Torn between Nursing and Medicine

ImThatGuy, BSN, RN · Feb 6, 2011

Yeah..... I don't like that comment. Not one bit.
Doctors will never understand the sense of reward that comes from being a nurse. Doctors act like God, but nurses are God. Intelligence has nothing to do with it. When it comes down to it, it's your personality. It's takes a special kind of person to be a nurse, but it only takes someone with resources, a bit of intelligence, and a boasting level of confidence to be a doctor.

Nurses are not God. Obviously, you don't acknowledge our true God, or you wouldn't have said that.

Cinquefoil · Feb 6, 2011

OK, who can agree on the following points?

1) In some locations, pre-nursing students take different, less rigorous pre-requisites than do pre-med students. In other places, pre-med and pre-nursing students are in similarly rigorous classes together.

Some nursing school admissions can get so competitive that even IF you only need to take "General Chemistry" on paper, you ACTUALLY need to take "Principles of Chemistry" to be competitive.

However, in general, after looking at several websites on pre-med prereqs, it seems safe to say that pre-med students have to take MORE courses at the > 200 level than most pre-nursing folks.

2) Nursing has recently seen an influx of people who try to be nurses because they've been told it's a hot ticket to a good paycheck. Some of these people pan out. Some of them don't. There is a possibility that a greater proportion fizzle out than they did in the days when nursing was less "hot", though the arguments for this often cite hearsay and anecdotes rather than statistics.

3) Some nursing schools may cater to a lack of academic rigor in their students. Instructors there, who have some idea how important the ability to distinguish good research from bad, bad math from good, and good writing from incomprehensible is, may grow frustrated with these conditions. This is understandable.

4) Other nursing schools may be very rigorous. A doctor, interviewed in one of these threads about one of my local schools, said he would only hire a nurse educated from that school if he wanted a nurse to challenge him and successfully make him consider things he wouldn't think of on his own. He meant this as a grudging compliment.

Can I hear an "Aye aye"?

metal_m0nk, BSN, RN · Feb 6, 2011

Here, at my program, nursing requires chemistry in one of two forms. If you're in the ADN program you must have had chemistry within five years. High school chemistry will suffice, and the VAST majority of ADN students are kids a couple of years out of high school. If you're in the BSN program, you have to have take a course my university (which is also my alma mater) calls "general chemistry." At this school, general chemistry leads no where. Science majors cannot/shall not/will not take it. The science course is called "university chemistry." After that one can take organic, physical, quant., etc.
The human anatomy and physiology courses (I & II) would equate to eight semester credit hours after completion. A biology major may take BOTH courses as electives but receive no more than FOUR credit hours. If they only took one course in the sequence they'd get nothing for credit.
I would say that no one else in my BSN program is scientifically oriented and few of them could survive well in general zoology. It's sad but true. I taught high school biology (as well as earth sci., chem., and A&P) for a year and a half before moving on to what I called bigger and better things. That, I fell into and needed to get a job with my purportedly useless science degree so I took it.
With my second degree I've approached it much more from consumer perspective than that of a student. I do not feel at all like we're being educated but rather "trained" like DNS said.
I may not be a scholar. My first degree's GPA was only 3.45, but like many college kids I never read nor studied. Listening to lectures got me by. Since that time I've taken an active interest in re-reading my bio, zoo, botany, physio, and genetics books. I've learned as much as I could about pathophysiology and pharmacoloy MOA as one could learn about in a hobby-related, spare time fashion. I went to paramedic school basically to learn something interesting, to make extra money while I was teaching (read: pad my savings lol), and stay busy by working weekends, and other off days. Did I do well in the workplace with my real career? You bet. I just wanted a change recently. I'm finding that nursing, or at least nursing school, isn't what I wanted. Healthcare and the medical arena interests me, but as I stated I don't think I'm being eduated in this area. Instead, I feel as if I'm being indoctrinated into "thinking like a nurse" which, more often than not, doesn't involve critical thinking. I'm taking a course in pathophysiology this semester and as I sit at home and read the book I finish chapters realizing that I've already learned or at least read what's printed in that book. During the lectures I often wish I were standing up front teaching it.
To summarize, I point all of this out not to suggest I'm an outstanding student or highly knowledgeable about the field. I am trying to point out though that I don't think nursing school is all that detailed. I wish it were. I'm sure some programs are, and I'm sure others are less so than mine. Honestly, I think my paramedic program was rigorous. The tests were certainly more difficult. Perhaps though it's that experience that makes me think nursing school isn't that bad.
I don't mean to step on any toes or offend anyone. I just read and hear so much about the profession trying to establish more of a professional identity, and I think solidifying the field's scientific foundation is the way to go about that.
If I had never taken an interest in the life and medical sciences, nor briefly taught the subject giving me a stronger grasp of the basics, I too might find difficulty with some of the content. To me, this simply suggests that those that are having difficulty with tying together the A&P, patho, pharm, and nursing-specific knowledge perhaps lack the scientific understanding needed to do so, and that scientific grounding would do inifinitely more to promote the profession of "nursing science" rather than psychology-mirroring theories about caring and socialization and the "are you strong enough to care" campaign.

