Residencies: doctors have it figured out - page 7

by Amistad

8,783 Views | 77 Comments

After chatting with a fourth year med student today at clinical, it occurred to me how vastly different the physician career-path is from our own. Fourth year medical students are undergoing the process of being matched to a... Read More


  1. 1
    Quote from Anoetos
    It's probably also worth pointing out that physicians go to school for much longer than we do and bear a larger responsibility with regard to patient outcomes. A slow and diligently managed post-graduate preparation program makes sense.

    Put simply, at entry level, it is probably quite a bit harder for a nurse to kill someone.
    I disagree. One med error could easily kill a patient.
    joanna73 likes this.
  2. 0
    Quote from ThePrincessBride
    I disagree. One med error could easily kill a patient.
    You seriously think a physician has an equal level of responsibility compared to a RN? Simply comparing the maximum consequence and finding them equal, then concluding there is an equal level of responsibility is a major failure of critical thinking... and logic... and/or a total misunderstanding of the roles of a physician and a RN.
  3. 0
    Quote from SummitRN
    You seriously think a physician has an equal level of responsibility compared to a RN? Simply comparing the maximum consequence and finding them equal, then concluding there is an equal level of responsibility is a major failure of critical thinking... and logic... and/or a total misunderstanding of the roles of a physician and a RN.
    Back up for a second. Where did I say that the consequences were equal or that doctors and nurses had the same level of responsibility? I didn't. I did state that it is rather easy for an entry-level nurse to kill someone with a simple med error. Case in point: my clinical instructor had a patient suffering from hypercalcemia. The doctor had mistakenly placed an order for medication that treated hypocalcemia. The nurse noticed this and immediately called the pharmacy. Had she given the med, according to the pharmacist, the patient would have died and both the doctor AND the nurse would have been reprimanded / lost their licenses.

    True story. Nurses have a great deal of responsibility. Not only do they have to watch their butts, they also have to cover the doctor's ass as well. You would know this if you had experience in the field...do you?
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    I don't believe that the level of responsibility of nurses are on the same level as a doctor. Are we in dangerous positions as nurses? Yes! Emphatically, yes.

    Staff nurses don't get phone calls on patients at home, when they've reported off to the oncoming nurse. We don't have the same level of obligation as a doctor does. Our obligation is gone when we leave, and starts back up when we come back.

    Does that make sense at all?
    joanna73 and SummitRN like this.
  5. 0
    Quote from ThePrincessBride
    Back up for a second. Where did I say that the consequences were equal or that doctors and nurses had the same level of responsibility?
    It wasn't clear which part of the quote you were responding to, and I assumed it was the first part, not the second, thus my response. Sorry we had this misunderstanding (apparently I wasn't the only one to read it that way).
  6. 2
    Both doctors and nurses are at risk for harming/killing patients due to medication errors, but the initial diagnosis process adds a crucial difference. If they get that wrong the consequences can end up to be quite dire - depending on what the patient actually has vs what the doc diagnosed and treated for.

    Although I do know that nurses are also the eyes and ears of the medical doctor and really experienced nurses do bring forward their observations - leading to a change in the medical diagnosis. Hopefully we watch out for each other. A really good doctor doesn't get their ego in the way when it seems they may have missed something, just because it was a nurse who provided the input.
    joanna73 and SummitRN like this.
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    Residencies might be a good idea, but if nurses are expected to complete a 2 year residency, then the pay needs to increase. Doctors make a lot more than 25 dollars an hour. Really, they would be wise to revamp the system within the BSN program and make that the mandatory entry point. Students would have 4 years of clinical time instead of 2 years, and a one year residency afterwards.
  8. 0
    Quote from FlorenceNtheMachine
    I don't believe that the level of responsibility of nurses are on the same level as a doctor. Are we in dangerous positions as nurses? Yes! Emphatically, yes.

    Staff nurses don't get phone calls on patients at home, when they've reported off to the oncoming nurse. We don't have the same level of obligation as a doctor does. Our obligation is gone when we leave, and starts back up when we come back.

    Does that make sense at all?
    ER physicians and hospitalists are the same. They don't take calls when they are off duty. The come to work, work their shift then go home. They don't get called by nurses or patients at home.
  9. 0
    Quote from PMFB-RN

    ER physicians and hospitalists are the same. They don't take calls when they are off duty. The come to work, work their shift then go home. They don't get called by nurses or patients at home.
    So a couple specialities overrides the vast majority? Ive called hospitalists at home to clarify orders, and so have many of my colleagues. I stand behind what I say.

    My stance on the OP would be, I love residencies and orientations. I felt my school prepared me well enough on the tasky things in the hospital. Med admin, making beds, IV and feeding pumps. So I feel like residencies should grow the decision making part of nursing. Should they be longer like doctors? Hmm, depends on the environment.
    Last edit by FlorenceNtheMachine on Mar 18, '13
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    So a couple specialities overrides the vast majority?

    *** What? Where did you get that? What a strange thing to say.

    Ive called hospitalists at home to clarify orders, and so have many of my colleagues. I stand behind what I say.
    *** Pretty much defeats the purpose of having a hospitalist program.

    My stance on the OP would be, I love residencies and orientations. I felt my school prepared me well enough on the tasky things in the hospital. Med admin, making beds, IV and feeding pumps. So I feel like residencies should grow the decision making part of nursing. Should they be longer like doctors? Hmm, depends on the environment
    *** No need to reinvent the wheel here. Nurse residencies don't need to be anything like as lomg as physician. We already have tons of good data supporting 9-12 month residencies. Might have to pry the data out of the hands of the private hospitals that have it though.


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