Docs-turned-nurses still think, work like doctors

[explorer]

Docs-turned-nurses still think, work like doctors

Oct 12, 2005
Updated 05:04am (Mla time)
Christian V. Esguerra
Inquirer News Service

IF YOU think being a doctor will put you in the express lane to a high-paying nursing job abroad, think again.

A number of Filipino doctors working as nurses overseas have been deported because of one crucial lapse -- they forgot they were no longer working as physicians.

Instinctively, they had changed the orders given by the actual doctors on duty, or questioned, if not ignored, the directives given them, according to Dr. Fely Elegado-Lorenzo, director of the Institute of Health Policy and Development Studies at the University of the Philippines’ National Institutes of Health.

Just two months ago, she said, two doctors were booted out of a Texas hospital for the transgressions. A similar case occurred in the United Kingdom two years ago.

"This is against the policies of the hospitals there," she said in a press briefing yesterday.

Lorenzo said health authorities were compiling cases of doctors-turned-nurses deported from abroad to get a clearer picture of the problem.

"So far, they belong to what we call the hidden population," she said. "But there are already trickles."

Couldn't help it

Ruth Padilla, president of the Philippine Nurses Association, mentioned another instance in Britain when a Filipino nurse performed "suturing" (or stitching) in an emergency situation.

That didn't sit well with doctors in the hospital simply because it was not his job as a nurse, she said.

"His being a doctor came out at that instance," she said. "Even if the doctor had the purest intention to save the life of that patient, the thing is you're not supposed to do that because you are employed on record as a nurse."

Padilla said the tendency of some doctors-turned-nurses was to do "medical management," not render "nursing care."

Flunkers

The difficulty among some doctors of adjusting to the nursing profession has also been reflected in nursing board exams. While they may be expected to breeze through the tests, some of them simply do not because the thrust of nursing is not exactly the same as that of medicine.

Forty out of some 800 doctors flunked the nursing licensure exam in June, according to Eufemia Octaviano, chair of the Board of Nursing.

She said the 800 doctors were among the 2,212 non-nursing graduates who took the test that time. The others included pilots, engineers and criminologists.

No more special program?

Partly to blame is the special program that has allowed physicians to jump into nursing with relative ease, experts said. The program requires them to complete just 1 1/2 to 2 years in a nursing program before they are allowed to take the nursing boards.

Lorenzo said there was a proposal to rescind this special provision for doctors through a memorandum order from the Commission on Higher Education.

If approved, the suggestion will take effect next school year, she said.

"We're not saying that they won't be allowed to become nurses anymore," she explained. "If they want [to become one], they have to go through the [regular] four-year program."

Passing rate

But even the regular four-year nursing course has its deficiencies in many schools, health officials said.

Out of the 450 nursing schools in the country, Lorenzo said, many registered only between 0 and 30 percent passing rates in the board exams.

"If you enter these schools, your chances of passing the boards are only between 0 and 30 percent," she said. "There's a bigger probability that you'll fail."

Lorenzo did not identify any of the schools.

Two months ago, she said, these schools had been told by the Commission on Higher Education to "shape up or ship out" within two years.

The problem was that some politicians ostensibly operating some of these schools were blocking their closure, she said.

"In fact, they even barged into our office, angry because we were making their performance public."

"If we can't close them because of political opposition, [we will] get the public to bring their children to where the good schools are," she said.

So far, there are only 12 schools classified as "excellent-performing" [meaning, the passing rate is 90 percent and above] while 17 are deemed "high-performing [with a passing rate of 75 to 89 percent], she said.

12 top schools

Also, of the 450 schools, only 175 consistently graduated students in the last five years, she said.

"Nursing education is deteriorating," she said.

Lorenzo said the top 12 schools were: • University of the Philippines-Manila • St. Paul College-Iloilo • Siliman University • West Visayas State University • University of Santo Tomas • St. Louis University • Mindanao State University • St. Paul College-Dumaguete • Pamantasan ng Lungsod ng Maynila • St. Mary's University of Bayombong • St. Paul's College-Quezon City • University of the East-Ramon Magsaysay Memorial Medical Center.

[IPSG_SlimShady]

Mas malupit siguro kung POLICE-turned-NURSE, tulad ni Michael Ray Aquino (who is studying in New York to be a nurse until he was arrested for espionage). Baka mamaya, iba yung iturok niya dun sa pasyente - lethal injection pala!

[wildthing]

Nakakatawa na realidad....ewan ko ba kung bakit walang bilib sa sarili ang mga doctor na ganyan....that they need to become nurses na lang just to bring-in money....tapos hindi naman pala matarok ng kanilang puso at utak na sila ay "demoted" na as nurse na lang....buhay nga naman

[ozcity]

at the end of the day..whatever your job is..............................PERA pa din ang dulo..

