- I’M A NURSE. I WANT TO BE A DOCTOR. WHAT ISSUES SHOULD I BE THINKING ABOUT?
One of the big issues for nurses is the nurse practitioner vs. MD question, discussed below; another is dodging the negative attitudes of nurses towards, as one poster put it, “switching teams”; and yet another, for many, is gaining the confidence to make the change. These are discussed in so many different forums that I have simply suggested a pair of search terms that you should use (making sure to set the time of posts to include all posts, either “From beginning” and button “Newer” or “From today” and button “Older”).
I realize that this seems like a pretty specific question if you’re not a nurse, and so maybe not worthy of the FAQs file, but using the search function of this site and then entering
RN OR nurs*
will show the many posts that discuss nursing, most from the points of view of nurses or people that at one time considered nursing. I won’t link to all of these threads here (again I’ll link below to one I posted to and so remembered and could find easily), but suffice it to say that if you’re a nurse and you’re thinking about becoming a doctor, you are far from alone. Use that above search as a start to finding your fellow nurses here at OPM.
OPM’s most often referred-to former nurse is our veteran member Mary Renard, RN, who is also a mom, third-year med student at George Washington, and all-around beloved superstar of geezer future doctors. However, as the above threads show, there are a number of others among us.
Among these many threads is one in which Zinacef posts a nursing advisor’s all-too-typical kneejerk negative response to the idea of becoming a doctor; both Mary R. and I discuss the pros and cons of nursing vs. medicine; I make a point-by-point comparison of some of the pros and cons of being a nurse practitioner vs. being a doctor; Mary R. explains her hesitancy about devoting herself to the advanced study of “nursing theory”, and others chime in too.
The AMA has a news article featuring nurses who made/are making the transition to being a doctor:
Nursing a dream: The drive to delve deeper into medicine
An urge to do more for their patients leads these nurses to become physicians.
By Myrle Croasdale, AMNews staff. July 29, 2002.
Cynthia Barker, MD, decided to go to medical school after the loss of two of her children sent her on a quest for knowledge.
She gave birth to four children in seven years but lost the first and the fourth. One died from undiagnosed eclampsia. Another was lost when the placenta abrupted.
Her obstetrician supported her desire to find out what happened and why, even offering his library. "He said, 'Read to your heart's content.' He was as devastated as I was," she said.
The research sparked an interest in women's health which, at age 28, led her to begin an undergraduate degree and follow that with medical school. Dr. Barker did two years of residency at Washington Hospital Center, Washington, D.C., and finished, serving as chief resident, at the Brody School of Medicine at East Carolina University, Greenville, N.C. She is now an assistant clinical professor in obstetrics and gynecology at ECU's medical school.
While it was her experience as a mother and a patient that inspired her to become a physician, Dr. Barker was no stranger to hospitals. Before she was a doctor, she was a licensed practical nurse.
Nurses who question a physician's orders are often met with a rhetorical challenge: If you want to be a doctor, go to medical school. Dr. Barker is in a unique subset of nurses who did.
These nurse-physicians share the drive to delve deeper into medicine and to write those patient orders themselves. They also share a style of doctoring developed from years of experiencing an intimacy with patients not often afforded physicians.
Edward Newton, MD, professor and chair of the ob-gyn department for the Brody School of Medicine at ECU, said Dr. Barker is not the only physician he knows who was a nurse first. They bring a different perspective to patient care than their more traditionally trained colleagues.
"They recognize the patient is more than a bunch of squiggles on a TV screen," he said. "They'll know patients will be having back pain if they've been in bed for five days.
"They better appreciate where the patient is in the family. As a nurse you deal with families. The physicians, they whiz in for five to 10 minutes and whiz out again, while the nurse is there all day and sees Aunt Sally and Uncle Billie and the five kids.
"They also tend to be better at documentation than the average physician, since nurses are used to doing a lot of documentation," Dr. Newton said.
Kim Hardin, MD, had a master's degree and had worked her way up to nursing professor when she went into medical school. She is now an assistant professor in pulmonary critical care at the University of California Davis Medical Center in Sacramento.
Art and science
"I think that I practice the art of medicine a little better than other folks who are science-minded," she said. "By nature I'm very compassionate and tend to be a patient advocate. I look at the person as a whole; that's part of why I went into nursing."
She sees that her patients, many of whom are in intensive care, are turned regularly, get oral care and have their hair combed. She makes sure their families are treated with respect.
