I have decided to write this piece on ethics and professionalism as I have faced a few situations of this sort during clinical practice that I felt needed to be addressed however I will be discussing one experience which really stood out by far.
It is very upsetting when patients tell you stories about health care staff who don’t treat them in a professional manner and respect which leads me to an instance where I was working at a CHC in Khaylitsha and there was this nurse who would take long breaks with her colleagues. The physiotherapist in charge asked the nurse to write out a new booking date for a patient when he comes in as all the physiotherapists including myself were leaving early that day and there was no way to contact him. She agreed to do it and once I was getting ready to leave I saw the patient sitting outside the office and asked him if he was given a new date yet and he said no and that the nurse told him to hold on a minute but he has been waiting for at least an hour. Very upset with what I was told, I went into the break room (where you would always find her) to ask her about this and found her relaxing with her colleagues, she laughed when I asked her about it and told me she forgot to get back to him and would be there in a second without moving. At this point I was outraged that someone like this would even be working with patients let alone calling herself a health professional.
This type of behaviour is not suppose to be tolerated and should be reported to which I informed my clinician the next day after personally making sure to apologise to the patient for having to wait and making his new appointment myself. However this could have just been a huge miscommunication between the parties resulting in the sad outcome but on the other hand she did confirm that she knew when and where she would have to reschedule with the patient and confirmed that she knew he was sitting there but unfortunately forgot which is a common human error. Although this is understandable, the upsetting part was her demeanour about the situation and her lack of empathy when she realised her mistake. What makes the situation even worse is that the clinician informed me that this was not the first time she has behaved immorally towards a patient.
This kind of behaviour in the health care system has been going on for years as (Downie, 1986) has written an article on professional ethics and stated that the principal feature of a professional relationship is the gross inequality of power between the client and the professional. He further said quote “The patient or client is weak, vulnerable and in need of help; the professional is strong, skilful, and specially qualified to help” to which he went into detail explaining that if we have a skill to offer in the economic system we have a legal and moral responsibility to the patients to provide good and effective service and treatment. (Mackenzie, 2017) Also said in a more recent study that health care professionals have a responsibility to the community to provide good service and act in the best interest of the patient regardless of the payer system. We all know this but it seems to be a common thing in the health system that is not properly addressed.
I feel like I did the right thing to let my clinician know about this as no one deserves to be treated in this manner. I do believe that she should have been given a warning as to make sure she knows that there should never be a repeat of this instance which will prevent other patients from receiving the same disrespect. The clinician did however explain to her that what she did was wrong and unacceptable and if she was to do something like this again there would be bigger consequences as it was not the first time.
Throughout my clinical practice I have experienced unethical and unprofessional mannerisms with staff towards patients and vice versa. The above experience stood out by far and made me more determined and ready to speak up for those too weak or who do not feel in a position to speak for themselves when being ill-treated. Patients should not be afraid to speak up when they feel they aren’t being treated with respect or their rights are disregarded. They should be able to complain and their complaints should be heard and appropriate action then taken. We are health professionals and its time we act like it. Then again we also have the right as health professionals to be treated with respect as well. The door goes both ways and everyone deserves to have their voice heard if any feelings of unjust treatment felt.
REFERNCES:
Downie, R.S. (1986). Professional ethics. Journal of medical ethics, 12(1), 64-65.
Mackenzie, C. R. (2017). Ethics and Professionalism 2016. Transactions of the American Clinical and Climatological Association, 128(1), 75–82.
3 thoughts on “Ethics and professionalism:”
Hi Gadieja
A good piece and I do think things like this happen often in the clinical setting and it gets ignored or swept under the rug by other medical professionals and by the patients themselves, as one may be hesitant to ‘create waves’ or make an enemy of the nursing staff. It is true when you say that patients may not always understand their rights, and do not realise that they have the right to complain. Many times I have found that patients say that they find no use in complaining about the way they are being treated as they feel that their opinions are not valued and that nothing will be done about it anyway.
A couple of tips on how to perhaps improve your piece:
Maybe you could start your piece in a stronger fashion or give a more compelling introduction to what the topic is, perhaps giving a brief description of what professionalism and ethics means to you personally, and what are general ethical guidelines in the healthcare profession.
