02 November 2011

Not the Doctors' Assistant


You probably have the same perception. 

That nurses are just but assistants to the doctors. 

The Yayas. 

The Chimays.

The Utusans.

The Aliping Sagigilid.

(insert other derogatory descriptions you would call a nurse here.)

Pardon the exaggeration on the first few lines but allow me to expound on that claim in a while.

I was reviewing my brother weeks ago about their lesson on “Community Helpers”. It was a thin pamphlet on the different jobs that people do in the community. You probably know the drill on these types of lessons. The schoolers identify the job based on the description indicated, vice versa. Things were going quite well until we got to the item about the nurse. I knew back then that what I saw would readily feed my next blog entry. I just had to take a picture of that specific number.

Here’s it is:


No wonder why society looks down on nurses! It’s probably because even in the primary level of education, they had been accustomed with the idea that nurses are assistants to the doctors, that they are inferior to them. That they are sunod-sunuran to whatever the doctor orders.

This notion may be traced to the early history of the nursing profession when nursing was viewed as a vocation with their actions being limited to what the doctors instruct them to do so. This was the scenario until Nursing finally became a profession and later on developed its own organized body of knowledge and scope. 

From my three and a half years of taking up Nursing at the UST, I was in no way acquainted to this ridiculous idea of being an “assistant” to the doctor. We were taught that we are an independent profession that focus on the more humanized aspect of health care. Yes, we may collaborate with doctors on certain aspects of the patient's medical management but nurses clearly do more than work on the disease’s pathophysiology!  

What I’m trying to say is that although assisting the doctor may be part of the responsibilities of a nurse,but it does not constitute their entire scope as professionals. In R.A. 9173 or the Philippine Nursing Act of 2002 it is stated that the functions of a professional nurse are as follows:

(a) Provide nursing care through the utilization of the nursing process. Nursing care includes, but not limited to, traditional and innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential primary health care, comfort measures, health teachings, and administration of written prescription for treatment, therapies, oral topical and parenteral medications, internal examination during labor in the absence of antenatal bleeding and delivery. In case of suturing of perineal laceration, special training shall be provided according to protocol established;

(b) establish linkages with community resources and coordination with the health team;

(c) Provide health education to individuals, families and communities;

(d) Teach, guide and supervise students in nursing education programs including the administration of nursing services in varied settings such as hospitals and clinics; undertake consultation services; engage in such activities that require the utilization of knowledge and decision-making skills of a registered nurse; and

(e) Undertake nursing and health human resource development training and research, which shall include, but not limited to, the development of advance nursing practice;

As far as I’ve read and studied in my Professional Adjustment subject, there was no single line that mentioned about nurses in the same light as the textbooks would put it. 

Sometimes it pains me to see some staff nurses panicking when a doctor arrives. One of our clinical instructors, who our group dearly call Mama V, would tell us that “Hindi kayo utusan ng mga clerks (4th year medical students).” And I loved her for that. If the nurses themselves won’t stand up for their profession, who would?  

As stated in the Philippine Code of Good Governance,

” No one group of professionals is superior to or above others. All professions perform an equally important, yet distinct service to society.”

READ: NO NURSE SHOULD BE AN ASSISTANT TO ANYONE.

Let this be a call to the Philippine Nurses Association to look into the erroneous descriptions of nurses on text books and other educational paraphernalia. I believe that this issue, albeit small, directly affects the society’s perception on the profession and thus must be addressed immediately.


15 comments:

  1. I admit that even I thought of nurses as simply assistants. I understand where your frustration is coming from. I remember a friend who once remarked candidly, "Kawawa naman ang mga pinoy na doktor sa ibang bansa, nagiging nars lang sila." How do we change people's prejudices? By doing what you just did, my friend. We fight to right what is wrong.

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  2. I do hope that through this humble blog post, kahit papaano maicorrect ang perception sa mga nurse. I also do get those expressions na "Nurse lang." Umiinot talaga ulo ko pag ganun.haha :)

    Thanks for sharing your insight! :)

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  3. the historical understanding isn't necessarily wrong, but it could be outdated. a small distinction, but one recognized could bolster your argument.

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  4. mister, you nailed your point :) but as much as you say nursing profession is an independent one to that of a doctor, consider the fact that the two professions are complements. Doctors need Nurses, Nurses need Doctors, bottomline is that patients need BOTH.
    It just happens that Doctors have the proper credentials earned by them in their Graduate School (read: MedSchool) as opposed to the undergraduate school of Nurses. Important thing is, we know every profession is vital to the society. kahit pa katulong lang yan or kahit CEO pa ng kung anong kumpanya ;)

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  5. line of light - yes, that is exactly the point of my entry: to recognize the outdated perception and to the realign society's image of nursing on what it truly is. :)

    Anonymous - of course, in that sense, the doctor and the nurse must, as you would say it, complement each other. there is no point of denying that fact. Yet, what I'm trying to say is that by being independent is that the focus of nursing is different from the other professions. :)

    If I would follow your argument on the second sentence, what if the nurse also earned the "proper credentials" should they have finished Master's or even a Doctorate degree? Does that equalize the society's perception on the two professions? I don't think so. But yes, I get your point that if we would only consider the undergraduate degree obtained by majority of the nurses.