Yep.

I could have written most every word of this post save for the teaching part - I did a smathering of research before I left the field for a glamorous life of changing diapers, instilling social skills, maintaining a discipline structure, fostering imaginations and wiping noses.

Nursing's philosophy of taking care not to encroach on the medical model doesn't have to necessitate abandonment of the roots of physiological manipulation altogether. I could get behind the BSN as industry standard if nursing curriculum uniformly tossed the disturbed energy field junk and replaced it with a thorough treatment of chemistry, mathematics, and human biology.

SuperSixEightMD · Feb 6, 2011

Hello! I've posted here multiple times about dilemma I pose: my love for both nursing and medicine. I am currently a pre-nursing student, but I'm a bit hazy about my potential future as a nurse. I love the nursing model; I want to care for a patient, not just treat their disease. Sadly, I love the medical model as well and I'm torn between the two. I've considered mid-level care, but I'm unsure of what I would be content with. For a time, I was highly considering DNP or CRNA, but cynics have stated I could finish med school in the same amount of time.
If you haven't read my previous posts, I will give a summary of myself and the path I plan on taking. I just turned 17, but I've been in college since I was 16. I'm in my second semester of getting my pre-reqs for a BSN program and I have two more semesters left before I plan on applying for direct entry to aforementioned program. The program will take two years to complete, leaving me with summers sans schooling. I was contemplating taking the courses needed for medical school during the summer semesters "just in case". If all goes as planned, I will graduate with my BSN in 2014. As stated in my other posts, I have two specialties of choice: emergency medicine and global health. If I were to go the MD route, I would definitely be interested in trauma surgery (mainly why I was considering MD over NP).
I know that medical schools generally frown upon nursing degrees, but if I have a great GPA, high MCAT scores and the required courses, is there any reason I wouldn't be considered? I've been told that I shouldn't take up a spot in nursing school if I'm even considering medicine, but for the time being, nursing is what I want to do.
I guess my main questions are: Has anyone here considered medicine instead of nursing (or vice versa)? If so, what was the outcome? Do medical schools really oppose nursing degrees as much as it seems? For the DNPs or CRNAs...how do you feel about your job? Would you change anything about your choice of career?
Thanks so much!

I'm a physician, so I'm going to give you my take on the issue.

First off, that claim that physicians treat diseases while nurses treat patients is absolute crap that the nursing professions seem to perpetuate, thinking that by saying it enough it will miraculously become true. It isn't. Physicians treat patients. If we didn't, we couldn't do our jobs properly.

Nursing and medicine are two entirely different professions. Radically different training avenues. And in many cases, radically different roles in health care.

