This is a repost from today’s Primary Care Progress. HealthCetera and Primary Care Progress are modeling that interprofessional exchange matters to advance the public’s health. We’re celebrating Nurses Week together.
The IOM’s 2010 report The Future of Nursing: Leading Change, Advancing Health called for “nurses [to] be full partners, with physicians and other health care professionals, in redesigning health care in the United States.” We need a culture of collaboration and interprofessionalism in education and practice. Here, an R.N. makes the case for interprofessionalism in family medicine in this post that originally ran in 2012 on STFM’s blog.
One year ago, I began teaching in an interprofessional student clinic. The student clinic itself had been around for decades, staffed by students in our family medicine clerkship. However, after a recent campus-wide push for more interprofessional education across health care disciplines, we began adding nursing and pharmacy students to our clinic and having all the students see patients as an interprofessional team.
I was slotted in as the nursing faculty at the last minute when it became evident the previously chosen faculty member had too many obligations to manage. Having not been in on the planning meetings, I had no idea what to expect from the whole experience. I was nervous and hoped I would be able to contribute something meaningful to our team and to the education of our students. Little did I know how profoundly this experience would change my life.
One of the first insights we try to give our students in this clerkship is the chance to learn about the other’s professional training, education, scope of practice, and ethics. In the first ever clerkship of interprofessional clinic, we too, as faculty, were learning things we never knew about our professional colleagues, despite having been licensed practitioners for years. I gained a better understanding of the nuances of medical education, which has been helpful. More importantly, I learned from family physicians what makes family medicine different.
In formal nursing education we don’t learn much about physicians, their training, or the differences between specialties. Really, we don’t learn much formally about physicians at all. What we learn about you as a profession is what you teach us. The attitudes of nurses and the ways in which they collaborate with physicians are largely shaped by the early career encounters they have with doctors.
Nursing graduates leave school with a basic understanding of different medicine specialties; we know cardiologists deal with hearts, orthopods with bones, and so on and so forth. However, we don’t graduate with a knowledge of the subtleties or ethos of different specialties. Among the least clear distinctions for nursing is the difference between internal and family medicine. Most of us would be able to tell you that family medicine takes care of kids in addition to adults. Beyond that the distinction is vague.
Imagine my excitement and surprise when I found out how much family docs care about prevention and social determinants of health. Beyond just caring for your patients, you are concerned with public health and that, often, family physicians make their medical practice an extension of social justice principles. These are things that nurses dig. These are aspects that are foundational to nursing’s world view.
Learning about and aligning with family medicine has renewed the purpose and passion in my professional nursing career. I was previously opposed to pursuing my advanced practice degree in family practice, perceiving that a family nurse practitioner (FNP) degree was only for nurses who want to work in “Minute Clinics” at chain pharmacies. However, since spending time working with family physicians, I decided FNP is the advanced practice route for me and that I wanted to get the background in prevention and public health that would help prepare me to stand up with family docs and work for change in our health care system.
In addition, I have become a vocal advocate for the specialty of family medicine, as have many of my nursing students who have come through our interprofessional clinic. Three of our nursing students from last year are new graduates who are helping to open a brand new inpatient family medicine unit at our academic health center. Their lives have been changed through exposure to your mission, and they tell everyone who will listen — and even some who don’t want to— about how amazing family medicine is.
What we, as nurses, learn about medicine, or family medicine, is what you teach us. In taking the time to show us the soul of family medicine, you will mobilize your greatest advocates.
Courtney Kasun, R.N., has worked in home health, oncology, emergency, orthopedics, and now, hospice. In her sixth year of practice, she has spent the last 3 years teaching at a school of nursing in addition to maintaining a professional practice. She is enrolled in a DNP program with a focus on FNP. “I passionately believe in the right of every person to quality health care,” she says. “I love the profession of nursing, but also think we have a lot of growing to do.”