Playing Second Fiddle to Doctors?

  1. Local Op/ed piece:

    Primary Care:Nurses don't play second fiddle when it comes to your health.

    Primary Care
    Nurses don't play second fiddle when it comes to your health.

    by Jenn Carbin

    An accomplished, open-minded friend recently told me that an 11-year-old she knows is talking about becoming a nurse. My friend explained that because this child is "very bright," she asked her if she'd considered becoming a doctor. "Are you not interested in calling the shots?" my friend wanted to know.

    Her question reflects a commonly held view of health care, which is that nurses work for doctors and that the excitement and challenge of medicine is experienced, and egged on, by doctors. The general idea is that if you're bright and interested in throwing your lot into health care, surely you should go for the brass ring, an M.D. Doctors have the more important challenges. Many suspect that nurses would be doctors if only they could: if they were smarter, more confident, had rich parents or more opportunities.

    I strongly suspect that had this child said she wanted to be a lawyer, my friend wouldn't have asked, "Why not a doctor?"

    Yet nursing is not only as important as those two professions, but as distinct. In fact, the only areas where that distinctiveness -- nursing's focus on all-around care and patient-centered interventions -- becomes less apparent are advanced fields where nurses are acquiring responsibilities practically indistinguishable from those of physicians.

    If you took nurses out of medical facilities for a day, health care as we know it would shut down. Though we pin our greatest hopes on physicians, the same can't be said about them.

    Patient monitoring and palliative care are essential aspects of health care, and belong to nursing.

    Women, of course, make up the majority of the nursing population, and this leads to problematic views. Romantics see nurses as purely selfless beings who simply don't mind cleaning up vomit. Then there is the related idea that nursing must be mere "women's work," far outside of science. Lastly, there is what some would tout as a more evolved, feminist view, which is that nursing is a prescribed role for women, and that female nurses should just believe in themselves already and become physicians.

    But despite what some women's studies texts will tell you, nursing is not a default profession.

    Not anymore, anyway. It's an exciting profession with a wealth of opportunities. And that's a good thing, because our country in the next few years is going to be desperate for registered nurses. Experts predict that the nursing shortage currently threatening health care is set to get worse over the next 15 years. Many nurses will retire, and the population, particularly the elderly portion of it, will increase substantially.

    It's important to know, then, that opportunities and diverse nursing career paths abound. Don't want to work for decades in a hospital? Studies show that just 52 percent of nurses are practicing in traditional health-care settings, and by 2010, that number is expected to drop to less than 40 percent.

    There's a lot going on. Most nurses these days acquire a bachelor of science in nursing, though some experienced RNs mourn the hands-on hospital "diploma schools" of just a few years ago. Men are joining the ranks in increasing numbers. We need more.

    Challenges? In addition to doing such things as monitoring vital signs, educating patients, creating patient reports, keeping physicians up-to-date and dispensing treatments, nurses specialize. A student of registered nursing may consider a future in surgical nursing (with a tidy weekday schedule), critical care, pediatrics, geriatrics or labor and delivery, among other areas. Do you want to practice gynecology, deliver babies and write prescriptions yourself? Get an advanced degree and become a licensed nurse practitioner. Do you have academic interests or a flair for business? Are you a natural leader? More and more, nurses are acquiring M.S. degrees, MBAs and Ph.D.s. The job options include teaching, research, management, administration, running a home-care network or editing a nursing journal.

    Outpatient surgery clinics, which offer diverse patient populations, regular schedules and multiple challenges, are virtually run by nurses. RNs get lots of respect in these facilities.

    Part of the problem with the image of nursing is, of course, the fact that for years it was an underpaid profession.

    But health-care institutions have come to see palliative care as requiring talent, even expertise. Due to this and in light of requirements for specialty areas, they are paying a much more appropriate wage these days.

    According to the Bureau of Labor Statistics, half of all RNs earned between $37,870 and $54,000 in 2000.

