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

(During my childhood
specifically a pediatrician, but as a high school student I realised I was
years I really wanted
not so sure about what career path to take, I had no plans in mind for
to become a
my future and when my parents encouraged me to become a nurse, I
paediatrician)
went through with what they have chosen for me, I also wanted to

work abroad as a nurse together with my sisters, so I enrolled in nursing.

When I became a fourth year nursing student, my parents offered me another career

path, they told me I could pursue my studies and become a doctor, I could fulfil my childhood

dream of becoming a paediatrician, the decision was hard and I didnt feel completely prepared

for it, but I wanted to make my family proud and be a help to other people so I went for the

long and hard path, to become a physician.

 According to the study of Heikkil et al (2015) the opportunity to help others has also

been the most influential factor for choosing medicine cited by medical students elsewhere

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.

Berghout (2014) stated that students with a non-science background struggle at first

due to the big gap in knowledge and demonstrate more effort in studying theory, These
students might be very aware of the gap in knowledge that they start their medical studies

with, and put more effort into the learning of the theory.

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 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 You don't have a

excel in this part of medical school. choice, it's either

you make it, or

I was able to overcome these challenges because of self-discipline,
break it."
determination, support system, faith in God and readiness (Physically,

emotionally, socially, financially and spiritually) because "you don't have a choice, it's either you

make it, or break it."

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.

 Morris (2015) stated that 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 , 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.

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, My other classmates who did not take up nursing were still adjusting because clinical

duties were still new to them, and then we nursing graduates are the one who excel. I think

every medical course has an edge.

As a nurse-clerk, I didnt struggle that much because as a nurse, our clinical exposure in

the hospital started during second year. In fact, I became excited during that time, i felt like i

am finally in the part where I master the best and in was used to going on duty.

According to Godefrooij (2010) students entering the clinical phase of the medical

education encounter difficulties in applying the clinical skills learnt in actual patient interaction,

whipple et al (2006) in their study proved that early introduction of clinical skills was confirmed

to be associated with increased comfort level of third year medical students during the

application of clinical skills, it also helps decrease their anxiety caused by transition into the

clinical phase of the medical curriculum.

 That when I was thankful for 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.

Jackson et al (2009) proved in their study that 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.

My experiences on clinical duties during nursing really helped me especially when it

comes to communicating with the patients, how to handle difficult patients and the usual

routine in the hospital.

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) asserts it is critical to establishing

meaningful nurse-patient relationships Provision 1 in the American nurses association (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 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 with.

BSN as a premedical course?....

So would I recommend other aspiring medical student to take the same path as me?, I

guess I would not do so, because based on my experience, it was really a struggle during first

and second year, in fact, if I knew I would become a doctor in the future, I would have chosen

to take another premedical course like MedTech (Medical Technologist).

To future nurse-physicians.....

The journey of becoming a physician is not easy, although all premedical courses have

their unique advantages as you take up medical school, it doesnt matter if you are not that

intelligent, what can really turn you into a physician is your own effort and determination. You
have to be prepared for all the challenges in this journey because its really not an easy one.

There are lots of challenges emotionally and financially.

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.

During 3rd year and 4th year you will really appreciate why you choose nursing as a

premedical course because you deal with patients in that years. During 1 st and 2nd years Im not

in the top of our class but when I reached 3rd and 4th year I was able to make it in top of my

class because residents would really appreciate my hard work and effort in how I deal with

patients and how I perform my skills and procedures. So as nurses we really have an edge

when it comes to clinical exposures.

But for you to pass the storm First, you need to be really determined if you really

wanted to graduate medicine because there is no other way, in my case, even if I got low

grades, at least I passed. Another thing it is also really important to have a support system; like

my family, they would encourage me not to give up and just catch up on the next semester.

Faith in God, is also a factor for during those times that I felt really emotionally and physically

drained.