What is the relationship between medicine and nursing?

One way to characterize the difference between medicine and nursing sees physicians as focused on treating the disease and curing the patient, while nursing focuses on caring for the patient as a person.

While nurses learn about human anatomy and all methods of care, medical practitioners are also trained to have much more knowledge of the human anatomy as well as medicines. While nursing focuses on the social and emotional needs of patients, medicine focuses on their physical needs. The main difference between nursing and medicine is that nursing is a practice of care that is linked to the practical process of taking care of people, helping people to recover from ill-health, and also to have better health. On the other hand, medicine refers to the study and application of drugs for the treatment of a disease.

Both nursing and medicine are important in ensuring that people recover from illness and injury. The duties of a nurse vary greatly, but it’s important to note that a nurse is not a doctor, yet a nurse needs to work closely with a doctor to ensure the best care for their patients.

Health care professionals that work in the medical field, who are specially trained to care for sick, disabled, or injured individuals, practice nursing. They are responsible for monitoring the health of their patients, administering treatment, teaching and guiding patients and their families, and delivering health care services to patients and their families.

Nursing means that you are making sure that something is happening correctly. It is about providing care and making sure that someone is doing well. A nurse is the one who helps people who are sick and injured feel better. If you are a nurse, you should take care of patients who are in the hospital, nursing home, or even their own home.

Nurses help their patients by taking care of them, making them take their medicine, and other things that will help their patients feel better. Nursing is a very important job. It is helpful to take care of patients and give them the attention that they need.

Nurses have varying specialties, and they must complete many years of training to practice. Usually, a person has to have at least a Bachelor’s degree in Nursing to practice as a nurse. Or an Associate’s Degree in Nursing, which usually takes around three years.

They must have excellent physical and mental health, as well as a lot of patience. Nurses work in hospitals, nursing homes, and other in-patient facilities. As a nursing student, there are many options in your future, such as working in an emergency room, pediatrics, or hospice care.

Medicine refers to the medical field that is related to diagnosing and providing the correct medicine and treatment to the patient.

A doctor is a person who practices medicine. A doctor is often called a physician in North America or a “medic” in colloquial speech. A doctor who practices medicine is known as a medical practitioner in Commonwealth countries and a medical doctor (M.D.) or a physician in the United States.

A medical practitioner is someone qualified to practice medicine. They have been trained extensively to treat the issues that our bodies encounter in life. They are trained in laboratories and the field by experienced medical practitioners. Usually, to become a medical practitioner, a person has to complete at least a Bachelor’s of Medicine Degree, which is of four years.

Parameters of Comparison	Nursing	Medicine
Meaning	Nursing refers to the medical field that provides care and support to the patient.	Medicine refers to the medical field that is related to diagnosing and providing the correct medicine and treatment to the patient.
Degree	For becoming a nurse, a person has to pursue Bachelor’s Degree in nursing.	For becoming a medical practitioner, a person has to pursue MBBS or MBD, or MD.
Course Time	Usually, nursing courses range from 18 months to three years.	Usually, to practice medicine around 4-7 years is required to the least.
Duties	The duties of a nurse are to provide emotional and physical support to a person as prescribed by the doctor.	The duties of a medical practitioner are to diagnose and prescribe medicines to a patient.
Specializations	Usually, a nurse does not require any specializations.	Usually, doctors have to specialize in a certain aspect of medicinal treatment like heart, bones, skin, etc.
Annual Cost	Nursing usually costs less than medicine.	Medicine usually costs more than nursing.

Main Differences Between Nursing and Medicine

1. Nursing and medicine are highly competitive fields to get into. One major difference is that it is easier to be accepted into the nursing field than in the field of medicine.
2. The nurse is the one who monitors the patient and their conditions. The doctors are the ones who treat the patients and prescribe medicine.
3. Nurses are also taught to be more empathetic towards the patient and are encouraged to develop a rapport while doctors, while still caring and compassionate, are trained to treat patients more efficiently and to have a more detached approach.
4. While nurses learn about human anatomy and all methods of care, medical practitioners are also trained to have much more knowledge of the human anatomy as well as medicines.
5. While nursing focuses on the social and emotional needs of patients, medicine focuses on their physical needs. The previous information was taken from the website askanydifference.com.

How Nursing Has Changed Over Time

The following was taken from the website minoritynurse.com which was written by Journalist Chelsy Ranard.

