Why physicians lack confidence in nurses

For those readers who follow me on Scrubs, or if you found me via social media circles, you know how big of a nurse advocate I am. I consistently praise and endorse our profession. I hold in very high regard the brave souls who work the trenches every day and every shift. Our job is not an easy one and not everyone can do it. Quite honestly, not everyone has the cojones for nursing.

But there’s an inherent problem with the performance and responsibility of our fellow professionals: No two nurses have the same function. I’m not talking about a “good” versus “bad” nurse–I’m referring to the expectations of a nurse as a healthcare professional.

The only way I can explain myself is by making a comparison. Unfortunately an equal comparison to another profession does not exist. My problem becomes exponential due to the very nature of the qualifications, education and training differences that exist among newly registered nurses.

This argument is further complicated by simple nomenclature, since the very word nurse translates into many different definitions, depending on the reference. Nurse can refer to a CNA, an LPN or an RN. And even then, things get fuzzy–an RN can have a 2-year diploma degree, a 2-year associate’s degree or a 4-year bachelor’s degree. Are you still with me so far?

This is what is wrong with nursing: the inaccuracy. Only those who work with nurses can truly understand the difference between the above vocations. Oh, wait. That brings up yet another source of confusion: Is nursing a vocation or a profession? A vocation is an occupation that does not require advanced education or specialized training, while a profession requires specific training, education and continuing education. Nursing seems to suit both these needs and definitions.

Are you confused yet?

Good–so is everyone else who is NOT a nurse. This includes most healthcare professionals, especially physicians! I can tell you from experience that most physicians do not have a firm grasp of what the requirements are to become a nurse.

After all that garbled discussion, I still have to explain what is wrong with nursing. Now back to my original point. No two nurses function the same. In essence, when you depend on the nurse to perform their responsibilities to their fullest, the outcome of your expectations is entirely dependent on which person is on shift at the time. During one shift everything may get accomplished or addressed, while on another shift the infamous ball inevitably will be dropped.

This is a major source of disdain among coworkers and is THE source of physicians’ lack of confidence in our wonderful profession. I’m not sure why it happens, or how it happens, but many nurses lose the ability to cognitively navigate through a problem. Instead, most will reflexively react to a result.

They pound this little concept called critical thinking into our brains as basic nursing students. We have to develop the skill over time, with experience and guidance. Yet we lack the consistency to see it develop. It seems to be spread out like Swiss cheese throughout our profession–and it’s that “Swiss cheese” that I believe is the problem with nursing.

I’m still trying to figure out how we as a profession can solve this problem and fill the Swiss cheese holes–but so far I’m coming up empty-handed. Anyone care to weigh in?