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Let’s learn from our nurses and make medicine great again-Miriam Knoll MD - News - Nurses Arena Forum

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Let’s learn from our nurses and make medicine great again-Miriam Knoll MD by Idowu Olabode : August 13, 2016, 03:28:26 PM
Sometimes, I wish I was a nurse.

As a nurse, my work-life balance would greatly improve because my three 12-hour shifts would constitute a rewarding and flexible full-time medical career. I would care for all kinds of patients, not just stick to one medical specialty. Maybe I’d go for an advanced nursing degree; I would enroll in school full-time and also maintain a paid full-time job. Like many nurses, my hospital employer would pay for my tuition. If I wanted to take time off and pursue other interests, I wouldn’t worry about risking my entire career. And if I was interested in health care leadership, I’d move up the ladder, one position at a time.

But, none of the above applies to me. Because, you see, I’m not a nurse. I’m a female doctor.

Throughout medical school and residency, I’ve wondered why most of my mentors were male. It puzzled me why there were few women in hospital leadership. But, then I learned how wrong I was. There are actually many women in medical administration, but they’re nurses not doctors.


How have nurses made it to the top and with accompanying lower rates of burnout? I believe that physicians have a lot to learn from our nursing colleagues. Here’s why:

Burnout

As a full-time radiation oncologist, my work-life balance teeter-totters on the seesaw fulcrum. Why does a full-time nursing job entail three 12-hour shifts per week? Because nurses like it this way. Most nurses are female, and many are mothers. If you’re working full time while raising children, it’s great to have a flexible work schedule. It’s not better for patients to have a new nurse every day, which is required if their nurse only comes in three times a week. Arguably, patients would rather have the same nurse every day (Monday to Friday, 9 to 5). Yet, nurses have won this battle and have good patient outcomes to prove it’s OK.

If a nurse wants to change her work environment, she can transfer to another specialty. On the other hand, there are no real options for doctors to continue their training. For example, if I wanted to practice cardiology instead of oncology, I can’t. In fact, there is no pathway even for residents to switch to another training program, whether in another field or in different hospital. And this certainly doesn’t exist for doctors who have completed their training.

Doctors experience high rates of burnout. A great way to prevent burnout is to take time to reflect and pursue other interests. I recently met a nurse who joined our department for 3 months. She worked for an agency that places nurses in short-term positions. After her current placement, she was going to tour Europe for 6 months. Afterwards, she’d return to a new position at a new medical department.

Can doctors take time off? Not without risking their entire careers. Some physicians work as locum tenens and provide temporary coverage. But a doctor who does this for too long — or who takes time away from medical altogether — may be unable to find a stable position within Medicine again. The prevailing culture believes, “Doctors aren’t supposed to need time off. And why would a doctor have any other interests aside from medicine; don’t doctors devote their entire lives and entire beings to medicine, and medicine alone?”

Leadership

Medical leadership is commonly composed of:

1. Male physicians
2. Female nurses

How have nurses made it to the top? Nurses have a strong desire to lead and the nursing lobbying groups have supported this goal very effectively. Over the past century, nurses have consistently insisted their voices be heard, and they have won the battle. For example, in many states nurse practitioners can practice solo without the historically required physician oversight.

The American Nurses Credentialing Center (ANCC) recognizes hospitals with nursing excellence and quality patient care with its prestigious Magnet Award. To apply for this designation, hospitals must complete an extensive application. Part of the required documentation is to show support for their hospital nurses’ “professional development.” You see, part of a nurse’s career identity is professional development.

Another component of the Magnet Award application is “recognition of nursing.” It’s incredible how the acknowledgment of nursing contributions has become a must. So you won’t be surprised that National Nurses Week was designated in 1974. It took 16 years for physicians to get their one day of recognition, National Doctors Day, which was established in 1990. Do “top hospitals” ask their doctors how supported they feel in regards to their professional development? No such responsibility exists for physicians, whether real or theoretical.