When nursing began it had very little to do with formal medical training and everything to do with your gender and willingness to do the job. In the early days of nursing, women learned medical skills from their mothers or other women in the same profession. It wasn’t really seen as a respected trade, but women weren’t really seen as a respectable gender, either. Women were caretakers, so nursing was just an extension of what their roles at home were anyway. Today, the nursing profession has changed drastically. There are extensive training programs, more diversified staff, and a level of prestige associated with this area of the medical field that wasn’t there before.

Time has done a lot for many career paths, but the nursing field has seen drastic changes to help the efficiency of medical care. There are more training programs, better hospitals, more responsibility, a sense of family, and a focus on patient care in the nursing industry that has saved lives and created generations of dedicated medical professionals.

Training

Training for nurses was very rudimentary in the beginning of the profession. Early on, training wasn’t even necessary and organized training wasn’t offered to caretakers. Many of those that were sick were offered care by mothers and family members, not outside health providers. Florence Nightingale was one of the first nurses offering some sort of training for nurses in Britain in the late 1800’s where she taught certain principals to women that wanted to be caregivers. In the United States, lectures and instruction manuals were offered for women to learn how to give care to women during childbirth and postpartum period. The Civil War caused many more women to join the rising number of hospitals offering nurse training that was more of an apprenticeship than the training programs we see later.

Today, the qualifications for nurses are very specific and in depth. There are a wide variety of nursing programs, specialties, degrees, and certifications for different types of nursing, but all of them require the student to pass different certifications in order to provide health care to patients. In the first half of the 20^th century, nurses were taught basic health care skills as well as hospital etiquette, such as how to address patients, how to dress, and to treat patients like they are guests in their home. Now nursing training is focused on the academic side—and not so much on wearing stockings and addressing patients by their surname.

Setting

The health care setting used to be in the home or on the battlefield for many women in the nursing field. There was a clear preference and need for health care to be practiced at home whenever possible. Home visits were more common than visits to the hospital, which were mainly reserved for those that were extremely ill, badly injured, or near death. It wasn’t until the early nursing programs that nurses started working inside hospitals as employees who obtained medical knowledge and not just an orderly who changed bedpans.

Now the medical settings for nurses are hospitals, physicians’ offices, home health care services, or assisted living facilities. Nurses are now medical professionals that are needed in schools, correctional facilities, or the military. Nurses are even traveling to fulfill nursing needs across the United States while gaining experience and pay. The setting for nurses really started to change with the added training for nurses that made them more respected medical personnel and not just women who focused on assisting doctors and giving sponge baths. With the added responsibility came the need for nurses all over the country, and many women flourished with this career path working in hospitals more than just providing care in the home.

Responsibilities

Nursing responsibilities used to read a lot like a household chore list, and it’s come a long way since. The change in responsibilities for nurses stem from a few changes in the field, including more comprehensive training, changing views of women, and the need for medical professionals growing quickly. When training for nurses became more extensive and required schooling, the education system started teaching nurses tasks that were originally reserved for physicians. This allowed physicians to concentrate on higher levels of education themselves and nurses were allowed more decision making for their patients. The view of women when nursing started was that they were subservient caretakers, and the nursing world wasn’t exactly seen as a prestigious career because of it. Once women started to become more respected and allowed to enter the workforce, obtain nursing degrees, and have more responsibilities in the medical industry, the nursing perception began to change.

Now the role of the nurse is not easy to define for many medical professionals. They take on many more responsibilities than they ever have before and are seen as respected medical professionals because of their extensive schooling and real world application of skill. The medical world is always changing and growing, which opens up a need for personnel in many hospitals constantly. With the growing amount of patients in our hospitals it’s important that our nurses know how to handle medical emergencies without asking a physician for aid, so that is what our educators are focusing on. Nurses are not seen as a doctor’s assistant, but rather as their own professional with the medical knowledge to back it up.

Culture

Nursing culture in the early 20^th century was known as being mostly female with a rudimentary amount of medical knowledge. There was a focus on being presentable, acting respectfully, and acting as the obedient wife to every patient. In World War II, nurses were badly needed but many women were starting to shy away from the profession because they weren’t seen as professionals, endured demanding work schedules, and were unable to keep up financially. When nurses started to be revered as heroes in order to help raise the nursing numbers the numbers started to rise a little. Today, this culture has changed a lot; nursing is about education and health care knowledge, has diversified the gender norm, and nursing salaries are rising due, in part, to the nursing shortage caused by retiring baby boomers.

