Medicine is an area of human knowledge and expertise aimed at restoring health. Broadly speaking, it is the science which relates to the prevention, detection, cure or alleviation of diseases. It is a highly important profession in any country as its performance directly affects the health of the general public who acts as a backbone for any economy. Medicine has two aspects: both as an area of knowledge (a science), and as an application of that knowledge (medical professions). This article tends to focus on the latter aspect of medicine along with one of the most crucial individual practice in medicine named as nursing.
By definition, nursing implies a profession that renders services necessary for the maintenance and improvement of health by giving attention to the requirements of sick people. It specifically includes the promotion of health, prevention of illness, provision of physical and mental care, promoting comfort and serving patients in every possible way to make their life better.
What nursing actually is has been a question that has received many different answers with the passage of time. There have been significant changes in the field of nursing, in how nursing is practiced and new developments and innovations that have been witnessed over the past century. The early 1990’s was a very bleak period for the nurses as the profession was ill-defined. Nurses mainly had to work all day long working merely as maids and carrying out duties such as cleaning, scrubbing, dusting and etc. Then came the World War II, a major turning point for the nursing profession. Nurses, for the first time, were at the side of patients, helping them to recover using their own discretions and choices. The world got to know the nursing profession better and started giving them the respect they it much deserved. The medical setup changed even more dramatically in the 60’s when for the first time Intensive Care Unit was established for the patients. As a result, nurses started working directly with their doctors at the patients’ bedside. The advancements in medical technology meant that nurses had to be more flexible in terms of adaption of such innovations and contribute more positively towards the recovery of the patient. This discussion takes into account the current nursing practice.
A slight examination of the two activities discussed in above paragraphs would reveal some connection and similarity between the two jobs. At a first glance, it might seem that nursing and medicine are indeed the same activity, a perception which has developed quite strongly in the minds of many. However, the discussion that now follows tends to disseminate the fact that the two jobs differ in many aspects though there is some definite connection between them.
To begin with, it would be worth mentioning few lines from the work of Richard T. Hull, an associate professor of philosophy at the State University of New York at Buffalo, who differentiates nursing and medicine with two analogies. He feels that the profession of nursing is similar to the work of a mother, both contributing towards the nurturing of their responsible. A similar analogy is that of a physician and a father where the role of each one of the two is to perform skilled applications.
As a general rule, nursing is a profession that has developed as a health oriented profession that emphasizes on the restoration and maintenance of health to persons. On the contrary, medicine has developed as an illness oriented profession aimed at prevention and cure of illness, injury and deformity through different medical techniques. The way the two jobs are carried out differ in many aspects and this has lead to altogether different ethics for each of the two. A physician job’s is much of a consultative in nature, without getting too much involved in the patients situation. For example, the physician obtains a medical history, reviews signs and symptoms of disease processes, obtains consent for proposed interventions, documents orders, supervises the training of other medical personnel in administering therapeutic procedures, reviews examination and test results, monitors clinical progress, and arrives at a diagnosis and therapeutic regimen [ Sarah Breier-Mackie]. On the other side, a nurse goes beyond what the doctor does. The nurse’s interaction with the patient is far more in-depth with a greater involvement in the patients’ activities. A nurse is always present by the side of the patient, providing him/her with constant company and someone to count on when needed. The ever presence of nurse in such a situation creates a feeling of trust that helps the patient to recover quickly and effectively.
Florence Nightingale, much known for her contribution in the field of medicine, was the first one to make a proper distinction between the two professions. She said, “Medicine is the surgery of functions, as surgery proper is that of limbs and organs. What [nursing does] … is to put the patient in the best condition possible for nature to act” [Lavin Mary Ann]. An interesting note on which nursing differentiates itself from medicine is in the word “nursing’’ itself. The term’ nursing’ originates from the Latin word nutria, meaning to nurture. Thus, nursing is akin to mothering in that it fosters education, growth, and protection of those in childlike states where they are unable to provide for their own care [Sarah Breier-Mackie].
Not only the way in which the two jobs are carried out differ, significant other disparities may also be explored between medicine and nursing. The research methods differ greatly for the two fields. Considering medicine, the research focus on how subjects are selected and assigned to groups. Such methods include the double-blind, randomized controlled trial; the randomized controlled trial; the controlled trial; and the cohort, case control, and case series [Sarah Breirer-Mackie]. While many of these methods are applicable to nursing as well, research in nursing extends to a greater variety of methods. Nursing’s research should be broad enough to include the necessary studies of medicines plus the conduct t that is required by the profession. It is thus impeccable for a person in nursing profession not to just stick by the books and the theory of medicine but rather explore beyond to provide a deeper insight into a particular situation.
