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2008/11/04

Distinguishing Nursing From Medicine

The formulation of clear and concise definitions of nursing also has been hampered by the lack of an obvious distinction between nursing and medicine. For example, it is not unusual to hear a prospective nursing student say, “I’ve always been interested in the medical field, so I decided to go into nursing.” Something of an interdependence exists between medicine and nursing, and they have somewhat paralleled one another in historical development. However, anyone who has been involved in the profession of nursing for any period of time will be quick to assure you that distinct differences exist. The primary differences between nursing and medicine are the purpose and goal of each profession, and the education needed to fulfill each role. Although the situation is much changed today, we must acknowledge that historically medicine has been perceived as a profession for men and nursing as a profession for women. We can dismiss these stereotypes today, but they had an influence on the development of both professions. Finally, the subservient role of the nurse in relationship to the physician in the past—often referred to as the handmaiden of the physician—has been significant in shaping the definition of nursing. In general, medicine is concerned with the diagnosis and treatment (and cure, when possible) of disease. Nursing is concerned with caring for the person in a variety of healthrelated situations. The caring aspects of nursing are well documented in nursing literature (Benner & Wrubel, 1989; Bevis & Watson, 1989; Carper, 1979; Watson, 1979). We think of medicine as being involved with the cure of a patient and nursing with the care of that patient. The role of the nurse in patient care (today we often refer to this as client care) also involves teaching about health and the prevention of illness, and caring for the ill individual. It also may encompass case management and is increasingly being practiced outside the walls of acute care facilities. Nursing takes place in the community and the home, in hospice centers, ambulatory care environments, schools and day care centers, and rehabilitation facilities. In all environments, nurses play a key role in promoting higher standards of health. With advancing technology in the health care fields, the diverse areas of specialization, the different routes to educational preparation, and the distinct practice settings and roles occupied by the nurse, it is critical that nurses provide clear information for themselves and for the public. To state that you are a registered nurse (RN) says little about what you do. It conveys nothing about where you are employed or your educational background. For example, as an RN, you might be employed in a community hospital or in a long-term care facility; you might have a significant role in a critical care unit; you might have earned additional credentials and be working in advanced practice; or you might be a nurse educator. Thus, you can see that the words “nurse” and “nursing” have been applied to a wide variety of health care activities, in many different settings, performed by people with a variety of different educational backgrounds. The old adage “A nurse, is a nurse, is a nurse” is out of place in a highly technical health care delivery system that struggles to keep “high touch” and “high tech” compatible.

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