A Matter of Perspective

I am often asked, what is the difference between nursing and (to follow form) doctoring? It is an important question.

I first thought about the difference when in my 30s I decided to switch careers. I had been a kindergarten teacher (read: college professor at a major northwest university) and I thought about becoming a nurse. An acquaintance, a doctor, asked, "Why nursing? You're smart enough. Why don't you become a doctor?"

Ignoring her annoying condescension, I told her flat out, "Because I don't like doctors."

Now, a little older, mellower and perhaps wiser, I realize that this is not entirely true. What I know now is that I like what nurses do more than what doctors do. We often talk of doctors "practicing medicine" and refer to it as an "art," but we talk about "nursing" flatly as a verb, a noun, and an adjective. Doctors practice medicine; nurses do nursing.

Aside from the semantics, the main difference between being a doctor and a nurse (in my opinion) is best understood vis-a-vis the patient: doctors diagnose and treat problems; nurses address the plethora of potential responses patients have to the problem(s) they are experiencing.

A doctor diagnoses a malignant tumor, perhaps cuts it out or reduces it by radiation or chemotherapy. Clearly, it is the doctor against the tumor, and the doctor is successful in as much as the tumor ceases to be a problem.

But what of the patient's pain and fear; the occupational and family crises that result from a diagnosis of cancer; what of the alopecia (hair loss), anorexia (appetite and weight loss), the parasthesias and paralysis and the myriad other side effects of cancer treatments? Who "treats" these? In fact, nurses do.

Doctors cure illnesses and fix injuries; nurses do almost everything else. This is why more than 90% of a patient's care is done by nurses.

Ultimately, however, the total care of the patient is a team approach. This is why I've changed my mind about (some) doctors. In my ER, nurses and doctors work very closely together despite our differing foci and roles. We have a truly collegial relationship, and all for the good of the patients.

I didn't go to nursing school because I wasn't smart enough to be a doctor. I became a nurse because I was smart enough to know what I wanted to do, and that was to care for people, not just fix problems.