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No Comparison

July 21, 2014

Having been both a nurse and a doctor, most of the questions I get from readers have to do with making the decision between nursing and medicine.  Let’s lay aside for a moment the reality that the fields are totally different and that direct comparisons are useless.  But people ask me all the time, so as a little experiment, I turned to the US Department of Labor.  The USDOL, in it’s Employment and Training Administration arm, has an Occupational Information Network, or O*NET.  O*Net Online has a set of what it calls Summary Reports, that list the tasks, knowledge base, work styles, values, abilities, and interests for a wide variety of jobs.  I looked up the one for Registered Nurse and compared it to the one for General Internist.  Here’s what a comparison of the two reports reveals:

Under “Tasks” the doctor list uses authoritative words like

The nurse list uses subordinate words like

This is the USDOL, not me.  Don’t shoot the messenger.  Virtually any member of either field would say that both nurses and doctors do all these things, to a greater or lesser degree, and depending on educational level and specialty.

The entry under “Technology” is virtually useless, except for it’s amusement value.  Apparently internists use splinter forceps while nurses use curved hemostats.  Who knew?

Here’s the “Knowledge” category:

1.  Both doctors and nurses need to know about medicine, dentistry, biology, psychology, and sociology.  Doctors need chemistry.  Nurses need math and computers.  I guess this suggests that the doctor does the experiments but the nurse tells us what it all means.  There could be some profound truth in there, but I doubt the DOL knows what it is.

2. Doctors need administration and management skills.  Nurses don’t.  I’m ducking now to avoid the rotten tomatoes coming my way from nurse managers and vice presidents for nursing, as well as any nurse who takes care of actual people.

3. Nurses need English language skills but doctors don’t.   Wow.  Truer, more hilarious words were never spoken.

Then we come to “Skills” and “Abilities”.  Here’s where the simplistic, incomplete nature of these Summary Reports really becomes clear, and potentially inflammatory, politically incorrect, and possibly felonious.  Right off the top, the internist needs science, complex problem solving, category flexibility, and active learning.   No laws of hemodynamics or pesky thinking involved in nursing, it seems; no need to “understand the implications of new information for oth current and future problem-solving”.  Ah, but nurses have their own skill set that doctors don’t need.  Things like service orientation, coordination, and monitoring.  Like, say, a waiter.  And finally, the kicker: both nurses and doctors need speech clarity but only nurses need speech recognition.  And if that doesn’t tell the whole story…

There’s a lot more categories with inclusions and omissions along the same vein, but you get the idea.  This post is all in good fun, and I have nothing against the Department of Labor or it’s misguided attempt to give us all Occupational Information.  But it does make my point that such comparisons are ludicrous and misleading, if not also occasionally humorous.  When someone asks me “Should I be a nurse or a doctor?” I don’t send them to O*Net.  I send them to their parents, their childhoods, their favorite authors and movies, their passions, what they dream about.  I send them back to their lives to ask the question of themselves.

One Comment
  1. Thought provoking. I would wonder why any one would shoot you for this. Honesty may not be PC but doesn’t no one deserves getting wanged for the truth.

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