How I ended up in nursing school

I’m now half way through my second semester of nursing school. I know that this seems a bit odd to most people. To my knowledge I am the first qualified medical doctor in Sweden to study nursing. But the moment I thought about applying it felt right and maybe that is the most important reason why I’m doing it: I’ve learned earlier in life that following my instincts and doing what interests me, even when it’s of no obvious benefit to the most common goals in life (career, money, status etc), is hugely beneficial to my personal development. 

There are two sides to this. One is the task-shifting of medical responsibility to nurses. Like most Swedish emergency physicians I have been very positive to the development and implementation of nurse practitioners in the ED. In the prehospital setting, nurses have had this role for many years. But practicing medicine requires medical knowledge and competence and as the medical director of an ambulance service I was constantly facing the question of how much medicine, and in particular medical decision making, nurses actually learn in nursing school. It was not easy to find the answer, since there is an overlap of knowledge that I consider medical, that the nursing profession (or professional bodies at least) prefer to call nursing.

I’m confident that nurses, with adequate training and mentoring, can manage medical conditions independently. But nurses constantly stress that they are not mini-doctors, but also providing nursing. So if nurses can offer medical assessment and nursing, while doctors can only offer medicine, what is it that we are not offering? What is nursing in the emergency department or prehospital setting? What is it that nurses can provide that doctors can’t? The question of what nursing is, never seems to have a direct answer.

The other aspect is the patient perspective in health care. I believe that what many patients perceive as inadequate healthcare is more a lack of good nursing than of medicine. We discharge patients when their medical needs have been met, but there seems to something missing, where more medicine is not the answer and over diagnosis and over treatment is becoming a quality problem. 

Nursing has a different history than medicine, but he nursing literature clearly states that it also has a different philosophy. One that is person-oriented, health focused and holistic. I can understand that claim, but I insist that this is just as much my philosophy as a physician. The more I’ve learned about nursing, the more it has become evident that there is a parallell track to medicine, where the common ground is not shared but fought. There is a power struggle that I, as a clinician, have been oblivious to, assuming that we are all on the same team. 

I enjoy learning and experiencing other cultures and the nursing culture is different from the medical in many ways. I want to understand it, because learning about other cultures always teaches you important lessons about your own culture. What is it that I don’t see? Why are the only people who have been critical to my studies other physicians? How can it be a big deal that I’m using some of my spare time to learn more about an adjacent field of healthcare? I don’t have the answers and there is no masterplan behind my studying, only a desire to learn.