Is becoming a Nurse Practitioner an easier route into medicine?
What a question! It seems deliberately designed to cause a slight clenching of the jaw in many a professional medic (also known as a doctor).
However it is a genuine question that is asked fairly frequently in the real world by people thinking about medicine as a career path.
The very fact that the question is even asked, must surely tell us something about the confusion that exists about the changing roles of professionals that work in healthcare and the very bad job we have done as doctors (and nurses) in clarifying key differences.
So in the following few paragraphs I will attempt to set the record straight and dispense some career advice at the same time.
Nursing, at it’s core involves caring for the sick and infirm. Traditional training for nurses reflects that, and a good nurse can make the difference between life and death for multiple patients simultaneously whilst making each of these patients actually feel cared for and comfortable. A good nurse can make the difference between a successful and a failed surgical procedure.
At the heart of nursing lies close adherence to protocols and to an overall plan of treatment set out by a doctor.
Medicine on the other hand requires an understanding of the sciences that underpin clinical medicine and an ability to apply that understanding to real life clinical problems. This may involve dealing with uncertainty, high levels of technical ability or even taking responsibility for deciding what to treat and what not to treat in each unique context. Medicine often involves close adherence to protocols but doctors are required to have an understanding that goes far beyond the protocol, and should always question whether protocols or guidelines are appropriate for the situation at hand.
This is all part of medical training.
So, where do nurse practitioners fit into all of this?
Well, a nurse practitioner is a nurse that has had extra training to perform some of the tasks that a (often junior) doctor might otherwise perform.
These might, for example involve seeing patients in general practice with ‘simple’ ailments that should free up a doctor to see more complicated cases. In some GP surgeries and hospitals, nurse practitioners may run asthma or diabetes clinics for example where monitoring of disease and adjustment of medication can be carried out without a doctor. They may have some limited prescribing rights and may be able to perform certain aspects of surgical procedures, vein harvesting in cardiac surgery, for example.
Because nurse practitioners have never been to medical school, they should not be expected to have the knowledge that a doctor should have about the conditions they manage. They are therefore supervised to varying degrees by doctors to troubleshoot any problems that may arise. A doctor will often take ultimate responsibility if something goes wrong.
Because much of the day to day of clinical practice is simple pattern recognition and adherence to protocol, nurse practitioners are able to deal with many of the problems that traditionally required a doctor. Many doctors worry that, without full medical training, nurse practitioners may make mistakes or miss important pathology which is often hidden among the routine cases in a busy clinic.
Should you consider a career in nursing?
If you are truly undecided about which sort of healthcare career you want to pursue, nursing my well be worth looking into.
However, we don’t feel that a nursing career will satisfy the typical medical applicant.
In spite of the considerable political power held by supporters of nurse practitioners and their ever increasing role, it remains the case that when someone wealthy, well educated or powerful falls sick, they turn to a fully qualified doctor for obvious reasons.
We’d love to hear your thoughts on twitter!
Use the hashtag #medicineornursing
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