NEGLECT:
“Life is precious” I’m sure all of us have heard this said at least once in our lives. As healthcare professionals we are beginning to realize just how precious life is and just how much we take for granted.
I chose this piece of art because it made me think back over a situation I had experienced in clinical practice. It is a painting that forms part of a series called Decaying by Valerie Hegarty, this particular painting is called sinking ship, the series (Audra, 2018)was meant to represent neglect of something beautiful or precious. The art work is made up of a painting that has been neglected to the point of starting to decay. The painting sits slanted on the wall as if it is about to fall off. Half the painting is falling off the frame and the exposed frame of the canvas looks rotted. There are puddles of melted paint pooled on the floor and the ruined half of the painting is hanging off the frame.
I chose to focus on the topic of neglect, much like the neglect depicted in this artwork, because during my clinical practice so far, I have come across a lot of instances of neglect by other health care professionals which has made me think a lot about my own professional ethics. Not that we had to be told but ethics and professionalism are cornerstones of our interactions with patients. Morals have always been a big thing in my family so for me I never expected that people would need to be taught something like ethics. Yes, the specifics need to be taught but I never imagined that there would be people in this world that would neglect people the way I have experienced so far.
To my great dismay I found too many articles looking into and describing neglect and finding the “reasons” and “motives” behind neglect as well as proposing ways of preventing and prosecuting offenders. To name a few: “Patient neglect in healthcare institutions: a systematic review and conceptual model” by Reader and Gillespie in 2013; “National Law Enforcement Programs to Prevent, Detect, Investigate, and Prosecute Elder Abuse and Neglect in Health Care Facilities” by Paul and Hodge 2008; “Detection and Treatment of Elderly Abuse and Neglect: A Protocol for Health Care Professionals” by Tomita; “Diagnostic Errors in Medicine: A Case of Neglect” by Grabler 2005.
It’s sad to think that neglect happens often enough that so many papers can be written about the topic. Health care by definition is looking after the well-being of people, and with this much neglect evident, where are the ethics and morals healthcare professionals are meant to have.
Most of what I have seen has been medical doctors that have either not asked the right questions or only asked questions and not done a physical exam before making assumptions and merely referring to the physio. In these specific cases the problem I identified in my exam was blatantly obvious and if the doctor had examined the area of pain and listened to the patient they would have come to the correct diagnosis straight away. Instead they neglected their patient and wasted everyone’s time. A couple of times they missed a serious diagnosis which if not caught could have had serious repercussion for the patient.
I was raised in a religious household, not the kind that enforced the religious rules with an iron fist but more one that taught me the morals and values to appreciate and care for anyone and everyone no matter their religious, social or economic background. Being part of the generation raised by those who experience apartheid it is easy to think our minds could have been poisoned by the experiences of our parents but I guess I was lucky. My parents instilled a sense of duty within us and turned us into people who wanted to anything they could to help people. I guess it was inevitable that both my brother and I went into the healthcare profession. I was always the more passive person where as my brother was more adrenaline based. I went into physiotherapy and my brother joined the front lines as a paramedic. Being raised with the morals and values based on caring about others makes it very difficult to understand people who aren’t governed by the same core values. Difficult to understand how someone can just overlook another human being, how they can do anything less than their best for everyone that comes to them for aid.
Another thing that hit me really hard was when patients, who were misdiagnosed and who I spent the time with to find what was really wrong, would say to me that no-one had ever taken this much time to help them, or put in this much effort to find out what was wrong. They said they were very grateful for everything I had done, which often didn’t feel like much. It’s sad that a student spending an hour chasing down doctors for answers and begging for x-rays is what it takes for these people to get answers and to feel like someone is trying to help them. Their experience of the healthcare system is of being brushed and being misdiagnosed.
When a patient is assigned to you or comes to you for help you take their precious life into your hands. You become responsible for their health and it is your duty to everything in your power to help them. It shocked me that this much neglect happens by people who are meant to have the same ethics as us and it makes me wonder how much empathy these people have, if any. It also makes me realize how important empathy is, empathy for others would make it harder to neglect them.
We have the knowledge and duty to take care of our patients.
References
Reader, T. W., & Gillespie, A. (2013). Patient neglect in healthcare institutions: a systematic review and conceptual model. BMC Health Services Research.
Paul, D., & Hodge, J. (2008). National Law Enforcement Programs to Prevent, Detect, Investigate, and Prosecute Elder Abuse and Neglect in Health Care Facilities.Journal of Elder Abuse and Neglect, 23-14.
Grabler, M. (2005). Diagnostic Errors in Medicine: A Case of Neglect. The Joint Commission Journal on Quality and Patient Safety, 106-113.
Audra. (2018, november 01). Decaying, Melting And Otherwise Disintegrating Sculptures By Valerie Hegarty. Retrieved from deMilked: https://www.demilked.com/decaying-disintegrating-sculpture-installation-valerie-hegarty/