NYTimesCubaScreenshotA few years ago I was sitting around a table with nursing leaders in Washington, D.C., discussing various ways to remedy the pending nursing shortage. One idea brought up was to train foreign physicians ineligible to practice medicine in the U.S. to be nurses. Part of the argument was that, since they were already trained as doctors, they would be able to learn to practice as nurses in a much shorter period of time.

I never agreed with that thinking. As we learn nursing we are learning a lot more than anatomy and physiology. We are learning to connect with our patients, to have compassion, and to work as a highly skilled team member. It is a different way of connecting with the patient than that of the physician. And nurses today have a lot more to learn and apply than ever before because of the increased complexity of health conditions, the increasingly complex health care environment, and the needs of the populations we care for.

The profession of nursing has come a long way since we were thought of as “handmaidens” of physicians. Nursing has evolved, with greater scope of nursing practice, autonomy, and novel roles within the health care system. And yes, if we want the recognition there are plenty of “doctor nurses” with doctorate degrees, as well as advanced practice nurses with independent scope of practice.

These issues hit home for me recently when I read an article in the NY Times titled: “Doctors in Cuba Start Over in the U.S.” I’d thought we’d left behind many of the biases subtly expressed in this piece. What could have been an enlightening article about the perseverance of Cuban physicians immigrating to the U.S. instead appeared to tout the superiority of the medical profession to that of nursing.

The author described how the foreign-trained doctors are unable to practice medicine but instead have had to “settle” for work as “medical assistants, technicians and nurses.” As a male in the nursing profession I am asked regularly why I chose nursing instead of medicine. Many comments and questions repeat themselves, such as “surely you are smart enough” and “why do you want to be the doctor’s helper instead of the boss?”

I chose nursing because I wanted to be a nurse. I am the son and brother of nurses and knew the profession I was choosing. I salute the bravery of those who struggle to leave their countries to escape persecution or to seek a better life. As the same time, I’d like to say this to doctors coming to the U.S. from other countries: if you think of becoming a nurse instead of a doctor as “settling,” don’t do it. If a part of you still pines for the profession and the title of physician, there may be a way to complete the requirements you need to function in the profession.

In nursing, we need commitment, caring, and a desire to further the profession, not individuals who choose it because they can’t be something else. The former physicians in this article may become excellent nurses, and I give them the benefit of the doubt—but even so, when I read an article like this I can’t help thinking, not for the first time, that our system would have better outcomes if there was a little more humility.

Michael C. Desjardins, MSN, APRN, is a member of the AJN editorial board

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