4.10.2008

Because I want to be a nurse. That's why.

I don't know how many times I've had to tackle the well-intentioned but highly-irritating question, "But you're so smart! Why don't you just go to medical school?" when someone learns of my nursing aspirations.

People just don't understand. I don't want to go to medical school because I want to be a nurse. I want to be a nurse for several different reasons... the holistic philosophy, the direct patient contact, executing treatment rather than choosing it. Maybe it's because I'm a little masochistic.

It's not because I want to go into health care but I'm not intelligent enough to be a doctor.

It's not because I'm female.

It's not because I'm worried about the cost.

It's not because I'm incapable of being in charge.

It's not because I'm afraid to take O-chem (although I'm not a big fan of o-chem, it's not a reason I want to be a nurse)

It's not because of the sleepless nightmare known as residency.

I don't want to be a doctor because I want to be a nurse. I know perfectly well that if I really wanted to, I could definitely tough it out through medical school and residency and as a doctor. I know that I'm smart enough.

Since when is someone "too smart" to be a nurse? I guess people outside of the field just don't realize that some of the brightest minds in health care belong to nurses. Nurses with Bachelor's degrees, Master's, even PhDs. Nurses who have written textbooks, performed medical research, educated thousands of students, changed policy, and sparked innovation. Nurse Practitioners who effectively fill roles once occupied solely by physicians. Nurse Anesthetists who are rivaling anesthesiologists.

So please, don't tell me that I'm too intelligent for nursing until you know what modern nursing is up to. Thanks for complimenting my smarts, but don't insult the field I'm passionately pursuing.

9 comments:

Unknown said...

Right on.

I get this a lot too, maybe because I'm male, maybe because I'm an engineering transplant. I get this from MY CLASSMATES, in addition to elsewhere.

While it's true that the academics involved in my associate's degree RN program have been..let's say..not difficult, I have a feeling going for an MSN will present significantly more of a challenge.

The job of an MD just doesn't look like as much fun, to me. Sure, medicine presents deep and interesting challenges intellectually, and plenty of opprotunities to impact people's lives through establishing therapeutic relationships, but the thing that's being treated so often seems to be the disease and not the patient.

The scope of Nursing is much broader, and so I find it more interesting. The question isn't "how do we treat an illness", it's "how to we improve health?". There's a lot of competing theoretical frameworks for nursing practice that all seem to involve using science creatively to solve problems.

The problems we have to solve aren't as cut and dry as medical diagnosis (which I should backpedal a second on and admit facination and awe with the complexity and artistry of -that- process), but rather the tougher questions about how people feel, how they can/should live, how they react to their changes in health status, and how individuals and families psychologically adjust to illness, hospitalization and death.

Sure, MDs in some environments may make a lot of money, but they also spent/borrowed a LOT of money for their education, and so have a more specialized role in the health care delivery system (from what I've seen so far, anyway). They're the part of the system that does "that", and we're the part that does "this".

I think you'll dig it. It seems like a lot of people got into this biz because they identified with the role or some kind of image in their mind of what it would be like, probably informed by the victorian stereotypes from the crimean war. True scholars and men and women of science are worth their weight in gold in this population, so don't let anyone spoil your excitement!

Epijunky said...

You GO GIRL!

Very well written. I loved it. Substitute Nurse for Paramedic and you are where I am now.

scopesandsneaks said...

I'm just about one year away from being a doctor and I've recently realized that the "nursing" stuff is my favorite part of what I do in the hospital. I find myself wondering at least three times a week if really I wouldn't rather be a nurse. Too late now!

Lucid said...

It's funny that you say that Scopes. I have a friend who just completed med school and he has major regrets. He wishes he would've gone for his PA or NP instead.

I think another important thing to note, however, is that being a physician doesn't prevent one from adopting a little nursing philosophy into their practice.

Sure, a nurse and doctor each have their own roles, but it seems that nowadays MDs are realizing the worth of focusing attention on treating the person, family, and community as a whole package.

