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    Read this article recently about what distinguishes doctors from nurses, according to the article, not very much at all.

    "Lifestyle and money? Nope. A primary care doctor makes less than a nurse anesthetist. Some doctors don’t take call anymore, and many nurses do, even those without advanced degrees.Surely knowledge, skill, and ability separate nurses from doctors? Of course not. Your experienced floor nurse knows way more about medicine than your average intern. Physicians assistants can sew up wounds and assist in surgery. A person who becomes a nurse is just as smart as a person who becomes a doctor, which has always been true but not always acknowledged. An MD is just a piece of paper that gives a person permission to start learning how to be an actual doctor."

    So what do you guys think, is there a real difference or is it all a matter of prestige?
    I know its apparently a common interview question to ask why one wants to go into medicine and not become a nurse.
    do you think most people want to become doctors because of perceived prestige and respect associated with the title if the roles arent even that different?

    Would love to hear some opinions
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    US article, there is a different relationship and dynamic in the US

    1. the US has had Nurse Practitioners for far longer than the UK, the US has Physician Asssistants which we don't have in the UK (as a primary registration - although the role exists in some specialities for RNs and ODPs)

    2. the US has a different career structure for Doctors.

    if you are exploring the issue for a paper or as part of preparation for interview, understanding the differences between the ' the Medical Model' and a the bio-psycho-social models that drive Nursing /AHP practice would be a start but also understanding how the tweo relate and aren't exclusive to either profession
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    Well for one, doctors make the most important and crucial decisions.

    I do agree that nurses are underestimated in the knowledge they have, they're a valuable resource indeed
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    (Original post by insert-username)
    Read this article recently about what distinguishes doctors from nurses, according to the article, not very much at all.

    [/FONT][/COLOR]
    So what do you guys think, is there a real difference or is it all a matter of prestige?
    I know its apparently a common interview question to ask why one wants to go into medicine and not become a nurse.
    do you think most people want to become doctors because of perceived prestige and respect associated with the title if the roles arent even that different?

    Would love to hear some opinions
    I must say i agree with your second paragraph.
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    (Original post by zippyRN)
    US article, there is a different relationship and dynamic in the US

    1. the US has had Nurse Practitioners for far longer than the UK, the US has Physician Asssistants which we don't have in the UK (as a primary registration - although the role exists in some specialities for RNs and ODPs)

    2. the US has a different career structure for Doctors.

    if you are exploring the issue for a paper or as part of preparation for interview, understanding the differences between the ' the Medical Model' and a the bio-psycho-social models that drive Nursing /AHP practice would be a start but also understanding how the tweo relate and aren't exclusive to either profession
    I know that this article relates to the US but I'm obviously asking in a thread based in the UK to get some discussion going about what its like in the UK health system. I'm not a doctor and would genuinely like to learn a little more about what distinguishes doctors from nurses in the UK. also a good way to learn a bit more and get a discussion going as i think its a very interesting topic.
    "2. the US has a different career structure for Doctors. " bit confused with what you mean by this? do you mean the training route is different?
    because as far as I know career structures are the same for doctors everywhere. A neurologist in the UK is no different from a neurologist in the US.
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    [QUOTE=zippyRN;52621937 the US has Physician Asssistants which we don't have in the UK (as a primary registration - although the role exists in some specialities for RNs and ODPs)
    [/QUOTE]

    We've got them in my hospital, I believe there's a couple of universities training Physician Associates now.


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    As zippyRN says, it's difficult to directly compare the US system to the UK. We are a fair few years behind in the implementation of nurse practitioners and physician assistants (although we do now have them).

    Being perfectly honest, senior nurses are capable of a lot (probably more than junior doctors). What distinguishes doctors though is the capacity to make decisions. Nurses tend to work within rigid frameworks and guidelines and the moment something a little different happens, they require leadership and guidance. For sure, they possess the clinical skills and for some, even the knowledge and aptitude; however; that is not the key role of a doctor within a multi-disciplinary approach, for example.

    Secondly, I believe that responsibility sets the two apart. Whilst nurses are in charge of direct patient care, they are not generally responsible for the patient. Again, this is a decision making process and similarly to above, doctors are not constrained to conventional thinking. They are regularly forced to try and think 'outside the box'.
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    (Original post by Kyalimers)
    As zippyRN says, it's difficult to directly compare the US system to the UK. We are a fair few years behind in the implementation of nurse practitioners and physician assistants (although we do now have them).

