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Is the doctor-nurse game still being played?

  • Comments (13)
  • Article: Holyoake DD (2011) Is the doctor-nurse game still being played? Nursing Times; 107: 43, early online publication.
  • Author: Dean-David Holyoake is a senior lecturer in the School of Health, University of Wolverhampton.

Key points

  1. The doctor-nurse game says that doctors and nurses share a special relationship founded on role expectations based on power, influence and territory. The nursing role showed respect, acted passively and never disagreed with the doctor
  2. In recent years, nursing has aspired to be a profession and take on greater responsibilities
  3. By 1990, the author of the doctor-nurse game said it was no longer being played because nurses were no longer competing
  4. Yet many of those working on the front line believe the doctor-nurse game is still being played
  5. Nursing is more dependent on medicine than ever before and medicine still holds all the cards

Let’s discuss

“Nursing has been so intent and fixated in mirroring medicine that it has turned itself into little more than a clone.”

Do you agree?

To think about:

  • Have doctors tactically delegated tasks to nurses so they can move onto more sophisticated aspects of care?
  • Is it relevant to measure the progress made by nurses in terms of medical functions they undertake?

Follow the debate on Twitter #NTjournalclub

  • Comments (13)

Readers' comments (13)

  • Michael, first point, the patients 'observable perspective' for this argument is irrelevant. We do act on a different paradigm than our medical colleagues, and yes we do not have the time to do a lot of the tasks our profession demands. But would you expect a single teacher to teach a class of 200 kids successfully? Would you expect a mechanic to be able to fix 68 cars in a single hour to a decent standard? Would you expect ... no, you wouldn't. So why is the expectation there that Nurses can care for the amount of patients we have effectively? In this case Michael, as usual, your so called 'observable' difference is irrelevant. The separate paradigms are still there, regardless of whether you see them or not.

    Also, I suspect that once the POST qualification exams and training is taken into account, then of course the two separate qualifications are more comparable. But taking your example, why then is the POST qualification exams and training of Nurses not afforded equal weight?

    The fact of the matter is, Nursing IS a highly qualified, highly skilled and essential PROFESSION. It is about time we are afforded the respect and status that other professional bodies enjoy, with the advantages like better pay and working conditions that go with that, and it is about time that the power that we have is wielded to give us equal standing with Doctors in the care we give to our patients and the influence we have over the running of the NHS. This is slowly happening already, as Anonymous | 1-Nov-2011 7:00 pm states, it is common now in many trusts for advanced Nurses to sit equally with Doctors in ward meetings as part of the Consultant team where comments and recommendations from all are valued equally. As I have said many times, this is NOT about Nurse V Doctor, but it IS about Nurses obtaining the same professional respect and status as an autonomous, separate but equal profession.

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  • Absolutely Mike, I could not agree more. Michael, with all due respect you are wrong. You say you have a Doctorate, so I assume that in your career, whatever it was, you were in a role that necessitated that and that role bought with it the respect and pay that your academic achievements deserve?? We are asking for no less.

    I have a diploma, a degree and a masters degree, as well as numerous post qualification exams and training, including prescribing as just one example. I also have 25 years experience in this career. Without wanting to compromise my anonymity, my role is highly specialised, highly technical and highly skilled, and I work alongside doctors, GPs and other HCPs to bring a valued level of care to my patients. Yet my pay does not reflect the position I have, the qualifications I have worked hard for, or anything else, yet a doctors pay is comparitavely much, much higher. When I tell people what I do, I often get 'oh just a Nurse?' or 'Oh I wouldn't do that job' or 'is that all?' Yet I can offer my patients a vital service that is comparable to any doctor. What response do you think a doctor gets when they tell people what they do? I am not passive or subservient to a doctor, I am an equal professional, and yes our roles are fundamentally different, just as my role is different to a Pharmacists for example, but the fact remains that we are not handmaidens anymore, nor are we assistants. Mike is right, we are professionals in our own right, and should get the respect as such.

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  • Anonymous

    I would say that nurses are being forced into doing more "medical" tasks to save the money that was being spent paying trained doctors to do them. If this had not happened, how else would junior doctors hours ever have been reduced?

    Having said that, on the whole patients have gained from nurses being able to carry out more medical tasks. However, nursing tasks are being carried out by, on the whole, poorly paid HCAs. Soon these HCAs will wake up to this fact and quite rightly demand more money. What will the NHS do then? Employ untrained and unqualified staff on the minimum wage? I do wonder sometimes...

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