What is doctors and nurses game

Stein LI. The Doctor-Nurse Game. Arch Gen Psychiatry. Coronavirus Resource Center. Our website uses cookies to enhance your experience.

By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Twitter Facebook. This Issue. June Leonard I. Stein, MD. Author Affiliations Madison, Wis. Like Cottle, Dr Duncan Mclean from the Anna Freud Centre says that the way parents react to exploratory games is very important, and that it is important to find the line between condemning and condoning the behaviour. Cottle advises: "A brisk but relaxed change of mood is probably a good idea if you feel awkward about your child wanting to play these sort of games with someone else's child, or they seem to be playing 'doctors and nurses' to the exclusion of everything else.

Take them to the park or think of another activity. If all else fails, be patient. My sister's children used to play "bum-sniffing" in which they would not only sniff each others bums but go round trying to sniff other children's bottoms. They seemed like little animals and when they started to do it in public I am afraid I did resort to saying that it was 'unhygienic' which is probably the same as saying 'dirty'.

The only thing that stopped them in the end was growing out of it. But what if the child does not grow out of it, or if one's vague embarrassment is replaced by a deeper unease? A friend's son who has played his fair share of exploratory games came home from tea with a school friend upset.

Later that evening he told her that the other boy had asked him to "suck his willy" and that he didn't want to play with him again. I remember hearing him asking my son how many fannies he had seen when he was about four, and comparing women's breasts.

She spoke to the boy's mother. I think her child had much older siblings and he had watched adult films and videos. Christine Cottle says, "There is a difference between children who are just naturally curious and exploratory and those who have been exposed to adult sexuality. This conflict sets up opportunities for chance occurrences, but mostly players make choices that then affect the outcome or payoff. This sort of analysis has been used to explore aspects of nursing practice Reeves, et al, ; Sweet and Norman, Game theory has also been used to explore how people are motivated to make moral choices Axelrod, , and communicate and signal understanding as in the work of Skyrms and Bicchieri Theorists such as Sober and Wilson and McKenzie have argued that the emergence of group norms or, in the case of nursing, professional standards, are founded on the bargaining and development of attitudes about morality.

These all too very human conditions make the issue of the doctor-nurse game a very real practical concern for discussion in the modern era of healthcare reforms. I believe that the game is far from over and that it is very much game on. In fact, it can be argued that the nursing profession is driven by a number of competing discourses and professional values that substantiate and perpetuate the game. I see the present-day game as simply part of that evolution - just more sophisticated and hiding itself.

The male doctor always knew best and the nice lady nurse if she was any good would follow orders. Here we are 35 years later and this explanation appears to still be perfectly satisfactory. When Stein intimated that doctors and nurses played a game that had the aim of maintaining a status quo in the perceived social relationships of both professions, he seemed to be suggesting that it was within the interests of both professional groups to perform in an expected fashion.

And all was well with the game until nursing, as Stein et al concludes, decided it did not want to play anymore. When they revisited the game, they found nurses had shed some of the handmaiden duties, improved their education and were in a process of redefining themselves. New nursing is too sophisticated to play games - or at least that is how it appears.

In short, nursing seemed to be in a type of identity crisis stemming from an inferiority complex and the illusion that equality was easily within their grasp Department of Health, a. Nursing extended, expanded and took on duties that previously would have been performed solely by junior doctors.

Taking bloods, prescribing and consulting with clients signalled a redistribution of power, influence and game strategy. But does this really show a reluctance to play the game or rather act as a reminder that medics have happily let go some of their grip in favour of taking a stronger hold of the more sophisticated issues of care - such as commissioning, research, and new technologies?

Manias and Street highlighted that nurses felt their medical counterparts did not listen to them during ward reviews. Bucknall and Thomas surveyed Australian nurses and concluded the potential for conflict was due to the physical and cognitive closeness of nursing and medical spheres. Others have pointed to the need to look at gender power relations Gatens, ; Butler, to better understand the doctor-nurse relationship. This insistence on empirical truths and a belief that it is both possible and beneficial to establish correct questions is itself an example of patriarchy because it reinforces the larger discourses that promote role expectations and construct the game.

If you were to ask nurses about their experiences, they would more than likely say - as they did in the work of Adamson et al - that they are more dissatisfied with their professional status than doctors.

Discussions of the doctor-nurse game may appear a fun distraction but it goes some way to show how nursing has squandered opportunities. For every nurse who has learnt to take bloods, prescribe medication, become a graduate or argued with colleagues to be called nurse consultant, there are 1, who simply see the profession as a practical hands-on affair concerned with care.

The opportunities and career ladders that replicate those of medicine are reminders that the didactic nature of the game is still very much ongoing. The nursing profession is still committed to emulating the medical profession by raising its status through the extension of role as opposed to an expansion of its caring definition.

The need for association, even acceptance, is a marker of the fact that the game continues. Who are the players? At the micro and interpersonal level is every nurse, healthcare professional and service user. As just discussed, these people compete against one another within a nursing establishment that includes the governing bodies, media, unions and collaborative organisations. These sectors are not neutral, but rather sustain the game through a process of naturalising, maintaining and manipulating the signs, apparatus and symbols of nursing.

Farrell describes how aggression and hostility between nurses have undermined their position in relation to other groups. For every nurse manager who argues the game is over, there will be a number of patients and an equal number of newly qualified nurses who will show you exactly how it is for them. But any nurse who has waited patiently for the consultant to arrive will tell you that the notion of collaboration is patchy at best and about power.

Nursing has been so intent and fixated on mirroring medicine that it has turned itself into little more than a clone. Like a third-generation photocopy, nursing has strived to be accepted as equal but faded in the attempt. This is because, in the grand scheme of things and put bluntly, nursing is not medicine and, if it was, it just would not be as good. It is true to say that perceptions of the nursing role have changed.

There is much literature regarding the power dynamic debate and the assumption that interprofessional working is beneficial for the patient Zwarenstein and Bryant, ; DH, b.