    Given increasing demand, nursing salaries will only grow and benefit packages, which these days often include education benefits and childcare, will only become more enticing. Health-care management teams are right now thinking of ways to entice RNs.

    Certainly the science of medicine, the quest for cure and (by and large) the art of diagnosis are the domain of doctors. But good nursing requires intelligence, specialized knowledge, a hearty appetite for problem solving, physical stamina, and at times, steely nerve, among other things. Nurses shouldn't ever be considered second fiddle.

    Jenn Carbin, a freelance journalist, is a former associate editor for the magazine Outpatient Surgery and former staff writer for City Paper. If you would like to respond to this Slant or have one of your own (850 words), contact Howard Altman, City Paper editor in chief, 123 Chestnut St., third floor, Phila., PA 19106 or e-mail

    What will it take to get nurses to be seen as something other than the doctors handmaiden?!
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  3. by   NRSKarenRN
    Great article---will email them! Thanks for sharing. Our message IS being heard.
  4. by   dawngloves
    I already did Karen. I suggest we all do.We should applaud our advocates. We have so few.
  5. by   nursedawn67
    Thanks for the article.
  6. by   perfectbluebuildings
    Thanks for the awesome article. I e-mailed them in strong support!
  7. by   P_RN
    Good article. Right to the point. Email of thanks on the way.
  8. by   jnette
    Good read ! Thanx again !
  9. by   funnygirl_rn
    Thanks for the article! I emailed them.
  10. by   JohnnyGage
    What a great article! This was my e-mailed response:

    I just finished reading the op/ed piece on nursing written by Jenn Carbin -- what a terrific piece!

    As a critical care registered nurse for three years I applaud her recognition that nurses are not doctors' "helpers" or "handmaidens" but professionals in our own right.

    The public should also realize that nursing is one of the oldest professions to incorporate the "new" fad of alternative, or complimentary therapies. From the beginings of nursing science we have explored and used massage, music therapy, touch therapy, nutrition, and aromatherapy to assist our patients to achieve whole health -- not just recovery from disease or injury. It is also not well known that nurses -- not physicians -- are professionals specifically trained to educate patients and the public about health and wellness issues.

    When asked why I chose to be a nurse and not a doctor, my answer is very straight forward: I enjoy spending time with my patients! I don't have to budget my time for clinic visits and hospital rounds on twenty or thirty patients, I can spend time with one or two for a whole shift. When the patient improves and transfers out of my intensive care unit -- I celebrate in the joy and healing; when my patient dies after a long illness, I comfort the family and share their sorrow. When a patient takes a dramatic turn for the worse, my collegues and I race into action stabilizing and treating before the doctor even has a chance to appear on the floor. I get to fly in helicoptors and planes transporting the critically ill (something that physicians rarely have a chance to do), and I get to help a frightened young man who just had heart surgery sleep with the reassurance that I will be at his bedside -- and that he will live to see a brighter day.

    Do I have bad days? Of course! Do I wish I was paid better? Naturally. Do I dream of another career? Never.
  11. by   -jt
    thanks for the article - I sent it to my contact at my local newspaper - maybe they will reprint here in NYC.

    great response there, Johnny. Let us know when it gets printed.
  12. by   gwenith
    Thanks for the post I will E-mail as it is an area I feel passionate about. In the meantime I feel a "funny" coming on -

    "Top Ten Reasons why I am a nurse not a Doctor!"

    Will post after I have written it.

    Sometimes it is easier to say things with humour.
  13. by   dawngloves
    Originally posted by gwenith
    Thanks for the post I will E-mail as it is an area I feel passionate about. In the meantime I feel a "funny" coming on -

    "Top Ten Reasons why I am a nurse not a Doctor!"

    Will post after I have written it.

    Sometimes it is easier to say things with humour.
    Lookin' forward to it!
  14. by   dawngloves
    I was thinking about this story as I took my kids to the park and wondered if I would encourage my kids to be nurses. A helicopter flew over and my son was so excited. A future flight nurse!!!