[BoyFerrari]

Nakakatawa na realidad....ewan ko ba kung bakit walang bilib sa sarili ang mga doctor na ganyan....that they need to become nurses na lang just to bring-in money....tapos hindi naman pala matarok ng kanilang puso at utak na sila ay "demoted" na as nurse na lang....buhay nga naman

Maraming dahilan kung bakit ang isang duktor ay pumayag na maging nurse sa Amerika. Pero sigurado ako na hindi dahil wala silang bilib sa sarili kaya sila naging nurse. Parang sinabi mo na yung teacher sa Pinas eh pumayag na maging yaya sa London dahil wala siyang bilib sa sarili bilang isang teacher?

Malabo. Napakalabo.

Agree din ako kay mbt na hindi rin pride kung bakit ginagawa nila yung higit pa sa job description nila yang mga duktor na naging nurse. Minsan kasi, automatic na sa kanila yung ginawa nila. Nakalimutan nila na hindi pala yun gawain ng nurse nga pala. Ilang beses na ring ginagamit yang plot na yan sa movies. Secret agent na nagpapanggap na maid or chauffeur. Kaso nabubuking sila dahil meron silang ginawa na isang bagay na hindi naman expected na ginagawa ng isang maid or chauffeur.

Isa rin yang dahilan kung bakit merong mga company na hindi tumatanggap ng mga over-qualified sa position. Tulad ng isang applicant na merong masters degree sa computer science na nag-a-apply bilang isang encoder. Delikado yan. Hehe.

[silhouette]

one of our very good family doctor is now completing his nursing studies.
his reason...not for money, coz hey have lots. he can't practice abroad as a doctor. why leave the phils when you have he money? SECURITY ng mga anak!

going back. mukang mahirap nga yun kung sanay ka na ikaw ang nag-uutos as a doctor as to what meds to give to a patient. lalo na kung well experienced doctor...

[explorer]

one of our very good family doctor is now completing his nursing studies.
his reason...not for money, coz hey have lots. he can't practice abroad as a doctor. why leave the phils when you have he money? SECURITY ng mga anak!

pag sa US pwede sya magpractice yata basta pasado din sya sa US exam para sa mga doctors. yung course/curriculum ng mga doctors dyan sa pinas naka-patern din sa US.

[wrxsti]

PRIDE, they need to throw it out of the window once they take up nursing.

[mbt]

i don't think it's pride or arrogance or lack of self-confidence or anything like that... but after a rigorous training regimen and years of experience, it's simply the mode with which they function.

take for example the nurse doing what he or she knows will save an emergency patient. alam niya yung gagawin, and inaction on his part may mean the death of the patient... as a doctor, i'd think it would be difficult not to do what he can.

yun nga lang, the americans or whichever have good reason to discourage this practice, kasi theyre officially working as RNs, not as MDs

[niky]

i don't think it's pride or arrogance or lack of self-confidence or anything like that... but after a rigorous training regimen and years of experience, it's simply the mode with which they function.

take for example the nurse doing what he or she knows will save an emergency patient. alam niya yung gagawin, and inaction on his part may mean the death of the patient... as a doctor, i'd think it would be difficult not to do what he can.

yun nga lang, the americans or whichever have good reason to discourage this practice, kasi theyre officially working as RNs, not as MDs

Doctors, by profession, must have a certain amount of arrogance in the hospital setting. They're the top of the heap, and they need to exert their authority over nurses and staff effectively in hospital work.

Take it from me. We graduated one batch of "doctor-nurses" in a special fast-track class (their medicine fundamentals are good, all they needed was the nursing subjects and orientation) and they were very difficult students. They couldn't help but look down on the "mere" nurses teaching them, and often didn't pay attention because they "already knew" what was being taught. My mother doesn't want to go through that again. :lol:

The problem with Registered Nurses in the US acting as doctors is big. Malpractice insurance and claims are expensive, and if the person is working for the hospital, any action, inaction or change in the patients regimen that the doctor-nurse takes upon himself/herself to perform will be charged against the hospital. In the case of the nurse trying to save a life, they can't be charged, but if doctor-nurses are doing what was said in the article (changing prescriptions, meds, contesting doctor's orders), major insubordination yung kaso nun, and the hospitals are right to deport them.

Wala naman silang lack of doctors... what they need are nurses... period.

[empy]

hehe...that must be frustrating. especially kung bopols yung doctor na nagbibigay ng orders and you know that it's not the best thing for the patient

[GlennSter]

let's not judge all of thm kasi hindi niyo naman alamang pinagdadaanan ng isang med student.

sa totoo lang, mga kaklase ko at this early age, may pagka arogante na. it's because of (too much) confidence na matalino sila...matalino naman talaga pero yun nga lang..walang people skills.

as for the topic, hindi ko talaga masisi sila kasi nga iba talaga ang doctor sa nurse. minsan mahirap ibqahin ang nakasanayan mo na..lalo na kung emergency na...

and by the way...i dont think na doctors are "DEMOTED" when they become a nurse...guys..wag sana ganito ang pag iisip.kung kami ngang med students hindi ganyan mag isip sa mga kasamahan naming nurse students eh...

it's a different profession naman...

