CHAPTER 3

RESULTS DISCUSSION AND IMPLICATIONS

Deciding my career path......

When I first enrolled in nursing I had no idea that I will be taking medicine afterwards, I
didnt imagine myself as a doctor in the future, I just wanted to follow the path my parents
planned for me, to become a nurse and work in the united states like my sisters who were
already registered nurse at that time, but when I was a fourth year nursing student, I made the
decision that changed my life, to become a physician.

Back in my childhood I really wanted to become a doctor, more specifically a

pediatrician, but as a high school student I realised I was not so sure about what career path to
take, I had no plans in mind for my future and when my parents encouraged me to become I
nurse, I went through with what they have chosen for me.

But as I perused my studies as a nursing student, I began to realize what I really wanted
to become, my childhood dream of becoming a pediatrician one day came back to me as a
possible goal I could strive a little longer to achieve, I was a graduating nursing student at that
time but I felt like my journey should not end there, that there was more to what I could
become, the decision was hard and I didnt feel completely prepared for it, but I was sure of
one thing, I wanted to become a doctor.

According to the study of Heikkil et al (2015) their outcomes indicated that those who
have a strong inner motivation to work in the medical profession are also able to adapt to the
sometimes challenging conditions faced by physicians accordingly, the most important motives
for entering medicine are related to the content of the work as a physician and to medical
profession in general.

My parents were supportive of my choice, they even encouraged me to pursue my

studies while I was still young, I started medical school in 2009 right after I passed the board
exam, thus, beginning a new chapter of my life I never knew anything about, we had no doctor
in the family and I wanted to be the first, but that also meant that I had no one to tell me what
to expect especially as a medical student coming from a BSN course.

A difficult beginning for a nurse....

Medical school, in all honesty, was really difficult for me, as a nursing student, the first
two years in med school it were really tough for me, because the subjects are hard and you
really make an effort just to pass the subjects. unlike my nursing years where you just listen
very carefully to the clinical instructors and professors even if you will not read your books and
you will able to get high grades.

But in med school, you will double; triple and even quadruple your effort just to get 75
grades. There are times that even I gave my very best; I was not able to pass my subjects. I was
so disappointed that time because I am not use to get that certain grades during my nursing
years. But I just get my confidence in my classmates who have the same premed as me,
because we can relate to each other in terms of the tough experiences in our first two years.

Medical subjects like biochemistry and anatomy were a great struggle, in biochemistry
for example; we just had an overview of the general concepts and principles but in medicine,
its much more deeper, the same thing goes to anatomy, the anatomy of medical school is very
different from the anatomy I studied during nursing school.

That was the time i started to appreciate other premedical courses like MedTech
(medical technologist) because the subjects during their fourth year were also the same
subjects during first year medicine which made it easier for them to excel in this part of medical
school.

Where BSN medical students excel....

The clerkship experience is where the tables have turned, as i became a third year
medical students, we started our clinical phase of medical education where we have duties in
the hospital that can last for 24 hours, that was the part of the medical school where all what i
learnt during my nursing school years was the most helpful.
 As a nursing student, i was used to spending 8 hours of duty in the hospital; you put to
use your communication and interaction skills with the patients, especially dealing with hard
patients

Nurses spend more time with their patients which plays a great role in developing their
assessment and communication skills, they are familiar with medical terminology and medical
procedures as well as working in collaboration in hospital settings (Morris, 2015), Berghout
(2014) attributed this to those students previous experiences in the medical field that have a
positive impact on their performance, those students are more familiar with what must be
done and how as future physicians.

I am also thankful having BSN as a premedical course because it was really useful during my
hospital exposure.It did not only give me an idea on what procedures are needed to be done
but it also helped me attitude-wise like how to be patient, to approach clients and how to
explain to the client in a appropriate manner.

Many medical schools provide a program for early clinical exposure to prepare first-year
medical students for clinical education. Early exposure of medical students to clinical
experiences will enhance their professional socialization process and will provide effective
learning along with understanding. Early exposure to a clinical medicine program helps new
students to cope with tension and job stress and improves their awareness of their profession
(Afra et al, 2015).

Jackson et al (2009) proved in their study that a pre clinical skills curriculum leads to
positive improvements in the performance of third year medical students, early clinical
experience helps improve the preparation of pre-clinical students for their clinical rotations by
introducing them to the reality of the clinical environment, and facilitating application of
knowledge to clinical practice, Berghout (2014) attributed this to those students previous
experiences in the medical field that have a positive impact on their performance, those
students are more familiar with what must be done and how as future physicians.
 According to the Philippines universities and colleges guide, these clinical duties are part
of what is called Related Learning Experience where nursing students are Supervised by an
experienced clinical instructor who will monitor their performance as they perform nursing
procedure on actual patients

The unique side of nursing is you are expert in being compassionate in giving care to
patients, because nurses taught how to treat right the patients with justice and fairness during
school days. But for me, there is also a personal factor, it depends on the person how a nurse
treat their patients. But if a nurse is very ideal, you are really compassionate and dedicated in
every detailed of your work especially in caring a patient.

Compassionate care, according to Roach (2007), requires immersion into the pain,
brokenness, fear, and anguish of another, even when that person is a stranger. Professional
standards call for nurses to practice with compassion (e.g., American Nurses Association [ANA]
Code of Ethics, International Council of Nurses), and innumerable hospital mission and vision
statements include compassion as an essential purpose and directive (American Nurses
Association, 2001; International Council of Nurses, 2006, Milton, 2003). Discussion of
compassion as a means of establishing a connection with a patient abounds in the literature
(Buck, 2006; Grant, 2004; OBrien, 2008; Schultz et al., 2007).

Furthermore, discourse on compassion asserts it is critical to establishing meaningful

nurse-patient relationships (Davis, 2006; Roach, 2007; Wallis, 2005). Provision 1 in the ANA
(2001) Code of Ethics expresses nursings commitment to patients and the community, stating
The nurse, in all professional relationships, practices with compassion and respect for the
inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of
social or economic status, personal attributes, or the nature of health problems

There are also advantages and disadvantages of BSN as a premedical course, like what I
have shared it was really tough during my first two years in med school. Its like everything is
new for me, because in my subjects during BSN years are very basic comparing to my subjects
in medicine.
 According to Afra et al (2015) the first years of medical education (especially the first
two years) are crucial to the success of medical students. The success is due not to the
knowledge gained, but the attitude and perceptions formed in medical students on the role of
physicians and status of medical knowledge.

There were medical subjects also that I found very relevant like microbiology during
nursing, and I had basic information about it, I found microbiology as an easy subject. Also for
the subject Physical Diagnosis (PDX), I found it easier because it has similarities to what I did
during my exposure in the hospital when I was in nursing for example history taking or the
patient and making the diagnosis, Pharmacology subject in nursing also helped me a little since
it kind of gave me some information but not that extensive compared to the Pharmacology in
medicine

Berghout (2014) who described the same findings in her study, she recognized that
students with health related background have the advantage of being familiar with certain
subjects or skills from their previous study.

From a medical student to a resident doctor....

What I am now...

To future nurse-physicians.....