Academic Medicine , journal of
the American Association of
Medical Colleges, has sent out a
recent call for articles addressing
the 2013 question of the year:


“What is a doctor? What is a
nurse?” Thirty years ago this
would have been an absurd
question. Not only would it have
been absurd for doctors and
nurses, but for patients too.
Roles were clearly delineated
within the disciplines, and the
white coat indicated a doctor
and the white uniform and cap
identified the nurse.

There are several reasons why
we have to ask the question
posed by Academic Medicine . A
big reason is the entry of women
into the field of medicine.
Another is the development of
advanced degrees for nurses. The
computerization of medical
records has spurred increases
the need for physician extenders
to support practices. A huge
reason recently has been cost-
containment considerations. The
erosion of the doctor as an
ultimate authority figure and
the rise of patient autonomy
have leveled the field as well. To
some extent access to education
is in the mix also.

Educational level is usually part
of the definition of a doctor or
nurse. This is no longer a
reliable indicator. A doctor has
an undergraduate degree and an
MD. But a doctor might be a DO
also, a doctor of osteopathic
medicine. A nurse has an
undergraduate degree in
nursing. Except that a nurse
might have an undergraduate
degree in something other than
nursing, and get the nursing
training later in a master’s
degree program. Up until
relatively recently you didn’t
have to have a BSN to be a nurse,
an associates degree was
enough. Now a nurse might
have a master’s degree or a PhD.

A nurse practitioner has a
master’s degree. A physicians
assistant might also.
Authority used to be used to
separate doctors from nurses.
Doctors can prescribe medicines.
But now so can many advanced-
practice nurses. Doctors can
write orders. So can nurse
practitioners. Doctors can
examine you and diagnose you.
So does your NP.

Nurses and doctors used to look
different. The physical
appearance and dress of nurses
and doctors in hospitals today is
actually emblematic of the
blurring of the lines of identity
that have characterized
medicine in recent years. A
doctor might wear scrubs; a
nurse practitioner might wear a
white coat; in the operating
room, everybody wears the
same thing. Clothing has long
been a tangible symbol of
turbulent times. The casting off
of corsets was a signal of
relaxing social restrictions. The
shock of a woman wearing pants
coincided with women entering
the workforce. Burning bras
were a way of protesting gender
inequality. It is no accident that
the shedding of the nurses cap
happened around the same time
nurses became college educated.
Lifestyle and money? Nope. A
primary care doctor makes less
than a nurse anesthetist. Some
doctors don’t take call anymore,
and many nurses do, even those
without advanced degrees.

Surely knowledge, skill, and
ability separate nurses from
doctors? Of course not. Your
experienced floor nurse knows
way more about medicine than
your average intern. Physicians
assistants can sew up wounds
and assist in surgery. A person
who becomes a nurse is just as
smart as a person who becomes
a doctor, which has always been
true but not always
acknowledged. An MD is just a
piece of paper that gives a
person permission to start
learning how to be an actual
doctor. An RN is much the same.

Clinical experience and training
are the only things that matter
materially to patients. Some
argue that training level is also
part of the definitional
differences between doctors and
nurses. Doctor’s clinical training
in a formal educational system
is usually longer. So you could
equivocally say that a doctor has
longer training.

I would suggest to my readers
that the only thing that truly
separates doctors from nurses is
ultimate responsibility. The
editor of Academic Medicine says
in his introductory remarks
introducing the question that his
daughter was trying to decide
between medicine and nursing.
This is the decision she must
make. Does she want to live
with the ultimate responsibility
for every patient under her
care? Because of our investment
of time and money, and
presumably because of the
economic and social standing
granted to us, we doctors bear
this ultimate burden. This is not
to say that nurses don’t also
have a responsibility to their
patients and their field, or that
they haven’t invested just as
much time and money.

I have been both a nurse and a
doctor, and am a huge
proponent of the expanded role
of nurse practitioners. But the
law and society have laid the
ultimate privilege and burden
on the person that people call
“doctor.” That’s the difference.


source
http://forum.facmedicine.com/threads/the-only-thing-that-truly-separates-doctors-from-nurses.19294/

Doctor is the father, and nurse is the mother...

Bro lalasticlala, please move this to career section

Gud one op...

Hmm

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Thank You!.