I have posted an article below that I found interesting, a surgeon seems to have a lot of issues with the fact that nurses are now trained in the university system and not under the old apprenticeship method. This article was published in The Australian on August 25, 2007. The Australian is a national newspaper owned by Rupert Murdoch's News Corporation and is distributed throughout Australia and other countries.
I thought about posting this thread under the Australian nursing forum but I thought that this article raises issues that are relevant to nurses around the world. These issues include the relationship between the nursing profession and the medical profession and the dominance of the medical discourse in health care. Please see read the article below and share your feedback. :)
Nurses could make life hell or heaven. If you had a shift of experienced and sensible nurses then life was easy. The alternative was the nurse straight out of university, who saw herself as the custodian of quality, the barometer of good care in our hospital system. The majority of these nurses were bureaucrats rather than carers. These nurses were the new breed, the norm.
In today’s university nursing educational scheme...
I found this doctor rather full of himself. He apparently wants to go back to the good old days where nurses were his hand maidens.
I didn't think that at all after reading his article. I think he wishes that all nurses were as good, confident, and well trained as the hospital trained nurses.
I liked his article, and agree with almost everything he said. It was funny, and well written.
Nurses complain endlessly about doctors, why should we think doctors have no opinions about us?
I thought the article brought up some interesting points. The scope of nursing has grown so much to include taking responsibility for practices that were once only done by doctors, that the basics sometimes do get neglected.
If he wants the nurses of old, the scope of practice will have to narrow. He will be called to hang blood, start IV's, place NG tubes while I deal with nursing that more closely resembles nursing assistant's work plus a few meds and treatments.
In a lot of ways, this article was contradictory. The surgeon clearly values good nursing care and has a great understanding of what nurses do which is great as I swear some physicians have no clue. He states "The hospital-trained nurses knew that rolling a patient over, washing them thoroughly, cutting their toenails, feeding them and caring for their wounds prevented complications that could result in significant morbidity or death." That's absolutely true. I love that he recognizes that as some nurses don't get it, most physicians don't and almost no patients or family members get it. So many people worship at the alter of IV abx, Coumadin and SCDs and have given up on the basics which truly make the difference in the recovery of the surgical patient. People have even stated on this board that they don't have time to do the interventions outlined on the nursing care plan, they don't see the value of it as what's on the physician order sheet is the priority and the nursing care is what's done if they have a lot of time left over and plenty of staff.
However, he seems to resent nurses having a university education and has decided that it is of no value to nurses, something that is not his place to decide. He bristles at the idea of nurses studying anatomy, physiology, pharmacology and behavioural sciences. Now what would a mere nurse need to know about those big topics? All we need to know is that you should keep the sheets straight so they don't get bedsores, right? I don't know anything about the education and training of nurses in Australia but obviously those of us in the USA who are university-educated might have a problem with the characterization of our education as being so deficient. Must it be either/or? If nurses seem all-consumed with paperwork, quality indicators and complete charting by the physicians, that is not the fault of their university education. That is the reality of a world that is driven by litigious clients, government regulation and here in the US, the JCAHO monster.
There's truth in every argument - sometimes less and sometimes more. The trick is to find it. Chew up the meat and spit out the bones....
IMHO, he makes at least 3 powerful observations:
1. Pts are nursed not doctored back to good health.
2. Much of University Nursing Ed is a waste - what did you think of your Nursing "Theory" or "Process" classes? Did you feel "prepared" when you graduated?
3. There isn't a clear promotional path for great clinical nurses (meaning making more money!)
I think there are opportunities associated with those observations. Why shouldn't nursing education move more toward skill development?
Why shouldn't "technique" related and assessment skills be given a higher priority? In medical education, there are "teaching hospitals" what's wrong with the same focus in nursing?
I came from an engineering background. Where I worked, we had a concept called dual path - it meant that you could progress in engineering and earn the same income as someone in a management position. As a "chief engineer", more was expected in both education, knowledge (not synonymous with education), development skills, and project responsibility.
Along those lines, shouldn't AP nurses have the opportunity to be given greater responsibility and significantly greater pay?
The problem is that the health care delivery system has been designed by people who are not and for the most part, have never been - involved in delivery!
I think nurses have a tremendous opportunity to be a much stronger influence now than ever before as the very nature of how we run the system is being debated. Its all a matter of being willing to step up to the plate and swing the bat (along with being ready to dodge some purposefully misaimed balls!)
maybe this is cruel comment to a really cool post by the oldguy but i went to a teaching hospital for nursing school and found some nurses reluctant to deal with me the nurse, i was wall paper in their eyes! however if we spent a majority of our time in the hospital for education as they do in the philippines, i'm all for this! philippino nurses are the best trained (for the most part) imho!
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cardiacRN2006, ADN, RN
4,106 Posts
I didn't think that at all after reading his article. I think he wishes that all nurses were as good, confident, and well trained as the hospital trained nurses.
I liked his article, and agree with almost everything he said. It was funny, and well written.