Downward Transition From the Role of Physician

Downward Transition From the Role of Physician to That of Nurse

This paper looks at the ideal of a self-concept paper with a view of a personal look at how a person seeks to be part of the medical profession in a change over from the role of the physician to that of a nurse, taking into context their personal views, experiences, and previous roles within the professions. Bibliography cites three sources.

A self-conceptual role and view to a personal aspect of Nursing see the role of a nurse as someone who treats the whole patient and how they interact with the illness of the patient, he or she is a caring person that promotes health issues with a complete medical approach, although in a widely specialized way, their main aim is to focus on the prevention of ill health also with the maintaining role of continually keeping health updates at an optimum.

As a nurse we can see that they are involved in many aspects of medical and health care for example during my time as a physician I was heavily involved with the nursing aspect of my role, with a sympathetic, compassionate, empathic and supportive attitudes moreover I was always careful to treat the patient and their families with a holistic, humanistic manner.

A also found that during my experience as a physician that many of the nurses around me were a little weird, for many were involved in therapeutic massage, alternative medicines, breathing techniques.

Moreover since I have been examining my role as a physician and looking deeper into the role of a nurse from a personal perspective I now understand that these learned people were not "weird" but were into more understandable techniques for relaxation of the patient.

We can see that this role differs greatly from that of a physician where as physician is more concerned with the treatment of specialized health issues and has less of a hands on approach to that of the nurse, a nurse is less aloof that an physician whereas the physician needs this form of detachment in certain ways to help him concentrate on the diagnosis for the patient.

From being a physician to taking on the role of a nurse I feel I will be able to bring forth a plethora of aspects and attitudes along with certain skills both learned from life experiences and from my role as a physician, such as the knowledge to make quick precise assessments, skills and practice gained from these assessments I also have a diverse cultural heritage and can speak several different languages.

I have studied medicine since 1982 and in 1990 I passed a speciality course in paediatrics, I have always worked in one form or another within the community or home health, especially on certain aspects such as the major flu campaigns that have been running for the elderly, I have also been involved with Mercy Hospital as a volunteer with the Aids community.

I do not feel as if my skills as a physician will hinder my role as a nurse rather I feel that it will enhance them as I will also be able to bring my role as a leader to this position and as any good leader knows the ability to look to your colleagues and superiors is a gift that few have, I am fortunate to have this gift and am always there to listen to advice and never afraid to ask for help where and when it is needed.

Coupled with this it is clear that my previous medical career I can bring many old attitudes to my nursing role for example simple first aid issues such as quick diagnosis of signs and symptoms, the knowledge of disease process, medication knowledge, what actions in emergencies to take or call for and also what side effects to look for in illnesses and injuries, I am also familiar with the style and practice of nursing roles as I have been in close contact in my working career with many nurses.

I am fortunate enough to have been brought up in different countries therefore I have been exposed to many different cultures with their different values. Along with this my parents were careful in the way I was brought up and as a result my non-academic schooling by them taught me a great deal of many attitudes such as how to be tolerant of other people, regardless of their sex, race religious and ethic backgrounds it was also illustrated to me that my view was not the only view in the world and therefore I should respect other peoples opinions and views even if they were different from my own.

It has been one of my greatest lessons in life to accept people as they are for what they are not who they are, therefore this will be a useful lesson to bring to the role of nursing and will be a great asset to not only myself but also could be a good influence upon my colleagues, as I would be more tolerant of the needs and views of the patients that many of my colleagues who have not had my experience may not be, again by my tolerance and close contact with them I may be able to pass on this to them and have an open tolerance ability with all my colleagues.

As a physician I have been fortunate to have been involved in many aspects of the medical world however one aspect and experience that is memorable happened during my years as a student and as an intern, my cleaning lady Carmela would look after me whilst I was a student and we became very close.

However when I began my internship I was introduced to a patient during our medical case studies the notes stated "...elderly female with Diagnosis (dx) of metastatic bronchogenic carcinoma..." The woman was my cleaning lady Carmela, Carmela was very ill and there was nothing medically that could be done to help her, yet I made her as comfortable as possible and I visited her every day even on my days off, for the remaining two days of her life I was constantly by her side.

I was responsible for providing her with medications even though the family could not afford the medical costs, not only did I carry out the role of physician I was also involved as a personal nurse for her, with her son I bathed her, brushed her hair, gave her sips of drinks, when she died I was with her and as a friend and her doctor was given permission to attend her funeral.

I feel that by taking on the role of a nurse as well as being her physician and friend I was able to help Carmela in her last days, giving her the personal care she needed that not only made her last days comfortable as a patient but also aided her in a psychological manner with the knowledge that her loved one were close at hand.

I have worked with nurses in many situations. One of which has been a flu vaccination programme, here there were may different health professionals working together. The role of the nurse here was key, they were able to look after the patients, help them in terms of physical movement as well as reassure them, treating them as human beings rather than non-people.

The doctor were needed for the actual injections, they were the prescribers, however, pre-care and post care, as well as much of the work to promote the injection programme, and also help with any aftercare if there were any complications.

There were also other healthcare professionals, records needed to be kept, these were made by both the doctors and the nurses, but they are stored and retrieved by the administration staff, who are also responsible for calling in a and processing the patients and their information., Even here there was a need for a positive attitude and a caring manner. Care workers were also invaluable. There were often shortages of nurses, and the care workers were able to undertake much of the work that nursing may perform, such as talking to the patients, reassuring and caring, and general daily care needs for those who required help. They supplemented the nurses, but also had more time for them.