Try to break your sentences up a bit, as some of them are quite difficult to follow. For instance, try this: “This type of behaviour is not supposed to be tolerated and should be reported. I informed my clinician the next day after personally making sure to apologise to the patient for having to wait and making his new appointment myself…” Try to keep your sentences shorter and present only one idea/statement in a sentence, this will help your piece flow better.
With regards to your referencing, it is not necessary to include brackets when crediting the authors in a sentence. For example, try “This kind of behaviour in the health care system has been going on for years as Downie (1986) has written an article…” and “Mackenzie (2017) also said in a more recent study that health care professionals have a responsibility…”
Also, an article from 1986 may not still be relevant, and there could possibly be more recent literature on the topic that may be more useful.
Minor things aside I thought this was a good piece, and I think that you handled the situation appropriately.
The nursing staff are the heartbeat of the hospital and deserve enormous amounts of credit for the work they do, as without them things tend to fall apart. One should definitely be empathetic towards nurses and understand that they work long, hard hours. But when a staff member is consistently neglecting their duties and if patients are suffering or are inconvenienced as a result, then the correct measures of reporting and alerting our supervisors needs to be followed. This is done not to get that individual in ‘trouble’, but rather to ensure that such an incident does not occur again.
Dear Gadieja,
I like you writing piece and we’ve probably all experienced something to this effect once or twice. Nursing staff are vital in the running of the hospital. Unfortunately, and across all disciplines, once in a while you’ll encounter someone who takes the easy way out. Perhaps she had a hectic day. But as you said it wasn’t the first time that a incident of this nature occurred. We are human, and yes we make mistakes. But the demeanour in which she chose to respond was highly inappropriate.
I’ve had multiple clashes with different people working in the hospital setting because I did not agree with the way they did their job. I’m not their senior, or someone who oversees their work, but at the end of the day we should all have a common goal – seeing to the well-being of patients and doing everything in our capacity to put the patient at the center of our attention and give them the most humane treatment and experience possible.
O’Connell, 2010 shares a quote that says: “Members of the staff behave as healers, leaders and partners. As healers they attend to the emotional as well as the technical needs of their patients. Patient needs are foremost in shaping their response in any situation”. It goes on to say that our behavior and attitudes as health care professionals and as colleagues should exemplify maturity, respect, ethical sensitivity and self discipline. Is this it relevant and so well said!
You did the right thing in informing the clinician as it is unacceptable to not do your job properly. Maybe speaking to the sister or nurse superior to her would have also been another option as that would be a better way to approach the dealing with the situation. Although it can be frustrating to deal with those who do not have the patient’s best interests at heart, we must try to remain cool-headed but report those who are repetitively showing disinterest.
One or two other comments I would like to make: relook your intext referencing. The author’s name does not have to be in brackets when you are using it to start a new sentence. Another tip is to keep your sentences short and sweet. Try not to have too many ideas or points in one breath as it can be tricky for a reader to follow at times.
Well done Gadieja and good luck for your final piece!
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References:
O’Connell, D. (2010). Dealing With Difficult (Interactions With) Colleagues And Staff. Presentation, Seattle, WA.
Hi Gadieja
I really like the duality of your piece (on the one hand and also on the other hand) voicing both sides of the argument in every instance leading to a more accurately depicted reflection of the events and dynamics within the situation.
I felt that your use of references could have been used to build your argument in a more concrete manor and also add an element of objectivity to the solutions and outcomes to the encounter and allowing you to delve deeper into what can happen to prevent or minimize unprofessional behavior in the workplace
The description of the encounter was very apt for the piece and its title but would have liked you to play a more integral role in the occurrences being a protagonist or antagonist and battling with the various options you faces given what you have just seen and how you very colorfully described how you felt.
Whilst the ethical misconduct was highlighted i would have liked to see you delve deeper into the calamity of the solution and what your role in it as a physiotherapy student may be, especially regarding your mention of now having the courage to speak up (an element a lot of us students lack) and the responsibilities we have as a semi-employee to ensure that the patients receive the health care that they are owed
I really enjoyed