Nursing positions deeply embedded in science

itsmejuli · Aug 3, 2012

Why are you looking at nursing instead of becoming a medical doctor?

DGabe24 · Aug 3, 2012

The insurance battles, the churn and burn mentality....the healthcare provided in the US at this point in time does no appeal to me to be honest. It's lost its MD/patient intimacy, we over medicate, etc. Unfortunately, this question is often asked by many MD's that I work under at this practice, after some very short conversations with me, they too wonder why I am not pursuing the MD route.

I have a truly deep passion for science, but the idea of directly helping others in some of their most dire moments seems like something very few people will have the good fortune of experiencing.

I am going into nursing with the mindset of taking it as far as I possible can, whether that is an NP of some sort, CRNA, etc. etc. So I was just wondering if there are any fields in nursing, or possibly available progressions/options that I may consider to still get my intellectual "fix." This is not meant to downplay or demean the RN and their vital role in the system, but in all honesty I do not feel it is academically challenging/stimulating as some of the fields aforementioned, and this worries me a bit.

I have very limited experience with the world of nursing, and acknowledge this, so please feel free to open my eyes if you deem necessary.

elkpark · Aug 3, 2012

My experience over a few decades in nursing has been that each individual nurse is welcome to delve as deeply into the hard science involved in a particular specialty as s/he wishes (or not). That doesn't necessarily mean that your actual job will require that knowledge on a day in, day out basis -- but it's not like anyone is stopping you from having a deeper understanding of what you're doing. My experience has been that, the better understanding a particular nurse has of the "big picture" of what s/he is doing, the better a nurse s/he is and the better care s/he provides. Nursing can provide exactly as much (or as little) intellectual stimulation as each individual nurse desires.

However, I encourage not to make the mistake of trying to make nursing into something that it isn't because of your own particular interests and desires -- that is just setting yourself up for disappointment. If you really need to be a "hard" scientist, by all means do that.

DGabe24 · Aug 3, 2012

Yeah that is sound advice, and I appreciate you taking the time. I do agree that the more I'm willing to dedicate myself to the science behind what nurses do will only lend itself to making me a better nurse.

I am just hesitant that perhaps down the road I will miss the necessity of thinking outside the box and asking the right questions (I know nurses do this, but I'm referring to a much different context). I try to maintain some sense of objectiveness thoughout and I do realize a lot of the higher end research does involve pipetting everyday nonstop, which in and of itself is going to be mundane and boring, until the point in time (if ever) I became the PI of a lab.

As of now, I do believe nursing will keep me happier and interested longer, and the amount of doors open to a motivated BSN-RN seem to be almost limitless. So that is a huge consideration, and the room to specialize and grow with a strong sense of autonomy is definitely important.

elkpark · Aug 3, 2012

Yeah that is sound advice, and I appreciate you taking the time. I do agree that the more I'm willing to dedicate myself to the science behind what nurses do will only lend itself to making me a better nurse.
I am just hesitant that perhaps down the road I will miss the necessity of thinking outside the box and asking the right questions (I know nurses do this, but I'm referring to a much different context). I try to maintain some sense of objectiveness thoughout and I do realize a lot of the higher end research does involve pipetting everyday nonstop, which in and of itself is going to be mundane and boring, until the point in time (if ever) I became the PI of a lab.
As of now, I do believe nursing will keep me happier and interested longer, and the amount of doors open to a motivated BSN-RN seem to be almost limitless. So that is a huge consideration, and the room to specialize and grow with a strong sense of autonomy is definitely important.

Yes, I've always joked that nursing is the ultimate "big tent" -- the range and variety of professional paths and roles available, that don't even resemble each other except that they all require that RN license, is incredible, and most people don't even start to realize the full range of possibilities until they've been in nursing for a while. And I would argue that "thinking outside the box and asking the right questions" is exactly what separates the really good nurses from the ordinary, mediocre ones -- I'm not sure what you mean by a "different context." However, again, nursing is certainly not for everyone and I'm not one of those nurses who thinks everyone should want to be a nurse. If it's not for you, it's better to recognize that early on, before you invest a lot of time, money, and effort.

DGabe24 · Aug 3, 2012

Yes, it's that big tent that makes me think I will find a position that I am very content with. By asking questions and thinking outside the box, I was referring to the research definition of it. As in, the theoretical questions you ask that lead to your research design and hypotheses. Nurses ask more clinical/diagnostic questions.

I'm starting to think that if intellectual stimulation is one of the "deciding factors" thats making me hesitate to fully commit to being a nurse, than that's a rather hollow reason. As you said, nursing can be as stimulating and demanding as you allow it to be, and I've always been a firm believe in getting out what you put in. So if I dedicate myself to it, there will be plenty of information for me to struggle to wrap my mind around I'm sure.

Again, thanks elkpark, I know my situation may seem somewhat trivial...but as you said, I would much prefer to choose the correct path initially than try to turn around later down the road.

llg, PhD, RN · Aug 3, 2012

Wow, elkpark beat me to it. She said exactly what I was thinking when I read your OP. Great posts, elkpark -- definitely on my imaginary list of "allnurses greatest posts." :yeah:

DGabe24, your questions are NOT trivial. They are excellent ones that more people should ask before they invest in a nursing education. More people need to do that deep and honest personal reflection (accompanied by a little research) before choosing a course of study/career.

