In July 1973, I was a freshly-minted intern in the ER at Jacobi Hospital. Jacobi is to the Bronx what Bellevue is to Manhattan. It is the safety-net hospital, overfilled with medical emergencies beyond description.

I had a MD degree (granted a few weeks earlier), but I was not a physician. I had facts in my brain, but no idea how to use them.

When the paramedics wheeled in a patient in acute pulmonary edema, frothing at the mouth, I entered the room and froze. It was an incompetent response, but it was the best I could do.

Gloria, the head nurse, noticed my incapacitation. She shouted to me: “Here is a syringe with morphine and another with Lasix. Help me get him upright. Now let’s get tourniquets on him. Have you ever done a phlebotomy or do I need to show you how to do one?” (Remember: this was 1973. Intravenous nitroglycerin did not exist. The seminal paper on nitroprusside was not published until 1974.)

You may be wondering: Where was my medical resident? Where was the attending? The resident had another emergency. And there was no attending. (It was 1973.) Gloria was the only competent person caring for the patient.

I did what Gloria told me to do, and the patient improved. I left the room satisfied with myself and sat down to write my note. One minute later, Gloria was shouting at me again.

“What are you doing sitting down? You need to be at the patient’s bedside. Is he getting better? Maybe he is worse. How would you know?” I scrambled back to the bedside.

On my next rotation, I (together with one other intern) was in charge of the care of 30 patients. How were we going to coordinate everyone’s care? Actually, we didn’t. Maria was the head nurse on the floor, and she knew everything about every patient’s status and needs.

If a patient was in pain, she needled us to do something about it. If we failed to obtain a repeat potassium, she screamed at us. If a patient in room 14 didn’t look right, she made sure that we found out why — STAT.

This wasn’t a private hospital. But the patients received the most outstanding care imaginable. And it wasn’t because of the physicians.

Over the next 3 years, I slowly and stubbornly became a physician. But I did not learn how to do that from the other physicians in the program. I learned because the nurses at Jacobi showed me what it meant to be responsible for someone’s care. Nursing (not physician-directed medicine) has always been the lifeblood of patient-centered care. By embracing its values and practices, I became a doctor.

Years later, when I started doing research in the CCU, two nurses felt sorry for me and helped me out. Their contributions were essential. So I made them co-authors on my papers; their names appeared on nearly 50 manuscripts!

When we established the first Heart Failure Center in the US at Columbia-Presbyterian Medical Center, nurse practitioners were the cornerstone of our service. They were responsible for coordinating each patient’s care. It was one of the first examples of a nursing-led heart failure program in the US.

Now hospital nurses are hardly at the bedside. Most are staring at a computer screen somewhere. The physicians are starting at their own computer screens.

But computers don’t go to the bedside. And computers don’t coordinate care. So who is looking at the whole picture? Who knows how the patient is actually doing?

Bedside nursing used to fill that role. But no more.

This story was originally published by MedPage Today, a trusted and reliable source for clinical and policy coverage that directly affects the lives and practices of health care professionals and provider of free CME.