I'd put my vote in for medicine, as I'm a firm believer that if you're going to do something, you should do it all the way. As a physician, you will have under your belt the most rigorous and complete training. And as a result, you'll have the most opportunity in front of you. You will also make quite a bit more money.

It's a much harder path, but well worth it in the end.

beewink · Feb 6, 2011

Nurses were the ones at the bedside, truly healing them.

You are lucky - I just haven't found the time for that to be true. Sure, I'm there at the bedside, but giving meds is about all I have time for these days....

BluegrassRN · Feb 6, 2011

Wait...there was only one 100 level chem class at your university???
Trust me, pre med has several chem classes that they have to take.

I simply meant there wasn't a general chemistry sort of course for non-science majors as well as a beginning chemistry course for science majors. There was Chem 180 the first semester and chem 182 the second. If you needed a chemistry class for your major, these were it. They were the prereqs for organic chemistry. I was in class with, well, 1100+ other students (lecture anyhow), including my friends who were pre-med.

CCL RN, RN · Feb 6, 2011

1100??? Seriously? That's crazy!

BluegrassRN · Feb 6, 2011

Nursing's philosophy of taking care not to encroach on the medical model doesn't have to necessitate abandonment of the roots of physiological manipulation altogether. I could get behind the BSN as industry standard if nursing curriculum uniformly tossed the disturbed energy field junk and replaced it with a thorough treatment of chemistry, mathematics, and human biology.

I will agree with this paragraph 100%. A BSN is bunk when the extra classes are all about nursing theory. Those are crap. Porifice should have been punched in the face when she presented her theory, not lauded as some amazing philosopher and nursing theorists. Most of them should have been laughed out of the profession, rather than have multiple courses about their silly theories.

My disagreement with DNS wasn't that he/she was completely wrong. I just think the gross generalizations of how stupid nurses are, how none of us have a basic understanding of science because *our* science prereqs classes are watered-down versions of the real thing, how none of us can write a a decent sentence (though this one may actually reinforce his/her point) was simply wrong.

I welcome higher standards. I recognize that not everyone had university level courses for their prereqs. Many of us, though, did. My chemistry, calculus, biology, anatomy, physiology, and physics classes were the same classes that the premed students took. My husband did get to take "Physics for poets" but nursing students at my university had to take the real thing. I think DNS was painting with too broad a brush, and thinks all of us are dull bulbs because she expects us to be. I have no doubt that the profession is full of dull bulbs; I went to school with a lot of them when I dropped out of my university due to health problems and later went the CC route. I had to take a couple of "retakes" as my science classes were too old, and I agree, they were a joke.

Make a BSN entry level, fine with me. Just make it a meaningful education. Maintain the science standards that apparently good universities have, and minimize the crap that deals with the likes of Rogers and Porifice.

DNS on the go · Feb 6, 2011

DNS on the go,
Sounds like to me the problem isn't the student, but the teacher. Why don't you step up your game? You say these students are unintellectual? Do you even know what intelligence compromises? Do you understand that the ability to write a coherent sentence doesn't indicate your success later in life? Do you know what Dale Carnegie a successful steel giant? Not his knowledge of steel, because he had people who worked under him that knew tons more about steel then he did. It was his ability to deal with people, and to motivate them.
DNS, although your comments may be true, to some extent, they are very negative stereotypes that you place on the nursing field as a whole.

I have to address your comment of "You say these students are unintellectual?" I never said they are unintellectual. I said they are not academically prepared. The academic deficits of the students who are attracted to nursing are significant and real and not easily remediated.

As an instructor, I am required to "train" these students and try to address their lack of academic ability and skills (writing, presenting information, assimulating data, etc).

Add to this that a significant number of these students have issues in how they present themselves and how they interact with others only adds to the burden of training them. It is sad to say but I have had to teach to the test (i.e. material was presented to reiterate the topics that are on the NCLEX) as opposed to teaching nursing so that the nurse has critical thinking skills.