Some nursing culture hasn’t changed a ton comparatively. Nursing is still seen as an extremely cumbersome job to have with nurses working very long hours, standing on their feet for most of their day, and having little time for their personal lives that doesn’t involve sleeping. They have historically suffered from back pain, high stress levels, and dealt with nursing shortages leading to unfavorable nurse to patient ratios.

Patient Care

Patient care is now an extremely important factor in the medical field for all medical professionals. The advancements in technology have created an environment that makes patient care more efficient and helpful for the patient. Technological advancements have changed almost every industry in the US and the medical field is no different. This has helped save more lives, made certain jobs easier for nurses, and created a better experience for patients. The culture for patient care used to be a very demoralizing experience for many patients where medical professionals weren’t as concerned for their dignity or enduring painful medical procedures. Luckily, patient care has become the number one priority for medical professionals and has flourished in recent years with nurses on the front lines of patient care.

The nursing profession has come leaps and bounds and continues to be a growing field. Historically, it has proven its ability to adapt to the culture around it. For nurses and patients alike, the advances made have helped the nursing field to go from being one that isn’t revered as being one that deserves respect. The changes in training, health care setting, growing responsibilities, nursing culture, and patient care have saved countless lives and helped it become the respected field that it is today.

PHYSICIAN AND NURSE RELATIONSHIPS

The following material was taken from the University of Missouri School of Medicine.

Relations between physicians and nurses are sometimes strained. Physician-nurse conflict, tension, and stress have been thought to be contributing factors in job dissatisfaction and burnout for nurses.

Controversy arises about the reasons for physician-nurse conflict, possible solutions to this problem, and the proper relationship between physicians and nurses. 

Conflict and tension do not characterize all physician-nurse relations.  In many healthcare contexts physicians and nurses communicate and work together to serve their patients.

Conflict can occur between workers in business and professional contexts outside of healthcare, of course.  Workers may not get along because of personality differences of various sorts.  Workers may perceive they are being treated unfairly relative to coworkers.  The organization may create a situation of competition among workers.  Sexual harassment can occur.  Situations such as these may conflict and tension between coworkers or between supervisor and coworker.  Ideally, management should be made aware of such problems and take steps to address and resolve them.

One can consider relations between physicians and nurses from the perspective of physicians or from the viewpoint of nurses.  Some research seems to show that physicians perceive less of a problem than nurses do.  In other words, nurses seem to think there is more of the problem than do physicians.

There may be a conflict about physician orders.  For example, a nurse could disagree with a physician about the appropriateness of orders the physician has given for testing or medication for a patient, or think the physician should give orders for pain medication the physician has refrained from providing.  The nurse could feel he or she knows the patient better than the physician does or have ethical qualms about the proposed action.  Nurses can get frustrated if they feel their concerns, questions, and opinions about patient care or other processes are being ignored.

Nurses often have to call physicians to ask for clarification or instruction in how to proceed with a particular patient, and physicians are not always receptive to such calls.  Physicians are sometimes impatient when the nurse does not have all the available information about the patient at hand that the physician needs to make a decision. 

Other situations can arise in which physicians are verbally (or even physically) abusive toward nurses, shouting at them or publicly correcting them with denigrating language.  A physician might be frustrated with a new nurse who does not know how to perform a task efficiently, or with a nurse who has not administered a medication to a patient as quickly as the physician desired.  Physician workload and time pressures can make them impatient with nurses who they perceive as taking too much of their time.

As mentioned above, interpersonal conflict occurs in many areas of business and personal relationships and sometimes it is due to the particular personalities of the parties involved.  Some people are simply less friendly, more impatient, have greater expectations, etc. than others.  This can occur in relations among physicians, among nurses, and between physicians and nurses.

Reports of physician-nurse conflict appear more widespread than could easily be attributed to just the typical personality clashes one finds in the workplace and society in general.  Several possible sources of conflict between physicians and nurses that have been repeatedly suggested are (1) the power imbalance between physicians and nurses, (2) differing goals of medicine and nursing, and (3) gender conflict between physicians, who have traditionally been men, and nurses, who have been overwhelmingly women.

