Question about Medical Knowledge

[premurse]

Hello everyone! I hope you're all safe and healthy!

I'll start off by saying that I was premed for the longest time and enjoyed my science courses. However, being a physician is not my calling and I am currently applying to nursing schools. I have nothing against either nurses or doctors and I am in no way trying to cause conflict. I'm asking these questions because I'm genuinely curious!

I've always been amazed at the wealth of knowledge that doctors have in regard to the nitty gritty details of disorders, biochemical pathways, molecular and cellular biology, and physiology. I like to think of doctors as medical dictionaries (this is the perspective I have of docs because my mother is a surgeon and could talk about anything and everything).

The depth and breadth of medical knowledge between a doctor and a nurse is arguably different since both pathways differ in educational years and emphasis on molecular/biological/chemical/physical knowledge (since they perform different roles, I don't see this as a problem).

I want to ask:

1. For nurses who enjoy learning about the molecular and cellular bases of diseases, did you take it upon yourself to learn more about diseases, anatomy, physiology, Chemistry, physics, biochemistry, etc? Do you feel at all limited when it comes to your medical knowledge? If I want to become a "medical dictionary" can I do this as a nurse?

2. I have read elsewhere that when asked about "why" a procedure is performed, a nurse wouldn't be able to tell you the scientific basis. Do you find this to be true or accurate? If yes, do you think this is dependent on the nurse or on their nursing education itself?

Again, no shade or harm intended. I'm so excited to join the medical field as a nurse and I couldn't think of doing anything else.

Thank you for your input! Stay safe and be well!

- premurse

[LovingLife123]

You do realize that a nurse and doctor are two different things and we approach things with a different thought process?

I feel like you are trying to throw shade whether that is your intention or not.  Physicians are my colleagues.  The fact that they think differently and have a different approach is a positive thing as I hope they see my approach and different thought process as beneficial.  We work together and that’s what works for the patient.  Sometimes it’s hard for me to see what they think as I’m sure it is the opposite.  But the fact that we can collaborate and have a positive outcome for the patient is rust is important.

[premurse]

3 minutes ago, LovingLife123 said:

You do realize that a nurse and doctor are two different things and we approach things with a different thought process?

I feel like you are trying to throw shade whether that is your intention or not.  Physicians are my colleagues.  The fact that they think differently and have a different approach is a positive thing as I hope they see my approach and different thought process as beneficial.  We work together and that’s what works for the patient.  Sometimes it’s hard for me to see what they think as I’m sure it is the opposite.  But the fact that we can collaborate and have a positive outcome for the patient is rust is important.

I apologize for my ignorance! Thank you! 

[JBMmom, MSN, NP]

You're comparing apples and oranges. They do blend well to make a tasty salad, but they're just not the same. Doctors by training are focusing on the disease/condition and nurses by training are focusing on the patients that have a disease or condition and how it is affecting them overall. 

I started out premed and decided not to become a physician. I have a master's degree in molecular biology and biochemistry and I worked many years in pharmaceutical research before I entered the nursing profession. I enjoy science and technology and I enjoy being a nurse. If you want knowledge in something, you can learn it. There are SO many resources available today you can study almost anything you want and it will augment your nursing ability in a way, but nurses that are not interested in that path are not missing something that they need to be a competent nurse. 

[MelEpiRN]

The only thing limiting your own knowledge is you. (I mean that generically). If you want to learn something, then do so. I have met many brilliant nurses who are specialists in their field, they absolutely have an understanding that supersedes mine/ many other nurses. 

["nursy", RN]

Learning something and keeping it in your head are two different things.  Doctors learn more than we do.  And if you become  a neurosurgeon you will  know the  brain inside and out.   But you would probably be a nervous wreck if you had to deliver a baby. Nurses can learn as much as they want, but you will probably only retain what is  pertinent to your practice.  But if you enjoy learning, there is nothing stopping you.

[Hannahbanana, BSN, MSN]

1) Yes

2) Of course we know scientific bases for things. We have to. AAMOF, that was one of the major shocks a lot of nursing students had when they realized how much physiology they had to learn. You can say, "This lab test looks at how well your kidneys are doing their job of filtering the blood  .... " I don't need to go into ascending and descending tubules, Loop of Henle, pH, Na+, and all that, even though I do know it, because most patients don't need to know that either. Plenty of nurses do know all that.