Add to this,fact the clinical classes really do not prepare the student for entry level practice only compounds the difficulty when the student graduates. Employers would rather hire a foriegn nurse who has more clinically oriented training and experience then a new US educated graduate. As an aside I am both a clinical instructor and a senior nurse manager so I know both sides of the street.

I do not want to offend any reader but rather describe the challenges I face in my day to day work. I am shocked that rather then seriously look at these issues, it is easier to attack me (Not you RN Brett) but the others that question my experience and background).

I have been in nursing long enough to seen nursing fades come and go and then come back again. The trend that I fear has the worst impact on the future of nursing is the poor caliber of student who is going into nursing. As a profession, if we do not attract top caliber candidates for our programs, we are dead. The prestige that nursing has today came from the efforts of the 1960's nursing leaders who had the forsight to create the NP and CNS movement, impliment shared governance and worked to establish fair wages and benefits for nurses. The newer nurses are not of the same caliber and do not have the social and emotional skills to accomplish these significant task. No amount of self praise or positive thinking is going to help. It is the caliber of the student who enters into nursing that will shape nursing future.

For those who have attacked me, go head, It does not change the situation or alter the outcome.

My advice to this young lady is go for medicine. As a doctor, you can focus yor practice and how you wish to interact with the patient. As a nurse, your practice is task oriented and is following physicians orders. You have the brains and youth on your side, go for the prize...medicine.

CCL RN, RN · Feb 6, 2011

. I think DNS was painting with too broad a brush, and thinks all of us are dull bulbs because she expects us to be. I have no doubt that the profession is full of dull bulbs; .

I edited your post for clarity of my point...

That's not how I took DNS' point. Here's what I got out of it...

If we have students who only complete the minimum standards, then nursing is faiing to achieve academically. The overall minimum standards in nursing programs across this country do not compare with other science degrees.

DNS, as a teacher, has seen many more of these students just barely meet these standards, this is his/her own professional opinion based on years of teaching.

This is my own opinion as well, based on what I see in clinical nursing students.

I wish when we take our stats classes and EBP classes, that we actually reviewed and studied quantitative research. Real research. Instead, we (my own well respected BSN program) studied theories, feelings, thoughts, etc,..

It's embarrassing.

I read as much research as I can and discuss as many studies as I can with physicians. It's hard to argue with a physician over patient care if I can't even understand what rersearch they are talking about.

And as much as I love learning, I can't see myself going further in nursing. I've seen many nurses go through their online, fast paced NP program, and yet still not know how to be a bedside nurse. But they sure know their nursing theorists!

I just wish nursing had a REAL emphasis on science, research, etc. And we all know that it doesn't. We all know...

ImThatGuy, BSN, RN · Feb 6, 2011

I'm a physician, so I'm going to give you my take on the issue.
First off, that claim that physicians treat diseases while nurses treat patients is absolute crap that the nursing professions seem to perpetuate, thinking that by saying it enough it will miraculously become true. It isn't. Physicians treat patients. If we didn't, we couldn't do our jobs properly.
Nursing and medicine are two entirely different professions. Radically different training avenues. And in many cases, radically different roles in health care.
I'd put my vote in for medicine, as I'm a firm believer that if you're going to do something, you should do it all the way. As a physician, you will have under your belt the most rigorous and complete training. And as a result, you'll have the most opportunity in front of you. You will also make quite a bit more money.
It's a much harder path, but well worth it in the end.

I agree wholeheartedly and if I were ten years younger I'd go all the way. I encourage any young people on the fence to go the premed route if they have the capacity.

The good doctor here hit it when he said physicians treat patients. That nursing nonsense stating the opposite is driving me nuts.

CCL RN, RN · Feb 6, 2011

.
The good doctor here hit it when he said physicians treat patients. That nursing nonsense stating the opposite is driving me nuts.

And THAT'S why we aren't respected. Because we present this myth that we do everything for the pt, and MDs do nothing. Again, embarrassing...

We do this to ourselves...