By Aaron Michelfelder and Fran Vlasses
As the health care professions struggle with defining a “doctor,” a “nurse,” and all of the other remarkable people comprising the health-care team, it is clear to us that the most important perspective is that of the patient. Who better to contribute to the conversation than a physician and a nurse who are patients themselves?
The Patient (a physician) on “What is a Nurse?”
It was the outpatient nurse whom I nervously called for an appointment with the surgeon, and who compassionately found a reasonably soon appointment time. At the visit, it was her gentle voice that immediately calmed me, and she who corrected the medication errors in my electronic chart. Later, as I lay on the hospital gurney awaiting surgery, it was the pre-op nurse who recognized the fear on my stoic face. She was the one who squeezed my hand and whispered, “Everything will be alright.” In the operating room through a haze of machines, bright lights, sedatives, and scattered voices, it was the pacemaker nurse, whom I have come to know well over many years, who triggered in me a wave of relief as she deactivated my defibrillator in preparation for surgery. Before the anesthesia, her face was the last I remember seeing, and hers was the first I saw when groggily recovering as she reactivated my defibrillator She who first relayed the good news of the successful surgery. It was the shaking hands of the student nurse, who attempted to change the IV bag, and his confident nurse professor who together, did everything right. At home, it was the surgical nurse practitioner who called to check on my recovery, and whose compassion and support bubbled through the phone. All of these extraordinary individuals have different training, duties, and approaches to health care; and yet as a patient, I recognize each of them as a nurse…
The Patient (a nurse) on “What is a Doctor?”
The physician joined the practice after residency. I was one of his first patients. For over 26 years he has cared for me and those I bring him: children, husband, aging mother, son in law, grandchildren, friends, “my people”. Now when I see him, whether I am the patient or the driver, I am struck by how well he knows the intricacies of my life. I don’t need to explain much. He knows me well enough to translate a situation into “Vlasses” terms. He once told my young son, “I think you’re fine but get this test, because otherwise your mother will worry.” That test turned my son’s attention to medicine for a career. He is equally at ease with asking tough life questions of my 92 year-old mother, “if we find something, do you want us to treat it?” and in getting a fix on how I am managing my caretaker burden.
No doubt he is a skilled diagnostician with firm command of practice guidelines. But his artistry is most apparent as he designs approaches that are custom tailored to the lifeways of the Vlasses clan. He has wordlessly accepted my invitation to walk with me on my life journey and, I suspect unknown to him, his impact is profound. In the words of my 2 year-old granddaughter following a recent hospitalization, “Doctor Lee made me better!” Yes, his special brand of doctoring makes me better too … better able to be who I am.
As medical professionals, we constantly wrestle with definitions and roles of the health care team members. As patients, we have decided that the question “WHAT” is a nurse or doctor, is not nearly as important as “WHO” is the nurse and the doctor. From our perspective as patients, the team is defined not by titles, academic publications and legalistic scope of practice acts, but by the individuals on the team, working together, who strive to comfort us, sometimes cure us, and always care for us.
Aaron J. Michelfelder, MD, FAAFP, FAAMA is a professor of family medicine, bioethics & health policy, and medical education at the Loyola University Chicago Stritch School of Medicine
Frances Vlasses,PhD, RN, NEA-BC, ANEF, FAAN is a professor of nursing at the Loyola University Chicago Marcella Niehoff School of Nursing
Together, Drs. Vlasses and Michelfelder Co-Direct Loyola’s Institute for Transformative Interprofessional Education.