One of the key differences in the two professions is the composition of gender in both the fields. There is a strong cultural bias in almost every society in the form of dominance of men in medicine and concentration of women in nursing. It has a lot to do with the perception of people who think that nursing is predominantly a women profession as it relates to caring and nurturing. This forms the basic reason why women lag behind in becoming physicians and doctors. Even if a nurse excels in what she does, she is not promoted to a full time doctor. The most that is done to such a nurse is to give her a post of junior doctor, remaining under the supervision of a senior doctor.
The professions of nursing and medicine are contrary to each other also in terms of the subject matter that is used. Medicine not only looks at how subjects are selected and assigned to groups, but it also categorizes these studies according to whether they apply to therapy, diagnosis, prognosis, etiology, prevention, or quality improvement [ Lavin, Mary Ann]. Though it may seem that these terms are used by nurses too but the way in which the two jobs carry out their diagnosis prove the point. In the article ‘Essential differences between evidence-based nursing and evidence-based medicine’, the authors put forward many metaphors to distinguish medicine from nursing. Medicine defines diagnosis in terms of diseases whereas nursing define it in terms of human response to illness and health. Medicine defines therapy in terms of treatment like drugs while nursing defines it in terms of nursing treatments and interventions itself. Medicine defines etiology in terms of disease etiology while nursing defines it in terms of factors related to human responses to health or illness. Such examples reiterate the fact that despite of the same terminologies used in nursing and medicine, the way two are executed in quite a different manner.
All the above major factors are useful in understanding two professions. However, there are many more relatively insignificant indicators of how nursing and medicine differentiate themselves form each other.
Educationally wise, nursing and medicine constitute altogether different styles of subjects. The study of medicine is much more rigorous and demanding than that of nursing. The former requires more time and effort to be spend on it to get one a degree while the latter is usually less of a headaches for students. The way the two subjects are taught are very different in terms of teaching styles, content and the depth of the information present in each of the area. Medicine has fewer mature students compared to nursing where the majority of the students are of older age with different backgrounds. Such differences simply reflect how different the two professions are in practice.
Money is a major factor that separates doctors from nurses. Doctors make money far greater that what nurses earn. This is obviously due to the rigorous training and education doctors have to go through but the financial reward they get once they start practice outweighs all the hard work. Doctors on average make anywhere from $150,000 to $200,000 per year, with highly specialized or renowned surgeons making even more than that [Eric Hebert]. On the other hand, nurses often find themselves in a weaker financial position, at times unable to meet their ends.
Although doctors and nurses work at the same workplace, the level of authority being practiced by each of them differs vastly. Most of the time, the doctor is running the show with a team of nurses. Doctors are said to be on the top of the ladder of medical profession and lead from front. It is common perception that doctors and nurses work in a same environment. However, this is true only if it relates to physical environment. The social environment is very much different for both of them. The doctors control such an environment with nurses simply obliging to their orders and instructions. Nurses act very much like soldiers on front line, winning the small battles and calling upon the doctors when big problems arise [Eric Hebert]. So while the doctors and nurses work under the same roof, their approach is much varied and they hold different positions on the field.
The perception of general public plays a key role in defining a particular act in a society. Generally, doctors are perceived to belong to an elite class of group being rich, intelligent and powerful. Nurses, however, are looked upon as working class group performing ‘blue-collar job’ while doctors carrying out the ‘white-collar job’. However, as more advanced nursing programs develop and the need for more APN grows, the line in perception begins to blur as people take notice of the different grades the nursing profession offers [Eric Hebert].
Nurses and doctors also differ in length of college study. While some nurses obtain
a specialized degree in a graduate program, the minimum degree requirement for a registered nurse (RN) is a four-year bachelor's degree. A doctor, however, must obtain a PhD, which takes eight years on average. A specialist physician, however, could remain in college for over a decade.
While it is obvious that the career of a doctor and nurse are different, it is important to note that the two complement each other in the process of healing patients. Neither could exist without the other and neither role is more important. Without doctors, the patient’s diagnosis would not be delivered whereas without nurses, the medical treatment and other services would be put to a halt. Whether such differences constitute an important part of medical ethics, following argument is valid. Support and care are the virtues of nursing whereas authority, courage and decision making are those of medicine.
Sarah Breier-Mackie PhD, RN (March/April 2006). Gastroenterology Nursing
Lavin, Mary Ann (Sep 2002). Essential differences between evidence-based nursing and evidence-based medicine
Richard T. Hull. Nursing Outlook 1982.
Erich Hebert (March 2007). The Difference between Doctors and Nurses