There is a tremendous difference in medical and nursing training. I greatly value the role that nurse and nurse practitioners are playing in bringing great medical care to our communities. But make no mistake:
The training is vastly different. If you watch the movie Sully, there is a terrific demonstration of the difference a highly educated, in-the-trenches experienced individual brings to a situation. (Sully, a pilot nearing retirement, managed to ignore the algorithms and outperform computer simulations, to land a plane of 155 people, safely in the Hudson River after complete engine failure.). That, like the extensive training of physicians, cannot be replaced by algorithms, computers, — or gene-tests and screening tools.
It’s relatively easy to prescribe a medication (and that is where the monied institutions MAKE MONEY) based on screening tools and algorithms. It’s not easy to do that well for purposes of more than symptom relief. For the healing of complex , treatment resistant, or chronic conditions, much more is needed. This is true also for catching issues interfering in diagnosis and treatment or detecting early the more subtle life/limiting patterns and symptoms being masked by neglect and self medication before they become intractable.
Wading into a post-“tornado” mental health morass, in an individual presenting for care of one or more chronic conditions is a whole another journey. Healing involves taking in another individual’s life whether of trauma, neglect, living in a dysfunctional family, often with a dysfunctional lifestyle, genetic vulnerabilities, emotional or relational or substance or behavioral addictions.
Not only is an experienced basic kindness needed, but more than two postgraduate years of experience and knowledge.
Personalized treatment involves having the training, yes, to receive and sift this information, listen and prioritize focus. Also needed are skills and patience to develop the relationship for collaboration, conversion to the intent and freedom to develop and utilize healthy self regard and that birthright of ability to love self and others, and transcend life’s difficulties. And select a path of intervention, intention, habit change that will have endurance and develop resilience to the stressors of life.
Hogan Pesaniello, MD
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