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Is nursing school built to “break us down” rather than “build us up?”


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This past week was my first week with our physician preceptors. As a nurse practitioner student we log many clinical hours with our physician preceptors. This week was learning about the ‘patient presentation’.

It may sound odd, but nurses are quite familiar with the concept. The patient presentation is when a provider ‘reports’ or ‘presents’ their patient to the physician. This could be for a consult, a new admission, or for the coverage hand-off between colleagues. While we nurses are familiar with this concept, it’s a whole different ball game when you are the one presenting.

It was another ‘pressure cooker’ situation. Something we are all too familiar with. We build up the scenario in our minds to be the end-all-to-be-all. We picture ourselves making every mistake in the book and of course we envision the physician as this mad-hatter like tyrant who will bark at your every word.

It of course was the complete opposite.

Throughout the entire process the physician was receptive, pleasant, and absolutely empathetic to our newness. She was an active listener and gave great feedback in such a positive manner. At no time during this experience did I feel ‘put-down’, inferior, or guilt-ridden. I could sense that our physician preceptor was making every attempt to level the playing field and teach us, not torture us.

My clinical preceptor brought up a very valid realization after this experience. He asked us if we noticed how much our physician preceptor tried to ‘build us up’, not ‘break us down’. He wanted to know if we have had similar experiences in our previous nursing education and training..

I honestly can say 90% of my nursing education and experience has been about ‘breaking us down’. Sad, but true. I can remember many times nursing preceptors ridiculing students for not performing well or making simple mistakes.

Our physician made it well known she expects us to make mistakes, and that the mistake made now will help save lives later. “It’s not about being wrong, it’s about not being prepared”. Being afraid to make a mistake is not the same as carelessness.

I think nursing education as a whole could learn a thing or two from physicians.

I find the professional relationship and their respective professional curriculum between nurses and physicians to be polar opposites, and I can’t understand why? Barring from the obvious difference between a nurse and a physician, how do two professions with the same goals arrive at their destination in two very different ways?

As a side note, to all my fellow nurses out there. Physicians are misinformed about our educational system and standards. I guess I automatically assumed physicians understood the requirements and curriculum progression of our profession. We took a great deal of time to explain how a nurse ‘becomes’ a nurse (RN, BSN, LPN, CNA), and how a nurse is trained for specific specialties (critical care, emergency, oncology, etc.)

I’m still amazed at how much I learn every day.

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