Sometimes, I wish I was a nurse.
As a nurse, my work-life balance could greatly improve because my three 12-hour shifts would constitute a rewarding and flexible full-time medical career. I would care for all kinds of patients, not just stick to one medical specialty. Maybe I’d go for an advanced nursing degree; I would enroll in school full-time and also maintain a paid full-time job. Like many nurses, my hospital employer would pay for my tuition. If I wanted to take time off and pursue other interests, I wouldn’t worry about risking my entire career. And if I was interested in health care leadership, I’d move up the ladder, one position at a time.
But none of the above applies to me. Because, you see, I’m not a nurse. I’m a female doctor.
Throughout medical school and residency, I’ve wondered why most of my mentors were male. It puzzled me why there were few women in hospital leadership. But then I learned how wrong I was. There are actually many women in medical administration ― but they’re nurses, not doctors.
How have nurses made it to the top and with accompanying lower rates of burnout? I believe physicians have a lot to learn from our nursing colleagues. Here’s why:
As a full-time radiation oncologist, my work-life balance teeter totters on the seesaw fulcrum. Why does a full-time nursing job entail three 12-hour shifts per week? Because many nurses like it this way. Most nurses are female, and many are mothers. If you’re working full time while raising children, it’s great to have a flexible work schedule. It’s NOT better for patients to have a new nurse every day, which is required if their nurse only comes in three times a week. Arguably, patients would rather have the same nurse every day (Monday-Friday, 9-5). Yet nurses have won this battle and have good patient outcomes to prove it’s OK.
If a nurse wants to change her work environment, she can transfer to another specialty. On the other hand, there are no real options for doctors to continue their training. For example, if I wanted to practice cardiology instead of oncology, I can’t. In fact, there is no pathway even for residents to switch to another training program, whether in another field or in different hospital. And this certainly doesn’t exist for doctors who have completed their training.
Doctors experience high rates of burnout (1, 2). A great way to prevent burnout is to take time to reflect and pursue other interests. I recently met a nurse who joined our department for months months. She worked for an agency that places nurses in short-term positions. After her current placement, she was going to tour Europe for six months. Afterwards, she’d return to a new position at a new medical department.
Can doctors take time off? Not without risking their entire careers. Some physicians work as locum tenens and provide temporary coverage. But a doctor who does this for too long ― or who takes time away from medical altogether ― may be unable to find a stable position within medicine again. The prevailing culture believes, “Doctors aren’t supposed to need time off. And why would a doctor have any other interests aside from medicine ― don’t doctors devote their entire lives and entire beings to medicine, and medicine alone?”
Medical leadership is commonly composed of:
1. Male physicians
2. Female nurses
How have nurses made it to the top? Many nurses have a strong desire to lead, and the nursing lobbying groups have supported this goal very effectively. Over the past century, nurses have consistently insisted their voices be heard, and they have won the battle. For example, in many states nurse practitioners can practice solo without the historically required physician oversight.
The American Nurses Credentialing Center (ANCC) recognizes hospitals with nursing excellence and quality patient care with its prestigious Magnet Award. To apply for this designation, hospitals must complete an extensive application. Part of the required documentation is to show support for their hospital nurses’ “professional development.” You see, part of a nurse’s career identity is professional development.
Another component of the Magnet Award application is “recognition of nursing.” It’s incredible how the acknowledgement of nursing contributions has become a must. So you won’t be surprised that National Nurses Week was designated in 1974. It took 16 years for physicians to get their one day of recognition, National Doctors Day, which was established in 1990. Do “top hospitals” ask their doctors how supported they feel in regards to their professional development? No such responsibility exists for physicians, whether real or theoretical.
Nurses have won a seat at the table and have broken through the glass ceiling in medicine. These women professionals enjoy high levels of job satisfaction while maintaining flexible work schedules. Working side by side with nurses, in the same hospitals and caring for the same patients, female physicians (arguably all physicians) have a lot to learn.
Let’s learn from our Nurses and Make Medicine Great Again.