Pm, sn, I think you put it perfectly: The question isn't "how do we treat an illness", it's "how to we improve health?".

This isn't to say that it's bad that the general role of the physician is to diagnose and treat the disease process, because I believe that the system actually works quite well. Someone needs to hone in on the problem at hand, and someone else needs to nurture all of the other factors, including the effects of the problem.

Lucid said...

By the way, congratulations Scopes. You're almost there. :)

Derek Elwell said...

I still get strange looks from people when I say I want to be a nurse (they still equate 'nurse' with female unfortunately). I chose it for the main reason that I can do some good in this world, and make some pretty good money doing it. There are very few jobs that allow that opportunity.

Plus with the recession coming up (or already here depending on your opinion) it's one of the most recession-proof industries there is.

B.J. said...

Oh yea!!!! I personally know of at least a dozen doctorally prepared nurse educators that would cream themselves after reading this post.

That you are so keenly aware of the framework of nursing as a profession that treats people instead disease, is awe inspiring. I have no doubt that you will be an asset to the profession.

As far as the why-not-to-be-a-doctor rationale, your altruistic passion for improving health is the best foundation for building a career in nursing, however lets not forget the pragmatic side of nursing as well.

One could obtain a degree and a license in 2-ish years and almost immediately rake in $100k/year. How many 19-20 year olds do you know making six figures? Or go for the four year BSN, follow that with a couple years in the ICU, (which is awesome, btw) dive into anesthesia school and be in your 20's making more than a bunch of physicians twice your age.

Figure in your 401k (which you maxed out while in the ICU), compounding interest, modest, if any, student loans, and earning potential for the next 40 years or so...and compare that to medicine.

Start with a four year science degree, paid for with student loans, hopefully get right into medical school at age 22, graduate medical school age 26 with a total loan balance somewhere around $250,000 and no 401k or savings.

Then start residency...lets say you want to be a pediatric thoracic surgeon. That starts with a 7 year (yep, seven) general surgery residency, including 2 years of research, followed by another 2 years in a thoracic fellowship, finish that and you get to start your 2 year pediatric thoracic surgery fellowship. Sure you make 30-40k/yr as a resident, but really, that pays for food and a couple beers to help you forget your student loan debt. So that's 11 years of residency after you graduate medical school, accruing interest on your student loans the whole time. So now your 37 years old, with over $300k in student loans (with interest), no savings, no retirement, and you get to begin job hunting.

Well, turns out there aren't that many pediatric thoracic surgery positions open, so you moonlight in the E.R. for $125/hr.

Then you have a bad trauma roll through the door and you can't intubate. You page the CRNA, who also happens to be making $125/hr, is 10 years younger than you, and had to step over his mutual fund prospectus and "travel" magazine to swing by the ER and drop an ETT in your patient.

Soo....when people tell you that you are to smart to be a nurse, laugh and tell them you are to smart to be a doc, you'll be right.

Anonymous said...

I'm SOOO glad I found this post and these comments. I just got into an argument with my mom over me going from Pre-ObGyn to Pre- nurse midwife. She called it everything from a 2nd rate doctor's assistant to a 'supernurse' *sarcasm* I don't think she understands that medicine is one thing and nursing is an entirely different philosophy. I have a passion for one and not the other. On Oprah I was listening to how you should listen to your body and note its reactions and feelings. When I think nurse midwife I don't feel the same excitement and passion that I do when I think pre-med and all the stress that comes with that and med school and all that in between and thereafter..I actually feel an anxiety attack coming on. How much clearer can it get?? Anyways my passion has been to improve women's healthcare and to take care of women and babies. Before I met a midwife I thought the only way to do that was by becoming an ob/gyn. i'm so glad that I met this nurse midwife and learned about all the different options. Hopefully my mom will come around. If not- oh well! ;-)
Thanks again

Jannet Mathews said...

You just have to forgive them for the misconception, dear. Some people think that Nursing is a step towards being a doctor, which is not the case. So just continue the path that you're taking and be proud of your profession. Be happy for the nurses who are nurses and for the doctors who are doctors. :)