+1 862 207 3288 • The Professionalization of American Medicine
Respond to the following prompt in one page:
Select a specific field in American medicine and analyze how it has evolved from its inception in the United States to the present.
https://mcphs.blackboard.com/webapps/blackboard/content/launchLink.jsp?course_id=_12079_1&content_id=_315829_1&mode=view
• Readings:
o Leavitt and Numbers, Susan Reverby, “Neither for the Drawing Room Nor for the Kitchen, pp. 253-265.
o Julie Fairman and Patricia D. Antonio, “History Counts: How history can shape our understanding of health policy,” Nursing OutlookVol 61: 5 (Sept/Oct 2013), pp. 346-352. (Available through E-Journals).
o Ray Bingham, “The Face-Off,” Health Affairs27, no.1 (2008): 210-215. http://content.healthaffairs.org.ezproxy.mcphs.edu/content/27/1.toc.
o Pauline Chen, “Nurses’ Role in the Future of Health Care,” The New York Times, November 18, 2010. http://www.nytimes.com/2010/11/18/health/views/18chen.html?_r=1&scp=1&sq=Nurses’%20role%20in%20the%20future%20of%20health%20care&st=cse
o Natalie Holt, “’Confusion’s Masterpiece’: The Development of the Physician Assistant Profession.” Bulletin of the History of Medicine. 72:2, Summer 1998, pp. 246-278.
o Perri A. Morgan and Roderick S. Hooker, “Choice Of Specialties among Physician Assistants in the United States,” Health Affairs, 29, no.5 (2010): 887-892.
o Michael J. Dill, Stacie Pankow, Clese Erikson, and Scott Shipman. “Survey Shows Consumers Open To a Greater Role for Physician Assistants and Nurse Practitioners,”Health Affairs, June 2013. 32: 1135-1142.
1. Write me a response about the following post.
“There are numerous fields in American medicine, and they have evolved from their original role in the field. Among those medical professionals, a nurse is a health care expert whose role has been changing since the beginning of this profession. Before the appearance of Florence Nightingale in the 1800s, nurses were significantly undervalued in the medical field even in the United States; although they also managed patients along with physicians, their job was to do miscellaneous work within hospitals, such as cleaning corridors and patients’ rooms. However, due to the effort of Florence Nightingale, nurses could focus more on managing patients by aiding medical doctors. Nightingale believed that nurses had to be able to know detailed information, such as names and medical history, of patients whom they were assigned. Even though Nightingale proposed her argument in the United Kingdom, her explanation has become the standard of nursing in the world, so nurses in the United States have also followed the standard in American medicine. In addition, a person who wanted to become a nurse was not required to obtain a medical license before the 1900s, until a nurse named Bedford Fenwick introduced nationwide nursing license. Fenwick argued for the establishment of nationwide nursing license in the United Kingdom and organized nursing curriculum, and her idea spread to the United States when the United Kingdom, the United States and Germany founded the International Council of Nurses in 1899 and shared nursing standards internationally. This is correlated with the course reading “Historical counts: How history can shape our understanding of health policy,” which explains that physicians need “educated allies” to maintain aseptic surgical suites and on hospital wards. In other words, a nurse has evolved from a hospital worker into a well-educated and nationally registered health care expert, who takes care of admitted patients more often than physicians.
The role of nurses has evolved even more in these days, owing to the increased patient population and the lack of medical doctors. According to the course reading “Nurses’ Role in the Future of Health Care,” modern America faces 32 million new patients, while the deficit of medical doctors will reach 100,000. The author of the article explains that our society only focuses on modifying policies like adjusting the number or medical schools to benefit medical doctors, not nurses. The author argues that the society should work on developing plans for nurses, since nurses form the largest sector in American medicine. For instance, the author brings up an example called the Transitional Care Model Program that is run by the University of Pennsylvania that saved as much as $5,000 per patient. In this program, a nurse is assigned to an elderly hospitalized patient with a possibility of relapse, and the nurse takes care of this patient up to three months after the discharge by providing home care services and accompanying them to other clinics. In addition, nurse practitioners even have an authority to prescribing medications, which was a right only for medical doctors in the past. Therefore, the nurse has significantly evolved throughout American medicine, so patients can receive better quality of managements that lead to the overall development of medical service. “
2. Write me a response about the following post.
“Nursing has markedly evolved from its inception in the U.S. to present time. Nurses currently form the largest sector of health care providers, with more than three million currently registered; but few have led or even been involved in the formal policy discussions regarding the future care of patients (Chen, NYTimes). World War II transformed nursing profession; until then, most nurses worked in patient’s homes. Prior to the mid 19th century, most Americans when ill stayed home and were taken care of by family; but If seriously ill and had the means, would have to pay for a nurse. Nurses were usually female and were labelled “nurses” mostly via self-proclamation and experience acquired through caring for the sick family members, domestic services, or hospital work (Reverby, 253). In 1873, the first nursing school was linked to hospitals that trained women to nurse. In the 1880s and 1890s, the role of a trained nurse was still ambiguous because an untrained staff could do majority of her work. The trained nurse, in order to get higher wages, had to prove herself to physicians and families through “her personality, bearing, and character, as a new vital creation” (Reverby, 254). However, by 1900, it was hard to determine the differences between trained nurses and untrained nurses. Both had the same job functions and were given the same label whether they had gone through a training program or not. Coupled with the struggle of getting licensing laws that differentiated the trained nurse from the untrained, in 1990’s the supply of nurses was greater than the demand and they had to “attach” themselves to physicians in order to be recognised for a position. Although physicians always had the upper hand when it came to patient’s health and nurses had a limit to their autonomy, nurses created a variety of ways for surviving, reshaping, and enjoying their work.
In the 20th century and beyond, the nursing profession has definitely evolved from what it used to be. Nursing is now a licensed profession and now has postgraduate certification as well, for example, Nurse practitioners (NP). Today with the increased volume of patients being seen due to the Patient Protection and Affordable Care Act, nurses are needed more than ever as part of a healthcare team. They can help to provide better quality patient care due to physician shortages and limited time. NP, who now have prescriptive authority, and ability to diagnose and treat certain conditions, help improve the supply of primary care providers that does not rely on physician supply (Fairman). The article “The Face Off” by Ray Bingham expresses the importance of nurses in health care. It reflects the role of Nurses in providing individualized care and their ability to recognise the uniqueness of each patient. This ability is acquired due to the amount of time they spend with each patient and it enables nurses tailor care effectively. Physicians, on the other hand, do not spend as much time with their patients. As a result may end up treating patients the “textbook” way before realizing the uniqueness each patient brings. Although the nursing profession has survived previous challenges on becoming recognised, “The Face Off” article highlights how nurses inputs in the decision-making process of providing health care is still often disregarded by physicians till date.
Nursing today is way different from what it used to be. Nursing profession should not be overlooked because they possess a lot of knowledge about patient care physicians do not have. These professions complement each other and should both be equally appreciated.”
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