Power Imbalance

The power imbalance between physicians and nurses in modern healthcare in the United States is well known.  This power imbalance occurs both outside and inside healthcare. 

In American society, physicians commonly experience significant prestige, respect, and financial success, and in healthcare they enjoy great authority.  Their education is among the highest of any profession, consisting of college, medical or osteopathic school, years of residency training, and possibly additional fellowship training.  In contrast, nursing, though a highly-respected career, does not enjoy as much societal respect or financial compensation.  Clinical nurse specialists and nurse practitioners may have a graduate degree, but many nurses do not even have a bachelor’s degree.  Their educational level and status in general is much less than that of physicians.  Their authority in healthcare contexts is also typically less than that of physicians.  The physician bears primary legal responsibility for the patient.  It is the physician who makes the key decisions about patient medical diagnosis and treatment and issues orders that nurses are expected to follow.  Physicians, who in hospitals are not the direct supervisors of nurses, nevertheless wind up often telling nurses what to do.  In small private medical practices employing a nurse the nurse is often hired and employed by the physician.

Hospitals are sometimes run with a dual management/authority structure consisting of a business or administrative hierarchy and a physician hierarchy.  The physician hierarchy enjoys significant power over crucial decisions concerning the current and future direction of the hospital.  The hospital nursing hierarchy usually enjoys no comparable authority.

Consequently, both inside and outside healthcare contexts, nurses have typically seen their role as subservient to that of the physician.  This power imbalance in the workplace and the education and socio-economic difference between physicians and nurses create the perception among nurses that their opinion in the healthcare context is not as valued as well as that of the physicians, creates situations in which their views are overridden or overruled by physicians, and results in tension and frustration on the part of nurses. 

Differing Goals of Medicine and Nursing

An outdated image of nurses sees them as merely doctor’s helpers, but nursing theorists claim this is a misconception of the proper role of nursing.  One way to characterize the difference between medicine and nursing sees physicians as focused on treating the disease and curing the patient, while nursing focuses on caring for the patient as a person.  (Obviously, though, physicians are concerned that their patients receive proper care and nurses are concerned that disease be eradicated.)

The differing goals of the physician and nurse for the patient are sometimes thought to be a source of conflict.  The nurse may believe he or she is more focused on the patient’s state of wellbeing and therefore should have a larger say in their care.  A specialist physician or hospitalist treating a patient in a hospital often sees the patient less than the nurse assigned to care for that patient; consequently the nurse may feel he or she knows the patient’s care needs and what the patient can tolerate better than does the physician.  The nurse may feel that he or she deserves more responsibility and authority for the patient than is allowed by the current system, with resulting nurse frustration, resentment, tension, and stress.

Gender Conflict

Years ago, virtually all physicians in the U.S. were men and all nurses were women.  Though today there are male nurses, the large majority of nurses are still women. The majority of physicians overall are still men, though women make up a great percentage of recently graduated physicians and current medical school students.

Some believe the conflict between physicians and nurses to be partly or largely attributable to conflict between the roles of men and women in society.  Many ethicists and political thinkers claim historical oppression of women in jobs, wealth, and power in society, though some progress eliminating such disparities seems to have been made in recent years.  The physician in the hospital, so the theory goes, sees the nurse as subservient because traditionally the nurse has been female and females have been subservient in society.

All of the above factors deserve consideration as causes of conflict between physicians and nurses.  Such factors and the resulting tension and stress can lead nurses to feel denigrated, disvalued, disrespected, intimidated, and disempowered.  Nurses who feel intimidated or have low self-esteem might be less inclined to point out errors they perceive a physician to be making.  The perception of denigration and disempowerment can lead to nurse job dissatisfaction and nurses leaving the profession, and ultimately poorer patient care.

Resolving Physician-Nurse Conflict

Though many suggestions have been made, the solution to physician-nurse conflict and resulting problems is not fully clear.

One common recommendation is to improve communication between physicians and nurses.  Poor communication can result in unmet expectations and resulting frustration and poor working relationships. But while better communication would help, it alone would not seem to solve problems engendered by massive power imbalances or sexism, for instance.  And specific recommendations about how to improve communication are needed.

Another suggestion often made is that there be available an optimal method of conflict resolution.  Nurses sometimes avoid conflict or are resigned to it, whereas some form of conflict resolution fostering collaboration and cooperation might help alleviate physician-nurse tensions and achieve better overall outcomes.  This is a good suggestion, but it is not clear that it is realistic to expect physicians to participate in any such method of conflict resolution if they are satisfied with the status quo or perceive the problem to be something nurses just have to work out for themselves.