"I will go the extra mile for my patients," she said. "I'll write the letter to Medicare to get them reimbursed for their hearing aid. ... I thought I was a patient advocate as a nurse, but now I really am a patient advocate. I thought I understood what doctors did, but I found out 'Wow, I really don't understand what the residents do.' I gained a sense of respect for what people give up to do this. It's incredibly demanding. You don't have control over everything as a nurse, but the flip side is that you can pass the buck. As a physician, the buck stops with me."
Lonnie Lee, MD, is a family physician in private practice with Kaiser Permanente in Hyattsville, Md. She went to medical school a couple of years after she finished her nursing program and has added alternative medicine and acupuncture to her practice.
"I don't know if it was because I was a nurse or who I am -- other medical students and residents had a strong focus on patient needs, but I think it helped me to focus on patients' needs a little more [than they did]," she said.
Gary Clark, MD, was fresh out of high school when he trained as a medic and went off to Vietnam. When he returned, his medic experience helped him pass the nursing boards. He worked as a nurse in the emergency department and intensive care while putting himself through college and medical school.
Now, he is a general surgeon with an emphasis on thyroid, adrenal gland and pancreas surgery for Kaiser in Richmond and Oakland, Calif. He also works with the University of California San Francisco, East Bay, surgery residency program.
"One of the things I try to instill in the residents is more empathy for the nurses, lab techs and physical therapists," Dr. Clark said. " to write their orders clearly, to not write unnecessary orders and to communicate directly with the nurses."
He's served as chief of general surgery at the medical center and has built an endocrinology surgical practice that draws referrals from across northern California.
"I think the only thing I really miss about being a nurse is the fixed hours, being able to go in and work an 8- to 12-hour shift," he said. "I picked general surgery, because I love operating and being able to fix something. You see something that's broken, take care of it and have a very grateful patient afterward, And I do a lot of unusual cases, which makes it really exciting."
Dr. Barker said nursing has given her an appreciation for patient education.
"I think nursing has helped me develop a closer rapport with patients. I'm not afraid to touch a patient or comfort them. I really like to educate patients and get them to buy into what we're doing. Ninety percent of my patients are compliant, which is unheard of. We discuss options. I don't just write out a prescription and say 'Do this.' "
She has a good rapport with hospital staff, as well. "I know both sides of the story and am more apt to listen to what a nurse says," she said. "They're with patients for far more many hours than you are. And I don't mind pitching in and helping when things are busy. If I need a new gown and bedpan for Mrs. So and So, I can do that and then they can help me when they're able."
Catherine Winchester, MD, a cardiologist at Community Medical Center-Fresno, Calif., values her background in nursing.
"We look at our patients a little differently," she said. "We see them from an emotional aspect much more than the physicians who have never been nurses. I pay more attention to the whole picture than my colleagues and to communicating instructions to my patients. The nursing part of me has done that."
A bumpy ride
While the other physicians said they faced obstacles during their physician training because they were nurses, Dr. Winchester's experience was particularly difficult. She found her expertise intimidated the other medical students.
"They knew you may know more than they did, and it was
quite threatening," Dr. Winchester said. "I did well in the clinical rotations, and they didn't want to be part of my team, because they didn't want to look bad in front of the instructors. That's what hurt the worst."
She found life as a resident brought more of the same.
"It was a high-powered residency, and they didn't want you to have a step up on them," she said of her colleagues.
Now that she's a physician at the hospital where she once worked as a nurse, she has to remind the staff that she's not a nurse anymore.
"I try not to let people know that I was a nurse, only because I want to be taken on the same footing as any other physician," Dr. Winchester said. "My colleagues, women and men, took it out on me, because I was a nurse and a woman. It's called the glass ceiling. You have to jump higher and prove yourself much more than a man. They're looking to see if they can break you. [But,] I've done a residency that most of them haven't, and I've proven myself through the years. They'd begrudgingly say, 'She's a competent physician.' "
But not every nurse-turned-physician felt ostracized. Dr. Barker found those who were part of her medical school and residency experiences supportive as she took breaks to pump while breastfeeding her children and tackled other demands of having a young family.
For many of these doctors, their experience in making the career change boils down to determination.
Nurse Cacia Engel is a second-year medical student. Her determination to be a doctor has lead her to the Caribbean.
"Go to the ends of the earth to make it happen, if it's your dream," Engel said. "I felt like a traitor for leaving nursing. Though I couldn't get into a U.S. school, I'm excited about this next step of my life. Nursing is a great way to get into medicine; the clinical background helps you appreciate medical school."
And the rewards can be great.
"Every day I go to work is exciting," Dr. Hardin said. "Not a day goes by that I don't have some significant impact on someone's health. Even if that means the patient dies, you assist them to end their life in a dignified manner."
Copyright 2002 American Medical Association. All rights reserved.