level of confidence to be a doctor.

Nurses aren't God either. Not at all.

Nursing requires no special personality. Trust me, I've seen all kinds of nurses!!

And if you think it just take a 'bit' of intelligence to be a doctor then you are sorely misinformed. Look, it's ok to be proud of being a nurse, but you don't want to come across as disrespectful and bitter.

CCL RN, RN · Feb 6, 2011

My university did not offer different classes for different majors. There was only one 100 level chemistry class that we all had to take. .

Wait...there was only one 100 level chem class at your university???

Trust me, pre med has several chem classes that they have to take.