    Being perfectly honest, senior nurses are capable of a lot (probably more than junior doctors). What distinguishes doctors though is the capacity to make decisions. Nurses tend to work within rigid frameworks and guidelines and the moment something a little different happens, they require leadership and guidance. For sure, they possess the clinical skills and for some, even the knowledge and aptitude; however; that is not the key role of a doctor within a multi-disciplinary approach, for example.
    that's a symptom of two main factors

    1. Senior Nurses in Management are almost universally traditionally trained and therefore powerfully socialised into the old ways of thinking and doing things

    2. Lsy Management are very happy to find a Nurse to |Blame and ward managers / Matrons happy to let that happen

    Secondly, I believe that responsibility sets the two apart. Whilst nurses are in charge of direct patient care, they are not generally responsible for the patient. Again, this is a decision making process and similarly to above, doctors are not constrained to conventional thinking. They are regularly forced to try and think 'outside the box'.

    Nurses are accountable for the patient shift to shift and will be held responsible for things that Junior Doctors do or don't do . It's Doctors who are not accountable for patient management until they reach CCT and are in consultant / Ass Spec / GP posts.


    With regard to Physician assistants in the US model of PAs working i nthe UK ;
    what legal processes allow them to prescribe medication or undertake interventions where medications are used ? ( and supplementary prescribing ( i.e. ticking off on a pre prepared list is not legal unless you hold an eligible Primary professional registration and the relevant post reg course , and PGDs cannot be used by none HCPs
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    (Original post by Mrs House)
    Well for one, doctors make the most important and crucial decisions.
    Thats quite a broad statement. I don't agree in general.
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    (Original post by zippyRN)
    Nurses are accountable for the patient shift to shift and will be held responsible for things that Junior Doctors do or don't do . It's Doctors who are not accountable for patient management until they reach CCT and are in consultant / Ass Spec / GP posts.
    That is the point... You don't stay a junior doctor; you train specifically to become a consultant and hold direct responsibility.
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    (Original post by KingGoonIan)
    Thats quite a broad statement. I don't agree in general.
    Give some examples of life saving decisions nurses make? I'm pretty sure doctors come up on top- according to what ive seen and what a CT1 told me.

    as has been said above, nurses take care of the patient but doctors are responsible for and make decisions on a daily basis regarding the patient care plan.
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    (Original post by insert-username)
    Read this article recently about what distinguishes doctors from nurses, according to the article, not very much at all.

    [/FONT][/COLOR]
    So what do you guys think, is there a real difference or is it all a matter of prestige?
    I know its apparently a common interview question to ask why one wants to go into medicine and not become a nurse.
    do you think most people want to become doctors because of perceived prestige and respect associated with the title if the roles arent even that different?

    Would love to hear some opinions
    You're reading an american article written by a noctor. I would take it with a pinch of salt.

    The rough and short of it is as follows:

    Senior doctors
    Make management decisions (starting/stopping non-basic meds, operations etc)
    Request advanced investigations
    Interpret said investigations
    Perform various advanced practical procedures on the wards
    Make decisions regarding discharge & follow-up
    Make decisions regarding monitoring & hospital location (ward, HDU, ITU)
    Run outpatient clinics/theatre lists/endoscopy lists etc etc

    Junior doctors
    Do initial clerking of patients
    Instigate basic investigations (bloods, imaging)
    Formulate an initial diagnosis
    Initiate first few steps of management
    Perform various basic practical procedures on the ward (cannulas, ABGs & catheters mainly)
    Review blood results and manage/escalate accordingly
    Organise the management requested by the senior
    Organise notes and paperwork for all the above
    Organise referrals, TTOs, drug kardexes etc
    Firefight on a large number of wards overnight
    Rearrange deckchairs on the titanic

    Nurses
    Responsible for administering medications & fluids
    Responsible for basic care of the patient
    Take vital observations of the patient
    Recognise deterioration & know when to escalate care
    Can also perform practical procedures here and there (bloods, cannulas, catheters, ECGs)
    Often the ones who communicate with families the most & nitty-gritty of discharge planning
    Probably many other unseen things which actually keep the wards together, but I am entirely ignorant of

    However, in the UK, these boundaries are becoming increasingly blurred as we see more specialist nurse practitioners who are very skilled in their area of medicine/surgery and can act relatively independently with consultant input as needed.
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    (Original post by Mrs House)
    Give some examples of life saving decisions nurses make? I'm pretty sure doctors come up on top- according to what ive seen and what a CT1 told me.

    as has been said above, nurses take care of the patient but doctors are responsible for and make decisions on a daily basis regarding the patient care plan.
    life saving decisions Nurses make

    - initial assessment and triage
    - resuscitation
    - when to call on call medical staff
    - ordering urgent investigations

    there seems to be a perception that Nurses stand around waiting for Doctors orders when there is a problem

    where the reality is that as well as speaking to on call medical staff , most acute settings will also be ordering / drawing / running tests and investigations

    I think you'll also find it;s the Nurses who share the overall accountability with the Consultant , not as is often portrayed on TSR junior doctors making decisions and the nurses following these decisions.
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    (Original post by Etomidate)
    You're reading an american article written by a noctor. I would take it with a pinch of salt.

