Over the last few decades, the demand for professional boundaries has drastically increased in many professions. This has been contributed by increasing demands for better services and specialization in various professions that serves not only to reduce underlying conflicts but also to anchor, host and defend territorial definitions as well as the accrued benefits. Such has been the case between the nurses and doctors fraternity for a long time (Kevin, 2006, pp. 74-75).
Doctors discard the low status and jobs, ‘dirty work’ while exploiting the immediate empathy nature of the nurses’ profession especially towards the patients’ oriented duties. Professional boundaries are a concept that is used to denote the extent and define requirements as well as the roles that are expected of a certain profession in the society. In Nursing, the term seeks to establish the immediate requirements and legislations that differentiate the nurses and doctors roles and modes of operation (Ruth & Constance, 2008, p.
39). Most importantly, it has tried to reduce the discrepancies that have been assumed by many doctors and invaders in the profession. Nursing is a profession focused on advocacy of health care to promote quality of life for populations, communities, families as well as individuals from birth to the end of their life. As indicated previously, nursing profession is strongly derived out of ethics and desire to ensure that high levels of sanctity and integrity of life is maintained (Barbara & Lynn, 2008, p. 109).
Therefore, immediate boundaries would enhance their operations by maintaining their security and autonomy thereby promoting professionalism and raising the quality of services offered to the people. This essay gives a clear discussion on the need to develop strong professional boundaries in the nursing sector. It explores the major aspects of doctor-nurse relationship with an inclination to establishing the major resultant implications. Finally, the essay concludes with specific recommendations aimed at harmonizing the problem and ending the quagmire.
Doctor Nurse Relationship. Ignorance for the nurses in the treatment and recovery process of the patient. Having been a nurse for a long time, it is easy to understand the immediate relationship between the doctors and nurses in their daily services delivery. High level insubordination based on the old perception of the nurses’ unquestioning obedience has taken roots so strongly in majority of the health care services. Taking advantage of this presumption, doctors have turned to abuse the position by excluding the nurses in their major decision making.
Due to lack of clear definition of specific boundaries in terms of specialization, the doctors are considered to have more impact in treatment of the patients than the nurses (Anne 2008, p. 277). Besides, even without such definition, the aspect has come to be informally accepted by majority of the medical practitioners including some nurses too. However, the nurses role in the immediate recovery of the patient is of greater essence as they do not just support the patient in taking the medicine through out the day and night, but also monitor their progress with great care.
In their training, nurses are required to develop high level attitudes towards the patients as they entirely depend on them for feeding, cleaning, interpretation of different medical aspects recommended to them while ensuring professional ethics and standards are maintained at the highest standards. Most importantly they offer the patients with emotional support necessary for faster recovery from their illnesses. The boundaries should therefore include their active participation in the treatment process as they play a vital role in the whole process effectiveness and progress (Woodward et al, 2005. pp. 845 – 854).
Nurses roles in the surgery rooms. In the surgery room, it has been more humiliating to the nurses as they are required to passively make the surgeons work perfect who is later strongly accredited with less regards to the perfecting team. Besides the nurses being fully qualified in other areas of caring for the patient, the doctor relegates majority of his work to them. As indicated earlier, the nurses are not required to challenge any of the surgeons’ decisions but abide by their requirements as they finish the patients operations within short periods and then leave the nurses to take care of the patient (Fritz, 2008, p.
82). Therefore, this indicates a complete overlap of the roles to be performed by the nurses and theater activities should be left to the doctors while the patients are handed over to the nurses for immediate and later care. Besides being a clear generalization, assumption, deliberate or unintentional underrating of the nurses profession, it is a clear indicator of torn delineations that lacks clear outlining for harmonious operations (Bessie & Huston, 2008, pp. 752-753). Duties relegation and position of nurses.
Over the years, the doctors have increasingly developed disregard to their work with definitions of the patients in waiting by the nurses. As a care giver, the nurse is requires to work simultaneously in harmony with the doctors to perfect the services delivery. However, doctors demand the characterization of the patient and relegate the duty of prescribing to the nurse on duty in their absence. Besides, majority of them have established consultancies where they attend to their businesses majority of the times.
Also, poor administrations have more often used doctors for managerial purposes and failing to replace them for their duties. Nurses are therefore required to assume their major activities when they are away irrespective of the main reason (Ruth & Constance, 2008, p. 40). Though professionally derived out of empathy, the doctors activities must be attended by the doctors and not the nurses. It acts as a strong abyss of high quality services since various nurse’s duties are late or left unattended to altogether.
Besides, it can never be reciprocated and may overload the nurses as they first leave their jobs for the doctors’ duties. This also outlines lack of clear legislative framework and internalized rules meant for higher efficiency. Major misconceptions and need for strong boundaries. Until recently, medical trainings have been run with major emphasis on the services to be offered to the patients. As a result general assumptions have infiltrated from generation to generation on the direct and unsounded demands for the doctors.
The perception that the doctors are the initiators of the treatment process and the nurses taking lesser account is fully wrong. Besides, it has come to be agreed that the doctors rank higher legitimately in their professional power. As a result, they feel less threatened as their activities are strongly guarded by the goodwill as well as legal backing at all levels both locally and internationally. Therefore, acting as a major umbrella for enhancing and protecting their niche, they have maintained the good name through special rules on their conducts ensuring little or no intrusion (Wiseman, 2007.
pp. 167-171). Nurses on the other hand have been involved in the services delivery for 24 hours to the patients. Adding to their inclusive and captivating training, they have had little concerns for the immediate legitimization of the profession. With revelation of the core roles they play in the preventive and recovery process, their decision to any case is a matter of life and death. Besides, their profession has come out to be clearly different from the biomedical specialization of the doctors.
As a result difference in definition of the boundaries is negatively effecting the services relay to the community and particular patients. Therefore, strong sealing through professional boundaries delineation requires a strong consideration for direct and indirect appreciation of the varying nurses tasks (Megan-Jane, 2008, p. 3). Some medical problems like epilepsy and depression demands more care than direct treatment by the doctors. Nurses therefore are increasingly performing unrecognized and unappreciated biomedical activities that should be extended in their definition for better identity.