[delprado]

sa totoo lang, mga kaklase ko at this early age, may pagka arogante na. it's because of (too much) confidence na matalino sila...matalino naman talaga pero yun nga lang..walang people skills.

There goes the saying na: ' It's hard to be humble when you're(even if you think you are) the best. ' ..hehe

[the josh]

let's not judge all of thm kasi hindi niyo naman alamang pinagdadaanan ng isang med student.

sa totoo lang, mga kaklase ko at this early age, may pagka arogante na. it's because of (too much) confidence na matalino sila...matalino naman talaga pero yun nga lang..walang people skills.

as for the topic, hindi ko talaga masisi sila kasi nga iba talaga ang doctor sa nurse. minsan mahirap ibqahin ang nakasanayan mo na..lalo na kung emergency na...

and by the way...i dont think na doctors are "DEMOTED" when they become a nurse...guys..wag sana ganito ang pag iisip.kung kami ngang med students hindi ganyan mag isip sa mga kasamahan naming nurse students eh...

it's a different profession naman...

I agree 9 yrs. I've worked 9 yrs. in a govt. hospital dyan sa atin and 3 yrs. na ko dito sa NZ,pero awa ng Diyos ay hindi ko naranasan ang mababang pagtingin sa kin ng mga kasama kong duktor. Siguro nasa nurse na din yun kung pano nya dalhin ang sarili, kung paano sya magtrabaho at sa kanyang pakikisama sa mga katrabaho nya. Kung titingnan nyo din ang flowchart sa isang ospital ay mapapansin nyo na ang MD at RN ay magkapantay, magkaiba lang ang kanilang job descriptions, siyempre ibang usapan na ang mga consultants

[explorer]

OT: mas bilib pa mga pinoy nurse sa pinoy doctors at mga nurses dito sa UK. yung nursing nila dito 3 years lang at hindi sya bachelor degree. iba parin daw yung curriculum ng nursing dyan sa pinas. thre very reason daw kaya pinoy nurses ang patok sa US at sa ibang bansa narin...yung curriculum nila paterned sa US nursing, pati narin yung sa mga physicians. sabi ni misis (a nurse) kahit daw yung mga doctors nila dito di alam kung ano ang i-prescribe na gamot sa patient lalo na pag yung doctor nagsisimula palang sa pag practice. kaya daw gusto ng mga patient ang pinoy nurses lalo na sa pag kukuha ng dugo kasi one time lang daw at tumbok na kaagad yung ugat. sa mga local nurses nila dito sa UK, malamang daw bubordahan yung arm ng patient ng karayum bago matumbok yung ugat.

[oldblue]

and to think a lot of rich pinoys nagpapaospital sa Amerika, tapos mga magagaling na pinoy doctors din pala ang bagsak nila. baka yun mga nurse cum doctor na nag-prescribe ay pilipino ang mga patiente.

[flakez]

siguro nakakalimutan nila na nurse na lang sila. hindi na sila doctor.

pano kaya kung bigla nila utusan ung kasamahan nilang nurse. hehehe

[Elroi]

just a little OT...
accdg to my cousin who documented the nursing course sa isang private school for her thesis;
1. 20 years ago, pag nursing daw ang course ng isang lalake, 100% na gay siya. now 22% ng nursing students sa skul na yun ay male..
2. 20 years ago, pang lower income class lang daw ang nursing. ngayon kahit yung mga "rich" ay taking up nursing.
3. 10 years ago, 2 school lang ang nag-ooffer ng nursing course sa lugar nila.. ngayon, 7 na..
4. 20 years ago.. if ur a nurse, kulang pa pang-upa ng bahay yung sweldo mo. ngayon, yung mga nurses (working in abroad) na lang ang nakakabili ng house & lot in CASH...
5. dumadami na ang % ng professionals na nag-aaral ng nursing. sa isang block lang ng nursing students (4 sections yata) - 2 are doctors, 1-dentist, 2-engineer, 1-hardware store owner, 3-teachers at 1-policeman..

buhay talaga, parang gulong...

[zidane21]

ot: naalala ko tuloy yung movie na "The Fugitive" si Harrison Ford dun ay isang napakagaling na doctor kaya lang na-frame up sya kaya isa sa disguises nya ay isang janitor ng hospital, biruin mo isang janitor ang gumamot sa isang kid dun sa hospital, di makapaniwala yung doctor!

[altec]

I remember a few years ago an article on the PhilStar, about a research that showed only a third of american doctors' diagnosis is correct. In turn, 2/3 of their analysis is wrong! If they are that good, and they are right only a third of the time, paano pa kaya sa ibang bansa. But the researcher says it doesn't mean that doctors are incompetent. It just means that there is still a lot to be learned, and doctors see things differently. Thus, they emphasize to get a 2nd, third, or more opinion. That's what I did when I tore the ACL of my knee. Went to 5 doctors. Only 2 of the doctor had the same diagnosis. The other three had three different findings!

THE PROBLEM is if you are in an emergency situation, wala ng time for 2nd opinion. And if the nurse was a former doctor, at iba ang nakita niya, profession or saving a life? Hirap na decision?