Professionalism in the medical field is a core component in the provision of value based health care services. As a result, it is important to establish the most appropriate medical professionalism trends in every health care setting. Medical professionalism focuses on a number of concepts and perspectives that deserve to be given maximum attention round the clock. The medical profession like any other service sector has its own professional standards, which are normally stipulated in an institution’s or health organization’s health care policy statement. The essay will focus on the most critical traits valued in the medical profession. These entail adhering to professional ethics and possessing emotional stability. To explain these characteristics, I will provide examples of practical scenarios depicting the two situations in different contexts. This will form the background for analyzing how the health professional acted in the two contexts. In as much professionalism is taught in various medical institutions, emphasis should not be put on the contemporary lecture method by pursuing an array of methods so that students can acquire adequate knowledge regarding health professionalism.
Definition of Medical Professionalism
Several definitions have been advanced towards the definition of professionalism in the medical domain. Nevertheless, none of these definitions stands out distinctly compared to the Webster’s definition. According to the Kirk (2007) of the Bayer Medical University Center “Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served”. Cruess, Cruess & Steiner (2008) emphasize that the process of developing professionalism takes time and cannot take place overnight.
Adherence to Work Ethics
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Draper, Dawson, and Ashcroft (2007) observed that adhering to work ethics is the most basic professional trait that should be considered when evaluating medical experts because it determines the extent to which one will deliver effective health service to the patient. There are several cases which can help to determine if a medical profession adheres to his professional ethics or not.
A young lady called Ann visits her family physician. The designated family physician is not present and has left her fresh graduate to take charge. The doctor welcomes the patient and offers her to a seat. The doctor looks tired and overworked yet it is very early in the morning. The doctor has sleepy eyes and justifies this to her patient citing lack of sleep for the past two days, because he had been treating many patients day and night. He also complains about his seniors not giving him time to rest whenever he is tired. He says even after working diligently for two consecutive days there is no slightest bit of break accorded to him.
He goes ahead and asks Ann what has prompted her to visit him. The patient says that she has a persistent nausea. She also vomited continuously the day before. Consequently, the doctor fails to acquire the patient’s complete history, examine the patient fully, and take note of vital signs. Instead, the doctor chooses to pursue the shorter route. So he gives the patient a Vistril injection of 100mg. In addition, Ann is also given three prescription of medication: 500 gm Keflex, Vistril and Vicodin. Nonetheless, much of the chart could not be read since the doctor records much information in French. Note that before she made the appointment to visit the doctor, she was in relatively good health.
Following the visit to the family doctor, the patient’s prescriptions are duly filled and she eventually returns home to rest. However, the illness continues to worsen gradually and after two days she falls critically ill. This prompts her relatives to call 911. An ambulance comes to her rescue and she is rushed to the hospital. Ann is taken to the emergency room because she is suffering from cardiac arrest and no spontaneous respirations. Prior to her arrival to the hospital she had received Epi and Atropine. She had also been intubated in route.
A central line is inserted and she is given medication through it. This is done after arriving in the emergency room. The monitor displays a complex tachycardia that degenerates to ventricular fibrillation. The patient is shocked severally but, there is no heart sound that can be heard. An echocardiogram is undertaken while she is at the bedside and it displays no mechanical activity. No tamponade can be noted. Cardiac revival is not successful and the patient dies. An autopsy is carried out the following day and her death certificate confirmed that she succumbed to multiple organ failure, sepsis and DIC.
According to the autopsy report, the patient died from multiple organ failure due to unnatural discoveries, which involve the heart, liver and lung were evident. The chemical analysis of her body fluids shows significantly elevated levels of prescribed medications that include promethazine (a medication for sedation and nausea); hydrocodone (a narcotic pain medication), hydroxyzine (a medication for sedation and nausea); diphenhydramine(sedation and itching); acetaminophen( a medication for pain). It is concluded that Daisy’s death was prompted by the ingestion of a combination of the aforementioned drugs.
Justification of Medical Professionalism Based On the Case
I have selected this case to demonstrate the elements of work ethics involving the medication that was prescribed to Ann by the family doctor. Ethically, if the doctor was suffering from fatigue, he should have taken a break and referred the patient to someone else. It is evident that the doctor was responsible for the overmedication that resulted in the death of the patient. The patient did not prescribe the drugs to herself, they were prescribed by the doctor. The doctor should not have given her an overdose (Peters & Peters, 2007). Previously, the patient had a good medical history. How could she take less than a week to die?
Furthermore, the initiative to visit the family doctor was personally driven and as indicated in her symptoms, her condition was not very complicated. To some extent the doctor was acting in a professional manner since she welcomed the patient. The doctor asked the patient what she was suffering. These two aspects are very essential in the medical field because if the doctor would have sent her away it would have been unprofessional. Secondly, the doctor asked what she was ailing from, which enabled the patient to explain herself to the doctor because it his job to aid patients.
The doctor was conscious of acting unprofessionally. According to medical profession work ethics, whenever one is asked to serve patients, he should do it diligently. Even if there are very many patients he should not give up or walk away from the patients. The fact that he was conscious of these requirements, he found it necessary to justify his physical form to the patient by stating that he had not slept for two consecutive days. If he was aware about his fatigue, he would not be in the hospital serving patients. Probably, he would be at home trying to catch up with his lost sleep. Thirdly, the doctor was a junior in the hospital, therefore he was to abide by what his seniors demand. Probably that is the reason why he complained to the patient about his lack of sleep. He could not face his seniors because he would be perceived as being lazy.
