How physicians can help strengthen the nursing image and the nursing profession
Physicians wield unmatched authority over how the media presents health care and how the public sees it. Unfortunately, much of the worst media about nurses, such as Hollywood dramas, is created in collaboration with physicians. Physicians write for and advise television shows, and they consult on many media programs and news articles. It's no shock that these media generally show little interest in nursing. But the collaborating physicians often cause or allow the media to give physicians credit for the work that nurses really do and to present nurses as low-skilled physician subordinates.
We need physicians to try to understand nursing better. It appears that few physicians learn much about what nurses really do in medical school or afterwards. With only common social and professional stereotypes to go on, many physicians wrongly assume they are "in charge" of nurses and that nursing care is rudimentary. The media they create reflects that.
There are exceptions, almost all in the print media. Physician Pauline Chen has written some pieces for the New York Times that reflect an unusual awareness of the value of nursing.1 Physician Richard Gunderman and Michigan NP Peg Nelson have teamed up to write end-of-life care articles in The Atlantic since at least 2009. In December 2013 the magazine published "Midwives for the Dying," a piece that consisted mainly of Gunderman interviewing Nelson, as a palliative care expert, on how to give excellent end-of-life care.2 Later that month, the New York Times posted physician Barron Lerner's generally helpful blog review of a book about nurse "Sister" Elizabeth Kenny, a pioneer in polio care.
And in March 2014, physician Victoria Sweet published a very thoughtful piece in the Times about Florence Nightingale's work. Sweet admitted that she once thought of Nightingale in handmaiden and angel terms, but she later learned that the "Lady with the Lamp" actually transformed health care through research and advocacy in areas like hospital design, health statistics, and of course nursing. Sweet observed that Nightingale was "a fighter" whose study of hospitals led her to conclude that "patients get the best care when no single power is ascendant, rather when there is the 'perpetual rub' between doctor, nurse and administrator."4
One promising way to improve physicians' understanding is through structured interactions during their training, such as joint classes in which nursing and medical students learn together. Even a video explaining the basics of nursing would help medical students understand the profession better. And consider the joint program of Dartmouth's medical school and hospital in which medical students shadow nurses for six lengthy sessions. The students ask nurses questions and meet later to discuss what they have learned. As Ellen Ceppetelli, the nursing co-director of the program, said, "You cannot collaborate with people unless you see them as competent."5 In 2012, nurse Megan LeClair conducted research at the University of Wisconsin showing that even a four-hour shadowing program of that type was effective in improving physician views on collaborating with nurses.6
Pauline W. Chen, "Doctor and Patient: When It's the Nurse Who Needs Looking After," New York Times (July 5, 2012), http://tinyurl.com/7w2dd2p; Pauline W. Chen, "Doctor and Patient: Nurses' Role in the Future of Health Care," New York Times (November 18, 2010), http://tinyurl.com/26jtfsq; The Truth About Nursing, "Oh, Inverted World" (July 5, 2012), http://tinyurl.com/lm3q8nl; The Truth About Nursing, "A Terrible Thing to Waste" (November 18, 2010), http://tinyurl.com/lrhudxg.