Nursing model vs Medical Model: Thinking like a Nurse has its challenges

[chrisspeilmanrules84]

Hello, I recently left my A.A.S Nursing program last fall in my first semester in 2011....., I applied to PA School (My second choice) that semester after I choose to leave. I recently completed the first semester of PA School with a B+ on Clinical Medicine 1, a B in Physical Diagnosis, a B+ in Clinical Biochemistry, a B in Anatomical Sciences 1 and Clinical Immunology, and a B- in Pharmacology. Is it hard???...Hell yeah, but I felt like my RN program was a lot harder for me and more frustrating. I realize I am one of the few who has done both.

Now, the reason why I didnt do Nursing to begin with if your wondering was two reasons: #1. Cost...an RN program is way way cheaper than the 100k id drop on PA and #2....Nurses get way more value for their Ed, possibly more than any profession....debt to income ratio is way lower, and Nurses have tons more upward and lateral mobility if you ever want to escape the direct patient care at some point in your career and teach or move up to higher hospital administration. In all actually, believe it or not, Nurses can actually make more than PA's in those more advanced positions, and I've even seen salaries for experienced floor RN's with years of experience make over 100k easy....and travel Nursing= $$$$....I mean Nursing just has so much going for it, but looking back, I wish I would have thought it through more and not been thinking about money and oppurtunity....thats the wrong reason to become a Nurse.

Mainly, My goal was to be a CRNA.....thinking Nursing and Medicine were the same thing academically....foolish me!..... ...Another reason why I avoided PA school after completing my B.S in Biology was because PA's cant be CRNA's....personally I think that needs to change not just for us, but for the Respiratory Therapists as well.

For me, comparing PA so far and RN schools, here's my own personal experience on what I felt like went wrong:

• Medical Model vs Nursing model: If you are science minded, and you know it, then you will not do well in nursing. This is my own opinion of course.
  
  This was my problem, I didn't know I was thinking "too scientifically". They taught us all about diverticulitis, Crhons's disease, heart disease, etc. etc. and I enjoyed it so much. Unfortunately, nursing is not about how the patient got the disease, what you can do to cure the disease, the pathology of the disease. Instead, there's the pathophysiology that the professors expect you to know and understand before class started, but more importantly, theres the Nursing specific diagnoses for the disease, the Nursing specific interventions, and of course you have to take into account the pyschosocial aspects as well when answering test questions. A test question could be medically correct, but if there is a psychosocial issue/ aspect that lingers in another....that takes priority.
  
  During class we were taught what to do in the case of complications of the disease, what to do if the doctor orders this, this and this, how to triple check meds, how to clean IV's. I can't tell you how incredibly frustrating it was to give pain meds when I knew that's not curing the disease, to check for clots and blockage in the IV, to assess for phlebitis, etc. when I knew this isn't a solution for the patient. Note: that was my view at the time. Everything above is absolutely necessary for the patient to get better. But that's not how I viewed it and it makes learning Nursing tricky. I had a difficult time trying to figure out what I was supposed to be learning at times......
  
  Nursing really wasn't as science based as I thought it would be.... in all honesty, I really dont think you need all those A+P courses and Mircro for Nursing, they're just weeding out courses. You could honestly get by on just A general survey Human Bio or Anatomy course and a specialized survey Micro course. When I started PA ...it felt good to be studying the hard sciences again like Biochem, Advanced Anatomy and Immunology. Next semester, i'll be taking a Physiology course. Nursing is really more of an art than a science because you need to apply the nursing specific ideas to the academic work like the Nursing interventions, diagnosis, rationales, Maslo and your ABC's etc...
  
  I know a few people who actually want to be RN's so they can go to Medical School some day or even Dental , and man you could NOT be on the more wrong path because of the medical vs nursing model and because the prereq's are different and your GPA will lower signifigantly in Nursing School....it's really for the more career goal Nurse. If anything Respiratory Therapy would help you more in that aspect. If any RT's are reading this im just gonna toss this in that you guys are the unsung hero's of the healthcare team, and its a great field....I have ton's of respect for what RT's do! RT is another great field I looked into and was my 3rd choice.
  The hardest part about being in the Nurse role is being responsible for every single persons job in every other field imaginable: the MD, the PT, OT, the RT....and technically your RN lisence when you get it is supposed to give you the ability to question, but its difficult sometimes to question people whom are supposed to be experts in their field unless its something blatantly wrong.
  
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    • Now I had a hard time myself with Nursing, as opposed to PA but one thing that really got me was this:
      

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  Also, idk what it was but, It seemed like everyone who was a CNA or an LPN thrived in the program while many others (except a few rare few) struggled mightliy. I still wonder: What is it about being a CNA that makes it so helpful to something that I thought was supposed to be more academically advanced and challenging? I always though a CNA would help you in clinical but never as much with theory as wekk.....

  Overall, I have found my first semester of PA school to be definetly challenging, and I seemed to have found my niche....But I do believe Nursing is the better profession...if youre up for the daily task to deal with the challenges it has!...

  I guess what im trying to say is : Make sure Nursing is really what you want and really for you if youre going to go that route.

[llg, PhD, RN]

When I first opened the OP, I thought it was going to be another "Here's why I have no respect for nursing or nurses" post. I am thrilled to see that I was wrong. I think you offered a lot of good insight ... and thank you for your post. I am interested to see what other people have to say about it.

As you discovered, nursing is both an art and a science. You need to be comfortable with both to be a good nurse. I am happy to read that you found your niche without having first spent thousands of dollars and many years struggling with nursing. Good luck to you in your PA studies and career.

[al3x117, RN, EMT-B]

Dude I am not gonna lie. Sometimes I feel the same way in nursing school. Some of the questions on the Kaplan tests in general are too wishy washy with no bite to them like the hard sciences. I am in my second year of nursing school and its been great, but I literally am feeling the same way you are. When you said that you would get frustrated when you were giving a pain med and thought that it wasn't what was best for the patient. Bro I feel you there man. Like seriously sometimes I think the same thing. I know that the meds are important, but is that the only thing that I can do for the patient at the time. Sometimes as a nursing students I always wonder what else I can do for the patient even after I give them the meds. I think today nursing has become super task saturated. Like even in clinical they tell me to get my a** moving cause I am too slow even though I want to talk with the patient at times. It is kinda strange seeing nursing in a different light now. Don't get me wrong though there are times that I do think about becoming a physician so I can make better diagnosis for my patients. Thank you man for this post it really has open my eyes.