doi: 10.1111/nup.
12081
If nurses nurse, why don’t doctors doctor?
It is a curious feature of the English language that
permits nurses to engage in nursing but is disinclined
to allow doctors to engage in doctoring – for doctor-
ing carries connotations of nefariousness with which
doctors are not normally, and nor would they wish to
be, associated. Assuming no historical or present
cunning plan to keep nurses in line and while wishing
to avoid accusations of paranoia, this limiting feature
of the designation ‘nurse’ extends beyond mere curi-
osity into the realm of perceptions, stereotypes, and
myths regarding the description of the roles of nurses
and doctors. Perhaps this language feature is no acci-
dent after all?
Nurses are nurses, right? Doctors can be physicians,
surgeons, paediatricians, geriatricians, pathologists,
radiologists, family (or general) practitioners, and so
on while nurses can be, well, nurses. In those countries
that have a strong association with the British medical
system, doctors who are surgeons can be conferred
with the title Mr or Mrs or Miss or Ms on obtaining
specified qualifications, reflecting a level of expertise
beyond that of regular surgical doctors – a badge of
honour and status apparently even though each of
those titles of Mr or Mrs or Miss or Ms is readily
available to non-doctors. Confusingly, at least to out-
siders, doctors need not be medical doctors at all;
doctors can be doctors of philosophy by virtue of
doctoral study leading to the award of a doctorate.
And then there are clinical doctorates, professional
doctorates, and various forms of course-based doctor-
ates to add to the general confusion of what it means
to hold the title doctor. And there are, of course,
nurses with doctorates, which make them both nurses
and doctors. In some countries, notably North
America, the term physician is commonly used to
describe medical practitioners and more generally is
used sometimes, but not always, to distinguish
between the practice of medicine (physicians) and the
practice of surgery (surgeons). Thus, doctors may or
may not be medical doctors; medical doctors may be
physicians or surgeons; and physicians may be sur-
geons. Further, doctors may be house officers, senior
house officers, registrars, interns, residents, consul-
© 2015 John Wiley & Sons Ltd
Nursing Philosophy (2015), 16, pp. 75–76
Editorial
tants, and so on. In North America, doctors might be
dentists. And all the while nurses are, well, nurses.
Admittedly, there are some titles that nurses can
aspire to – matron and sister spring to mind but by
and large, most nurses are known as nurses. Titles
available to nurses rarely stray from the root word
nurse. The title registered nurse reflects a specified
level of qualification and is legally protected in many
countries. Staff nurse is commonly used as a job title
for a registered nurse, and a staff nurse working in a
surgical unit might consider himself or herself to have
a specialty although that specialty is not reflected in
any generally accepted nursing title. But in some
countries, staff nurse might merely mean a nurse who
is on the staff of an organization as opposed to a nurse
who is freelance. There are some titles for nurses
with specialist expertise such as nurse practitioner,
advanced practitioner, and consultant nurse but
notice how few of these titles do not feature the word
nurse or some derivative of that word.
In contrast, there are a number of meanings of the
word doctor. One meaning of the verb to doctor
implies corruption. To say that a document has been
doctored would be to say that that document has
been altered so as to mislead the reader; often for
the purpose of practising deceit in a such a way as to
obscure unfavourable outcomes. An accountant
accused of doctoring the books would be understood
as attempting to show a healthy bank balance where
one did not exist for the purpose of personal finan-
cial gain. A researcher accused of doctoring data
would be understood as seeking to fabricate results
to fit a hypothesis or to maintain a reputation. Simi-
larly, a nurse accused of doctoring patient records
would be understood as attempting to falsify events
so as to cover up an error or an omission. There are
a number of meanings of the word nurse but as a
verb, to nurse does not lend itself to the kind of nega-
tive connotations that can be associated with the
verb to doctor.
Thus, to say that nurses nurse is not open to the
kind of negative interpretation available when saying
that doctors doctor and this may go some way to
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explaining why common parlance permits doctors
more words for practice than allowed to nurses.
Doctors practise medicine whereas nurses practise
nursing. Doctors do not, on the whole, practise doc-
toring. The negative connotations attached to the idea
of doctoring are not consistent with the professed
values and intentions of doctors despite the attempt
by Mol (2008) to rehabilitate the term doctoring to
describe work for health based on a logic of care
rather than a logic of choice.
There is, however, no reason for nurses to become
smug with the recognition that the word nurse
remains relatively immune from the negative associa-
tions to which the word doctor can be subjected for, as
outlined above, this same feature of language restricts
descriptions of nursing in ways that doctors can tran-
scend with ease – albeit with an associated danger of
confusion and imprecision.Thus, linguistically at least,
it is truer to say a nurse is a nurse is a nurse than it is
to say a doctor is a doctor is a doctor. Whether or not
this linguistic limitation has been translated into a
clinical constraint for nurses will likely forever remain
an open question.
Derek Sellman
University of Alberta
Reference
Mol A. (2008) The Logic of Care: Health and the Problem of
Patient Choice. Routledge Taylor & Francis Group,
London.
© 2015 John Wiley & Sons Ltd
Nursing Philosophy (2015), 16, pp. 75–76