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Dialogues@RU is published annually
by the
Writing Program at
Rutgers, The State
University of New Jersey
Volume One
Spring 2002
Removing
Cultural Stereotypes to Find Real Differences
Between Doctors and Nurses -
Page 1
by Jon Laor
In literature that notes the differences between nurses and doctors, many parallels are drawn to domestic and societal differences between males and females, comparing the historical roles of nurses to the roles of nineteenth century families' wives. With these metaphors of nursing as female servitude, certain images arise that seem to characterize and limit the potential of nurses. How does the prevalent use of imagery that compares nurses to female servants affect the nature of the controversy about the roles of nurses and doctors and how do these constrictions play into effectiveness of patient care? This imagery is an example of a "sleeping metaphor" that Emily Martin warned about, in her article "The Egg and the Sperm" (Martin 104). She explains how biological scientific literature misrepresents the facts of reproduction by adding imagery that evokes cultural stereotypes of males and females and "have an almost dogged insistence on casting female processes in a negative light" (Martin 91). The description of these scientific phenomena uses language specific to the intent or effect of representing social and cultural biases as based in fact thereby perpetuating these beliefs. In a two page sweeping generalization of history, Shirley A. Smoyak notes in her essay "Problems in Interprofessional Relations", found in Issues in Collaborative Practice edited by Jean E. Steel, that the original role of women in hunter-gatherer societies was to care for the children, the old, and the sick. Later in her writing, she skips to the discussion of nurses and physicians without any adequate connection between the two topics, though the analogy is implied. The sleeping metaphor in Smoyak's essay endangers the future of medical care by setting limits on nurses and female doctors. If, however, the roles of nurses were not to be shown as analogous to female servitude, then what does gender contribute to the division between nurses and doctors? In order to understand this, it is important not to generalize doctors as male and nurses as female but instead to explore the relationships of workers who do not fit the stereotypical gender description. An article by Raj Persuad in "A Doctor's Health Clinic" reveals the stress felt by a female doctor as a result of her relationships with nurses that she works with. It deals factually with the difficulties women face as doctors. Conversly, Eileen Willis' essay "Time and the Labor Process: Construction of Masculinities in Nursing" approaches the nursing from the perspective of male nurses. Eileen Willis' essay seeks to show that previous literature on the subject of male nurses does not adequately deal with the way male nurses do the actual work to which they are assigned, but rather that older literature, sticking to the concept that nurses and doctors are analogous to the wife and husband in a 19th century family, mostly deals with the migration of male nurses away from bedside positions to positions of more authority or emotional detachment. These two essays effectively show that the difference between doctors and nurses cannot be simply attributed to the difference between the genders that dominate each respective occupation. What then, draws the line between nursing and biomedicine? Is it, as Smoyak says, "physicians are concerned primarily with identification of disease and strategies for treatment and cure, while, in general, nurses are concerned primarily with nurturing, caring, helping to cope, comforting, counseling, and life-supporting activities of the care of patients" (Smoyak 83)? There seem to be more ideological differences between the two professions rather than a difference in goals that Smoyak asserts. In the end, the goal of each is to treat the patient. How they approach this problem differs in ways discussed in Vivien Woodward's "Professional caring: a contradiction in terms?" and Carl May's and Christine Fleming's "The professional imagination: narrative and the symbolic boundaries between medicine and nursing." To sum up the difference between nurses and doctors as a simple difference between womanly and manly behavior, as Smoyak and many others have done, damages the respect that nurses deserve, prevents medical progress in terms of collaborative practice (Steel 6), and medical understanding (Woodward), and allows for the continuance of cultural imposition on scientific terrain, as Martin warns against. How patients are treated relates to the institutional ideologies, which are developed through discourse and power. The way to give patients the best care, therefore, is to filter out ideologies based on gender bias and allow distinct ideologies to collaborate and learn from each other to further their unified goals.