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  6. oh yes! I agree with you mister nice guy, a lay person wouldn't expect a master's degree from a nurse as a pre-requisite of his or her respect to them. Of course that's funny! :)) What matters to them is that you deliver quality service; regardless if you're a doctor or nurse.

    sa palagay ko ha, mataas naman ang tingin ng mga Pilipino sa mga nars eh (no source cited. haha). But your article makes sense. It makes me think :)) I just hope the "nurse-discriminating-doctors" would read this. They should treat their nurses as their colleagues, not some yayas or chimays, as you just said. Especially if a nurse is as brilliant as you are ;) haha. nice talk.
    Same anonymous guy ^ there

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  7. Anonymous - True. It really is their right to receive the best care they could, from nurses and doctors alike :)

    Sana totoo nga yang tinggin mo.hehe I also dont have statistics to back my claim, mere objective observations lang naman ako.

    You sure know how to flatter me. Anyway, I am intrigued who you are. Mind introducing youself? PM or tweet me. :)

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  8. Dear mister blogger, never mind my identity :) I just saw your blog while I was browsing from blog to blog. :)

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  9. "From my three and a half years of taking up Nursing at the UST, I was in no way acquainted to this ridiculous idea of being an “assistant” to the doctor. We were taught that we are an independent profession that focus on the more humanized aspect of health care. Yes, we may collaborate with doctors on the medical management of the patient but nurses clearly do more than work on the disease’s pathophysiology!"

    Why did you use the word MAY to describe your involvement in a patient's care? Is this "collaborative effort" optional for nurses? ;-)

    I also do not understand why you take offense on being called an assistant. Bakit nga ba?

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  10. That's a good observation and probably a vague part of the blog entry. What I'm trying to point out in using "may" is that we nurses are not always involved in all the medical management done on the patient. Simply put, we may collaborate with some of the medical management up to wherever our scope covers on.

    Why take offense being an assistant? Basically because we are not assistants. According to Dictionary.com, an assistant is defined as "a person who is subordinate to another in rank, function, etc.; one holding a secondary rank in an office or post". I guess the definition serves as a valid explanation on why I take offense in being called an assistant.

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  11. Since napag-uusapan na rin naman ang definition sa dictionary.com, siguro nga hindi KA dapat tawaging doctor's/physician's assistant. Ayon sa dictionary.com, ang physician's assistant ay "a specially trained person who is certified to provide basic medical services (as the diagnosis and treatment of common ailments) usually under the supervision of a licensed physician."

    Sabi mo hindi doctor's assistant ang nurse. Pero hindi mo naman sinabi kung ano talaga sila. The last picture says. "We take care of you."

    Matakot ka baka umalma ang mga caregiver! Inagawan mo pa sila ng role :p

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  12. Hindi lang siguro ako, pero pati na rin ang lahat ng mga nurse. :) Btw, iba ang physician's assistant sa nurse since we don't do diagnosis and treatment.

    I think I already made clear kung ano talaga ginagawa ng nurse. They are not the doctor's assistant dahil sila ay mga nars. Paki basa po yung part na may RA 9173 para malaman yung functions ng isang nurse.

    Haha. Di naman siguro sila aalma dahil kahit papaano ang work ng isang caregiver ay naka-integrate na sa role ng isang nurse. :)

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  13. You mentioned what the nurses DO. But you didn't define what nurses really are. Sinabing mong hindi doctors' assistant ang nurse... so, ano nga sila? Kasi 'yun ang pinupunto ng article mo diba? :)

    One more thing, are nurses these days really trained to do accurate internal examinations?

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  14. hi! i am a nurse who worked abroad, to be honest you can say that nurses are doctor's assistant because we follow "doctor's order" or in a sense that we assist for we are client centered. Another point of view is "health care team" consist of different professions and different health care roles, now with this idea we can say that the members of the team will assist each other for the health benefits of the patient (there are situations where you can say that the doctor is the one assisting the nurse, there are times that the physical therapist will be assisted by the doctor...oh well you get my point *hopefully*) ...sa mga first world country highly educated ang tingin sa nurses, sa third world country, nars ang tingin =D so ano ang solusyon? gawin first world country ang pinas! haha

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  15. @Anonymous 1 - Well it's quite a vague concept to discuss what nurses really are. Even the nursing theorists have different ideas of what a nurse is. One concept is that they are the ones who focus on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and wellness.

    I am not sure if the level of proficiency of nurses with regard to internal exam passes the definition of "accurate" but according to the scope and limitations, allowed naman sila. :)

    @anonymous 2 - you have good point there and I totally agree with the idea that each should assist each other from the health care team. Probably ang pagtinggin ng mababa sa mga nurses ay may social thing din diba?

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Let me know what you think. :)