Nurses have won a seat at the table and have broken through the glass ceiling in medicine. These women professionals enjoy high levels of job satisfaction while maintaining flexible work schedules. Working side-by-side with nurses, in the same hospitals and caring for the same patients, female physicians (arguably all physicians) have a lot to learn.

Let’s learn from our nurses and make medicine great again.

Miriam A. Knoll is a radiation oncologist.  She can be reached on Twitter @MKnoll_MD.  This article originally appeared in the Huffington Post.

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Re: Let’s learn from our nurses and make medicine great again-Miriam Knoll MD by Idowu Olabode : August 15, 2016, 05:10:05 AM
From Lori C on our Facebook page

Here is the response : by Diana Ball - SMYS for Change.

I respectfully disagree. This article is full of patent falsehoods. In order to address them all this will be a long comment.

" I would care for all kinds of patients, not just stick to one medical specialty."

I don't know what kind of nurses this person is dealing with. We specialize.

"Maybe I’d go for an advanced nursing degree; I would enroll in school full-time and also maintain a paid full-time job. Like many nurses, my hospital employer would pay for my tuition."

There is no hospital anywhere that pays your tuition.
Tuition reimbursement is, at most $200 per pay period. Try paying off $100K in student loans with that. You can't

"If I wanted to take time off and pursue other interests, I wouldn’t worry about risking my entire career."

That's not how it works. We punch a clock, have to have PTO and request vacation. It will be denied because the unit is short staffed.

"And if I was interested in health care leadership, I’d move up the ladder, one position at a time."

That's not how it works. You have to be promoted. You have to be friends with the right people and throw the right people under the bus.

"There are actually many women in medical administration, but they’re nurses not doctors."

Wrong again. They are neither. They are MBAs with LSSC.

"How have nurses made it to the top and with accompanying lower rates of burnout?"

If you think nurses make it to the top with less burnout you are either not paying attention, insane, intoxicated, or all three.

"Why does a full-time nursing job entail three 12-hour shifts per week? Because nurses like it this way."

Uh, no. Administration likes it this way. This was to deal with a phantom "nursing shortage"

"Most nurses are female, and many are mothers. If you’re working full time while raising children, it’s great to have a flexible work schedule"


Way to be misogynist. A woman wrote this?
Three 12 hour shifts is not flexible. Someone else drops your kid off at school, someone else picks your kid up, forget making dinner, forget after school activities, forget anything except for watching your kid sleep or sleeping through their childhood.

"If a nurse wants to change her work environment, she can transfer to another specialty"

Good luck with that with no experience in that specialty.

"How have nurses made it to the top? Nurses have a strong desire to lead and the nursing lobbying groups have supported this goal very effectively. Over the past century, nurses have consistently insisted their voices be heard, and they have won the battle."


Nonsense. Nurse to patient ratios exist in ONE STATE- California
Strong labor unions have been virtually eliminated in half the country.

"For example, in many states nurse practitioners can practice solo without the historically required physician oversight."

Also nonsense. NPs can only practice independently in 21 states.
Here is a map: https://www.aanp.org/legislation-regulation/state-legislation/state-practice-environment

"The American Nurses Credentialing Center (ANCC) recognizes hospitals with nursing excellence and quality patient care with its prestigious Magnet Award...Another component of the Magnet Award application is “recognition of nursing.” It’s incredible how the acknowledgment of nursing contributions has become a must. So you won’t be surprised that National Nurses Week was designated in 1974."


Magnet is nonsense and "Nurses Day" is nonsense. Neither improve our practice environment, neither mandate ratios, neither foster worker protections, neither accomplish anything we have been demanding for over twenty years.
They are both useless platitudes, one on an organizational scale, and one on an individual scale . We would gladly give up both for mandated minimum nurse to patient ratios, worker protections, and just compensation.

"Nurses have won a seat at the table and have broken through the glass ceiling in medicine. These women professionals enjoy high levels of job satisfaction while maintaining flexible work schedules."


You do realize nurses in leadership positions are salaried employees that routinely work more than 60 hours a week putting out fires right?
They make less than minimum wage.

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