    The rough and short of it is as follows:

    Senior doctors
    Make management decisions (starting/stopping non-basic meds, operations etc)
    Request advanced investigations
    Interpret said investigations
    Perform various advanced practical procedures on the wards
    Make decisions regarding discharge & follow-up
    Make decisions regarding monitoring & hospital location (ward, HDU, ITU)
    Run outpatient clinics/theatre lists/endoscopy lists etc etc

    Junior doctors
    Do initial clerking of patients
    Instigate basic investigations (bloods, imaging)
    Formulate an initial diagnosis
    Initiate first few steps of management
    Perform various basic practical procedures on the ward (cannulas, ABGs & catheters mainly)
    Organise the management requested by the senior
    Organise notes and paperwork for all the above
    Organise referrals, TTOs, drug kardexes etc
    Firefight on a large number of wards overnight
    Rearrange deckchairs on the titanic

    Nurses
    Responsible for administering medications & fluids
    Responsible for basic care of the patient
    Take vital observations of the patient
    Recognise deterioration & know when to escalate care
    Can also perform practical procedures here and there (bloods, cannulas, catheters, ECGs)
    Often the ones who communicate with families the most & nitty-gritty of discharge planning
    Probably many other unseen things which actually keep the wards together, but I am entirely ignorant of

    However, in the UK, these boundaries are becoming increasingly blurred as we see more specialist nurse practitioners who are very skilled in their area of medicine/surgery and can act relatively independently with consultant input as needed.
    your list of things is very much blurred and has been for a good number of years

    as an RN i've been in roles where requesting investigations has been part of my role for 10 + years and it wasn't new then ...
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    (Original post by zippyRN)
    life saving decisions Nurses make

    - initial assessment and triage
    - resuscitation
    - when to call on call medical staff
    - ordering urgent investigations

    there seems to be a perception that Nurses stand around waiting for Doctors orders when there is a problem

    where the reality is that as well as speaking to on call medical staff , most acute settings will also be ordering / drawing / running tests and investigations

    I think you'll also find it;s the Nurses who share the overall accountability with the Consultant , not as is often portrayed on TSR junior doctors making decisions and the nurses following these decisions.
    You've only listed one decision, the rest aren't decisions they're just treating a patient.

    And again, nurses have to rely on medical staff to make the important decisions as some nurses don't/may not have the capability/knowledge/experience to do it independently.
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    (Original post by Mrs House)
    You've only listed one decision, the rest aren't decisions they're just treating a patient.

    And again, nurses have to rely on medical staff to make the important decisions as nurses don't have the capability/knowledge/experience to do it independently.
    Nurses may have to officially rely on doctors to make the decisions but don't assume that they don't have the knowledge or experience to know what that decision needs to be.
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    (Original post by ForestCat)
    Nurses may have to officially rely on doctors to make the decisions but don't assume that they don't have the knowledge or experience to know what that decision needs to be.
    I know some nurses are very experienced but some aren't and need guidance. Yeah it's all official and legally nurses can't do what they've seen doctors do a million times so they may have the knowledge experience etc they still can't do it
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    (Original post by Mrs House)
    You've only listed one decision, the rest aren't decisions they're just treating a patient.

    And again, nurses have to rely on medical staff to make the important decisions as nurses don't have the capability/knowledge/experience to do it independently.
    and how many years clinical experience have you got *as a Healthcare professional*

    becasue junior doctors with that kind of attitude find themselves alone, alienated and looking at poor evalutations
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    (Original post by Mrs House)
    I know some nurses are very experienced but some aren't and need guidance. Yeah it's all official and legally nurses can't do what they've seen doctors do a million times so they may have the knowledge experience etc they still can't do it
    would you like to tell me what a Nurse *cannot legally do* ...

    vs things which nurses do not delcare competence in due to organisational issues or a lack of numbers of procedures to maintain currency AND allow *Doctors in training* to do sufficient numbers of these procedures to demonstrate the competencies


    there is also an issue with Nursing Staff and other AHPS where certain skills / groups of skills/ interventions may trigger a job evaluation re score , which many trusts are unwilling to do.
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    (Original post by zippyRN)
    your list of things is very much blurred and has been for a good number of years

    as an RN i've been in roles where requesting investigations has been part of my role for 10 + years and it wasn't new then ...
    Well, I'm just trying to give OP an idea of what the day-to-day responsibilities are for the majority of the people in those positions.

    Your average staff nurse on your bog standard general medical/surgical ward won't be spending a significant part of their every working day requesting xyz investigations as far as I am aware.

    This will clearly be very different for say, a specialist respiratory nurse running a COPD clinic.
 
 
 
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