There's a semi-pervasive misunderstanding that "nurses can't give scientific rationales", but the way the phrase is constructed I don't know whether it means that they are unable to because of lack of knowledge, or they are forbidden to.

Since it's vanishingly rare for a physician to spend the time at the bedside to do patient teaching, validate learning, and ask for a repeat back to be sure, that's where we excel.

From the first week of nursing school when we don't know nothin' we have to create nursing plans of care based on nursing assessments and making nursing diagnoses. Every week our plans had to have at least one patient teaching component. You can't teach something you don't know, so that was one more way for us to learn things.

So of course, learn as much as you like, no knowledge is wasted, it can only enrich your practice.... but always be sure you're learning to think like a nurse, not a physician-appendage or -wannabe. Big, big difference in how we look at and deal with the people in our care. Not more than or less than, but different. You'll learn more about that.

[NRSKarenRN, BSN, RN]

A nurse can soak up as much nursing and medical knowledge as they want.

A vent dependent adult appeared one night on my general medical unit in 1979-- experienced with trachs but not vents. .Respiratory Therapist called pronto, gave me crash in-service on how to ambu to hyper-oxygenate, suction and reconnect vent--checked patient hourly with me. Promptly took myself to Respiratory ICU Nursing course. Transitioned to Respiratory Telemetry unit therafter

In early 1980's, traveled to Las Vegas yearly on my dime to attend Society of Critical Care Medicine yearly conference to learn more.    Had supportive Pulmonologist -unit director and Cardiologist teaching us how to read CXR's  + interpret complex cardiac rhythms.  RN's gave Grand Round presentations including pathophysiology and disease process to the interns and residents --something unheard of then.  Fast forward 40 years, used that knowledge to care for my husband with End Stage Pulmonary Hypertension requiring non-invasive vent due to high oxygen demands.

Hope you will enjoy a satisfying nursing career.

 

[JKL33]

No sarcasm: Do you feel that nursing is your calling?

 

On 3/15/2021 at 7:09 PM, premurse said:

I have read elsewhere that when asked about "why" a procedure is performed, a nurse wouldn't be able to tell you the scientific basis. Do you find this to be true or accurate?

Depends on the nurse.

 

[Okey Foley, BSN, RN]

My favorite aspect of nursing is teaching. Here's two good examples of how I've learned over time and pass along to my surgical patients. 

-Doc wants to place a wound vac on wound day after surgery. Patient says "whatever you think is best I guess?". Later I explain what a wound vac is, how it works, how he can move around, dressing changes, how it helps, why hes an excellent candidate. Doc decided to do it, put in order, but I make sure pt understands the process and why!

-Pt had abd surgery, pretty extensive. Feeling pain in different part of abd than where surgery was. She was worried something was wrong. I knew from listening to surgeons about visceral pain and how it's not good at localization. Explained to pt how this is different than say if you cut your hand, you know it's your hand. Your gut doesn't do a good job of telling you where its pain is. She was much more at ease that this was normal and thanked me for taking the time to tell her.

I listen and pay attention to all other disciplines: RT, PT, OT, physicians, PA, NP, RN, NA... and I learn from them. I synthesize the information to ensure my patients understand their plan of care and can make informed decisions. That is my #1 goal as an RN.

[lmichelle25, BSN, RN]

I would argue that the reason we wouldn't explain the "why" of a procedure is because that is the surgeon's job. If a patient asked us why they were having a procedure after the surgeon had explained it, we could discuss it with them. But it's the surgeon's' responsibility to make sure the patient is fully informed. And there's nothing stopping you from (or anyone else) from becoming a rambling, walking dictionary. There are so many classes posted for free online, that you would already be well versed in all the science courses if you actually wanted to.  Also, not to burst your bubble, but once you're interacting with doctors on a regular basis, you'll realize they're human and don't know everything. Just like everyone, they'll have to look something up on their phones or ask someone else and I've met some really dumb doctors. So, definitely don't think of doctors as God-like, all knowing creatures, because they are not. Lastly, if for whatever reason you think nurses are less than in some way, I would suggest you do some more research because this may not be the field for you. If you failed your pre-med classes and think nursing school will be a cake walk, then you're in for a rude awakening. 

[vintagegal, BSN, DNP, RN, NP]

Nurses treat the human, physicians treat the disease. Nurses are trained on treating the response to the illness, which has many physical and psychosocial facets. After all, a nurse was the one who determined light and air aided healing as well as washing hands prevents infection. So, I am happy to be an RN.