There were also many others who helped, form the helpful cleaning staff to the volunteer drivers, all had to work together in order to archive the desired results.

I see my future as a nurse. I have always been drawn to a caring profession, and have working in similar roles for many years. Now I have the opportunity to learn to undertaken that role in a more professional and effective manner. I want to help my patients, not only in making them well, but in terms of quality of life of the patient and also their family. I want to be able to make a difference and ease suffering or at least make life more comfortable for those who are suffering.

In gaining this qualification there are two aspects. One is the personal development and the way I can grow my own skills to use for others., However, I also need to have these skills recognised and documents so that there is peace of mind regarding my employment and a recognising in terms of the requirements for nursing professional. I see it as the first step in developing my nursing career, but not the last, I know I will need to continue to learn and develop afterwards, but with a good foundation this will be easier, and my main goal is to be a good, efficient nurse that patients find caring and ethical and peers and employers respect.

There are many different aspect to the nursing career, we can look at the different ingredients in terms of the nurse and the patient, and also the concept of nursing and health and the environment in which they occur.

In defining what we mean by human this can be perceived from an external or an internal perspective. The internal level may be seen as stating with the cells formations and branching outwards with the physiological. This includes not only the physical presence of the different organs and body parts, but their interaction and the systems that operate the body. It is at this level that my professional experience of the past has focused. Looking at the body as the sum of the parts and seeking to identify the systems that were not functioning properly and attribute this to the physiological causes. Moving into nursing this underlying understanding of the physiological functions should help.

However, we also need to look at the patient in terms of externalities. These may be seen in aspects such the psychological attitudes, fears and desires, the personality. A human may have a very similar make up to every other human on the earth, but even identical twins will have different characters and personalities, with different hopes and fears. These attitudes may be influences by the outside world, the environment such as the political and social conditions, economic ability or class will impact on the development of the individual, in both physiological and psychological terms. If we look to theorist such as Betty Newman these ideas may all come tighter, we have the patient as an holistic whole which is not only their symptoms, and as such we need to treat the entire body and the person, looking at what they need in order to consider the quality of life for the patient (Weingourt, 1998).

The role of the nurse is also difficult to define, it can be seen as both reactive and proactive, and has been defined in many ways, for example, by the American Nurses Association it is defined as; "the diagnosis and treatment of human responses to actual and potential health problems" (American Nurses' Association, 1980, p. 9).

Nursing is a caring profession, if we look to the philosophy of Leininger then this philosophy of caring is continued. Caring is described as "human acts and processes that provide assistance to another individual in order to meet an expressed, obvious or anticipated need." (Leininger, 1985, p. 209). Nursing is an act of caring under this definition, with the nurse aiding and working with the patient. Therefore the nurse will be skilled not only in caring, but demonstrating that care to the patient, such as the use of advanced listening skills and the ability to see things not only from a medical perspective but also a social perspective and the patients perspective (Leininger, 1992). Here the way the treatment is approached is different as there is a great input form the patient here the patient is a client and the decisions are made "with rather than for the client" (Leininger, 1992, p. 32).

We can also look to the theories of people such as Betty Newman, there is a bi-directional relationship between patients and nurses and the patient may often be able to recognise what is best for them, as such we can look at servant leadership theory. This is not new, and can be seen as influencing not only the nursing care of the individual by the nurse, but also the way in which nursing leaders will

Servant leadership theory can be briefly described as a management technique where the leader is a facilitator making the necessary resources and facilities available to those they manage, rather than the authoritarian approach where it is the manager that determines the course of action in the first place (Porter, 2000). Therefore nursing can be the indirect care as well as the direct care.

If we look at the term health then this must also be seen as subjective. For a young man health may be that all his organs are functions and he is fit both mentally and physically, for an elderly patient with several conditions health may be sought to the level where they feel well and can cope with everyday life. We need to consider this from the perspective of the patient.

In defining health we may also argue that is created and impacted on by a range of factors, the internal environment, from the body and the organs, as well as the external environment, for example factors such as stress and pollution. There needs to be an equilibrium between the different factors reach as well as the internal and external well being of the patent. The model of servant leadership may be seen as aiding with achieving better 'health' for patients in some cases. In some cases management of the patients by the servant leadership principle there will be a faster recovery, but in others it will not speed recovery, but will lead to a higher quality of life and a much happier patient, and this in turn aids the nursing profession as when the patient in happier as well as the potential for faster results there are also practical implications.

In looking at the role of society and the environment this cannot be avoided. I have seen from my experience that there are many different attitudes and expectations that are individual or even cultural. These will impact on the health of the individual. For some communities there may be a reluctance to go to a doctor or a nurse, for some communities a nurse may be seen as more approachable by the community. Therefore, as a nurse I have to understand what the environment will be or may be.

The environment is everything around us, that which we can see feel or hear, and that which we cannot. These may have direct or indirect influences on health. Just as the position of the patient, for example rich or poor, young or old will have an impact on the level of heath and potential problems, they will also be element that are results of an creators of the environment. It is well-known that in environment where there is poverty there are different illnesses than in wealthy neighbourhoods. These influences may be positive or negative, air quality, food quality, also aspects such as stress, family life and any other factor may have an impact on the health, and also on the way that nursing can take place.