Sometimes the suggestion is made that nurses should strive for more independence, power, and authority.  Many nurses are already doing that.  Needed are ideas on how nurses can attain greater power if physicians do not wish to relinquish it.

In recent years healthcare has emphasized the importance of the role of the multidisciplinary team.  A common idea is that the physician should see his or her place as a member of the team and in that context the contributions of others are to be valued.  It should be noted, though, that the physician is likely to see his or her role as being that of team leader or director, and so nurses may still feel their contribution is dictated or marginalized. 

An important point to note is that conflict between physicians and nurses is likely to hurt the optimal functioning of the team and result in poorer patient care and lower quality healthcare, so senior management in a healthcare organization should take whatever steps are necessary to ensure the organizational culture and management support create an environment in which such destructive conflict is minimized and nurses feel more empowered.

In a hospital setting, the head physician executive (such as the medical director) and head nursing executive (such as the director of nursing) should build a relationship of collaboration and mutual respect that can act as a model for others.  They should learn each other’s disciplines and contributions.  They should also develop an organizational vision of how physicians and nurses should interact.  This vision should include expectations of their own and other’s behavior – physicians stating their expectations for nurses and nurses stating their expectations for physicians.  The vision and expectations should then be translated into standards of behavior and concrete policies to correct misbehavior (violations of the standards).  Inappropriate behavior will not change unless it results in consequences for the perpetrator. 

Physician and nursing heads need the support of hospital management in this endeavor.  Furthermore, they should examine hospital systems and policies to ensure they are not interfering with the development of better relations; for example, if nurses have to police the physicians’ compliance with medical record policies, collaboration will be difficult.  Also, opportunities for collaboration should be pursued – physicians providing continuing education to nurses, nurse serving on credentialing committees, etc. — where they can develop respect and good working relations.

The problem of physician-nurse conflict needs to be addressed not just by individual clinicians but by a healthcare organization’s executive leaders.  Hospital administrators and managers may prefer to avoid dealing with the problem.  Rather than trying to sweep the problem under the rug, senior management should work to develop an organizational culture in which inappropriate attitudes and behavior of physicians toward nurses and vice versa are not tolerated.

Conclusion

Medicine requires doctors to have undergraduate degrees before entering medical school. While nursing does require a degree, it is not a prerequisite for becoming a nurse. Some people decide to go back to school for nursing. Nurses work in hospitals and private homes, and they may go on to become consultants for medical equipment manufacturers, educators, or healthcare administrators. Right or wrong nurses are held to higher standards. Nurses are held to a higher standard than other professionals because they deal with patients on a constant basis, and their actions could lead to injury or death to someone if they are not careful.

In the previous chapter on the history of nursing I describe in detail what they went through to legitimize the profession. There was a great deal of antagonism between the two medical disciplines. Medical doctors did not want to lose any power to nurses and they were very protective of their storied past. However they also did not want to be responsible for all the menial tasks that were required to return a patient back to a healthy state. They soon realized that medicine and surgical procedures alone were not enough. They realized that there was a need for another discipline in the medical field for a balanced patient care model to be present. It took constant hard work, constant pressure and assurances by the nursing professionals that they were not trying to take away their power before they finally acquiesced and gave in. I grumble about car plans and care maps, but they were an integral part in establishing the legitimacy of nursing. The care plans and the patient care act together acted as building blocks for the establishment of nursing as a profession. Nursing uses diagnosis as a tool just like medical doctors do, however our diagnoses revolve around recovery of the patient and the ability for self functioning.

Nurses have to walk a thin line every day so as not to be accused of practicing medicine without a license. The medical field is still controlled by the medical doctor and is order driven. Without physician orders there would be no care. Over the years the medical profession realized that doctors could not be everywhere nor did they want to be everywhere. Due to the inordinate amount of time and money involved in becoming a medical doctor, they needed to work in areas that were financially solvent, so that they could not only pay off their debts but to pay their overhead as well. This is where physician assistants and nurse practitioners came into play. They were simply willing to work in less populated and less lucrative areas. Therefore, I want to postulate that it was the almighty dollar and greed that played the greatest roll in helping to establish nursing as a profession.