OPINION: Can Doctors work without Nurses and Midwives?

OPINION: “They’re just nurses, simply a doctor’s assistant,” a cliché that is nothing new to us. In fact, some patients treat us as if we are their paid servants. They think doctors are superior to nurses and midwives forgetting that these are two different professionals, each with their own roles. As professional health care providers, we usually marginalize such perceptions and focus more on our patients and their wellbeing. However, for the “nth time,” it would also be best to demonstrate how nurses and doctors work hand in hand.

We have seen and heard most people, especially after discharge praising their doctors, and hardly do they recognize their bedside nurses and midwives. All the praises to doctors are always publicized. But the question is, were nurses and midwives not involved in the care of such patients during their hospital stay or visit? Other people actually go ahead to praise hospitals and don’t single out any of the exceptional services provided by their nurses or midwives. 

For the years we have practiced, we have hardly noticed any moment where a doctor works alone in absence of a nurse or midwife. These two are inseparable. There is hardly any moment where a doctor stays at the patient’s bedside 24/7. It is always the bedside nurse or midwife. To be honest, a doctor will always be available for review or a phone call in case of emergency consultations. With this, we confidently say, there are so many reasons why the nurse or midwife deserves to be recognized and praised after all a good doctor with a bad nurse result in poor patient progress and outcome.

Nurses and midwives are caregivers. If we may ask, “how many times does a doctor stand by the nurse or midwife to observe their work especially after a prescription has been made?  In most hospitals in Uganda, what matters most is the doctors’ prescription but not what will be done to the patient? The doctor prescribes and returns later to confirm if an intervention was done, and there after he or she quickly re-assesses the progress of the patient. Rarely, will the doctor ask how it was done. It takes an authentic nurse or midwife with integrity to offer interventions as documented and record on the file. 

How many times have you called for help and found a doctor reporting to you before a nurse or midwife does? Even when the doctor is nearby, he or she will most likely wait for the nurse or midwife to update him or her on the emergency. Nurses and midwives are life heroes. This may be an old statement in your ears but nurses and midwives are surely self-sacrificing and protective to you.

Additionally, how many times has a doctor come to check your vitals such as blood pressure, temperature, pulse rate, the respiratory rate among others before a nurse does? Sometimes you may get discharged when the doctor has never even checked your vitals because he or she relies on the results of the nurse. This means that if the nurse or midwife has wrongly assessed the patient or has even poorly taken vitals or written wrong information about your vitals, you may be discharged and unfortunately deteriorate shortly after. 

Being a good doctor is not enough. What is actually key is being a good doctor with a good nurse or midwife with you. It’s the nurse or midwife at the dot of time that makes a difference. A good striker with a poor team including mid-fielders and wingers may never score nor yield good results.

It is therefore paramount that patients and the community at large start to recognize and appreciate the efforts of the nurses and midwives that contribute to their well-being.

The authors are; Alupo Alice; Assistant Nursing Officer working with Lira Regional Referral Hospital & BScN scholar at Aga Khan University Uganda and Lilian Nuwabaine Luyima; BSc Nurse & MSN-Midwife & Women’s’ Health Specialist