As elkpark said, you can engage in the type of intellectual activity you seek as a nurse -- but the job may not require it. The best nurses usually have a better-than-average knowledge base and continue to develop their knowledge and skills throughout their careers.

I am in the specialty of Nursing Professional Development. My colleagues and I teach classes to the hospital staff. For us, a deep understanding of the science (and art) of nursing practice is often required so that we can adequately teach others. It's a big advantage in my job. There are lots of nursing roles (advanced and otherwise) for which a deeper understanding of the underlying facts, principles, and theories is useful. In the long run, you might be happier as a nurse is one of those positons than you might be as a staff nurse.

As nursing continues to develop as a profession, we see increasing expectations that nurses of all kinds to participate in research, evidence-based practice, etc. So there will be increasing opportunities for you to engage in those kinds of activities. But these activities have not been emphasized in the past and not all jobs/settings/roles emphasize them and not all nurses value them. If you are looking for a well-established track to follow for those things, the realities of nursing may disappoint you. But if you are looking for a "young" profession trying to further develop its intellectual aspects -- and are willing to be a leader and forge new paths -- nursing may be a wonderful choice for you.

mrmedical, ASN, BSN · Aug 3, 2012

Just my opinion, OP, as I feel that I was once in that same boat.

Have you considered PA school? It quite more scientifically oriented compared to nursing and is a masters level preparation. Bedside nursing isn't really that intellectually stimulating for the most part (in my opinion, I hardly consider myself an expert), even in the ICU; once you see the most common presentations you kind of know what to expect.

Like elkpark mentioned, if you really want to pick up stuff, a lot will be independent study and self teaching. Is it great that you memorized the anatomy and function of the brachial plexus and it's dorsal roots and innervations? Sure! Will you ever get to use it outside of impressing your coworkers? Probably not.

To be honest, I think nursing is one of the low end of the spectrum when it comes to medical science, most offer basic coursework in anatomy and physiology, and may or may not even require biological sciences.

Looking at curriculum for professions like RT, PT, Pharmacy, Speech Path, they generally have a broader scientific base: probably because they stem from the medical model. Heck, even seasoned paramedics (in my experience at least) are more well versed in emergency management explaining the WHY behind it than my RN colleagues (paramedics always seem to teach ALCS), myself included at times (I attribute this to our knowledge base being so broad, but lacking depth - this is where self study could come in).

At the risk of sounding like that I hate my profession (I don't), I think you will be disappointed if your seeking some kind of stimulating sustenance from it. I remember graduating 3 years ago and we still had professors lecturing on holistic nursing about stuff like "chakras" and "reflexology". I stopped taking them seriously after that lecture.

As a clinical nurse, at the end of the day your main goal is feeding your patient medications and making sure they don't start decompensating. Is there some challenge in recognizing these changes? Yes, lab values, symptomatology, ect... But after a while it is monotonous and you're not really calling the shots anyway.

My advice, if you going to pursing nursing and want those incentives, go get your CRNA or ACNP. I would personally consider the PA profession as well, as being bachelors prepared you probably have all the prerequistes completed (good science GPA, good overall GPA) anyway and just take the GRE and send all your results in through CASPA. Look at the coursework for the different programs and decide if it's bunk or if it interests you. My opinions stated above are really only how I feel about bedside nursing (my only exposure thus far).

kabfighter · Aug 3, 2012

Bedside nursing is task-oriented labor. I'm a nerd, and med-surg isn't really cutting it for me for mental stimulation. When a patient is admitted I select a pre-formed care plan, and then everything is dumped onto a spreadsheet for me with due times, including medications. My shift mostly includes doing patient care, checking the box saying that I did it, and making beds when I don't have anything due on the task list. Since you have such a solid science background, I second the opinion that you should look into PA school. I have to imagine that diagnosing an illness requires a lot more scientific knowledge and thought than absentmindedly writing a note about how a patient has "ineffective tissue perfusion" because their O2 saturation is 85%, or that they have a "knowledge deficit" because nobody ever bothered to explain their disease process to them.

Not to crap on nursing too much, but that's how I see it. I do, however, like doing my job despite its shortcomings. I just wish there was more to it.

HouTx, BSN, MSN, EdD · Aug 3, 2012

Great advice and insight from PPs.

I would encourage you to investigate a field that no one else has mentioned.... kinesiology. I really didn't know that much about it until I met some of these "critters" in my doctoral classes. They practiced in diverse settings, from academic medicine to rehab and specialty clinics - conducting hands-on studies and working directly with patients. Some worked solely with children - developing exercise programs that would improve the 'hardiness and resiliance' of children with congenital heart defects. Others worked with traumatic brain injury or stroke patients. One lucky fellow was a full-time employee with NASA who helped develop all kinds of things for use in a zero gravity environment. Another one worked with professional athletes, analyzing and remediating performance issues - he also worked with an athletic shoe manufacturer, conducting studies to improve footware for marathon runners.

I have no idea how many programs there are, or how competitive it is to get into a program - but all the folks I met were major smarties.

applewhitern, BSN, RN · Aug 3, 2012

Just don't confuse nursing with medicine. As a nurse you can think outside the box all you want to, but the bottom line is that you have a doctor dictating the medical care of the patient. You can delve into the pathophysiology, etc., as you mentioned, but if it is autonomy you are after, nursing isn't it. You said possibly "RN in ICU." You would still be held to the limits of your practise, and can't even give a tylenol without a doctor's order. I think you might be bored as an RN, cleaning poop, etc., kinda limits your aspirations of something more....