There are several circumstances that prompted him not to act in a professional manner. First, the doctor was overworked. Secondly, he failed to neither collect all vital signs nor perform necessary tests. Thirdly, he prescribed an overdose to his patient. Secondly the doctor lacks several attitudes, for instance, a good attitude. According to Heller & Veach (2008) attitude is the manner in which one feels about an issue, something, or someone. Attitude helps one to mold his personality. In this case, if the doctor had a good attitude towards his profession he would not have complained to the client about the problems he is facing instead he would have raised the issue with the hospital administrator. Probably, the administrator would have helped him by employing another doctor to help him. On the other hand, the administrator would have asked him to take a rest whenever he felt sleepy or tired. Possessing a good attitude helps one to flourish his personal and professional life (Heller & Veach (2008). In this case, the doctor’s attitude is likely to draw people away from him, consequently leading to the perception that he is unprofessional.
The doctor could have acted unprofessionally because her communication skills are questionable. Much of the chart could not be read because the doctor records much information in French yet he lives in a nation which French is a foreign language. If he could have written information in English the overmedication could not have occurred since the chemists could have noted and corrected the error of overmedication. Medics should possess strong communication skills since they always communicate with patients from all walks of life, healthcare professionals and they also learn medical terminologies Heller & Veach (2008).
In addition, the doctor may not have had sufficient education to help him run his duties smoothly. Probably, that is why he complains to the patient yet the patient is the one who is supposed to complain regarding her health. The doctor also gives the patient overmedication and he does not even take time to assess her condition before rushing to give her medication. According to Heller and Veach (2008) true professionals empower themselves with education. This can be explained by considering that the more knowledge you have, the higher the chances of serving your patients better. To some extent, the doctor did not master well what was learnt while he was in the university.
Emotional stability is an important trait in any medical professional. This is because it determines the level of one’s endurance to potentially strenuous situations, which are certain to occur in the hospital setting.
Daisy was very bright in class. She had enjoyed good passes all along; however, before she could clear her high school education, she developed medical complications. These prompted a thorough examination at the local government funded hospital to establish the cause of the complications. Nothing could be established, which led to her to be transferred to various hospitals. This went as far as taking her for overseas consultations so that she could get specialized medication. Still there was no hope as these efforts did not bear any fruits. Her parents spent more than $185,000 dollars in a span of three months. Initially, the family had never spent such an amount in a span of three months. This prompted them to hold several fund raising events so that they could treat their daughter.
Within three months after visiting the first hospital visit her legs and left hand arm became paralyzed and her right hand was steadily deteriorating. Her capability of speech also deteriorated such that she could not communicate well with anyone. She stammered a lot and used her remaining movable body parts to make signs whenever she wanted something. She had a big problem when swallowing food since she could not swallow food gently. Whenever she felt hungry she could not express herself clearly since her speech had deteriorated considerably. She depended on the nurses who had been assigned to her to do everything. This is just part of the problems that she is experiencing. What Daisy lost is herself! It is like everything was being moved away from her reach and presence yet she was still alive.
She was taken to another hospital where she was diagnosed with amyotrophic sclerosis. Her arms were amputated. It is like her life come to a standstill; hence, she could not do anything. The doctors and nurses in the hospital had no way of helping her rather than encourage her that one day she would get better. However, this was not the case because Daisy had lost what she valued most. Her condition shook the nurse who was assigned to her. The nurse thought of giving up on her but she had to stick to her professional ethos. The nurse considered spiritual intervention by praying to God on behalf of Daisy so that she could become well. Her condition continued to worsen the more the nurse prays to God.
What came out clearly was that the nurse was emotionally attached. The nurse even made prayer requests to several pastors who were renowned for miracles. The nurse pitied Daisy and was planning to use medical mechanisms to induce her death so that she could alleviate her suffering. She strongly felt that Daisy needed to end her suffering permanently. Hence, if she would have given her an overdose of drugs, it would have alleviated her suffering, especially since her condition was worsening day by day. She designed several mechanisms through which she can give the patient the drugs. Finally, she decided to insert a slow killing drug in one of the routine medicines given to Daisy on a daily basis. After a week, Daisy died.
Justification of Medical Professionalism Based On the Case
I chose this case scenario because nurses are very essential in accomplishing the patient healing process. By virtue of the fact that nurses spent a significant amount with patients, they are required not to become extremely emotional. They help to reduce patient’s pains. This is enabled by the unique skills that they have acquired. They are meant to aid patients recuperate from assorted levels of pain. For example, terminal illness is among the vital diseases that form the focal area for specialized nursing care. They ought to give company to patients by encouraging them to live positive lives while helping them to reduce the displayed effects of a disease.
In the above case scenario, the nurse should have ensured Daisy’s image is restored by encouraging her that everything will be well. In the beginning, the nurse acted in a professional manner by demonstrating emotional stability. This is an important aspect of nursing since it helps them to handle many patients with complicated condition and emotional situations. Some nurses witness patients dying while undergoing treatment. The nurse was able to sit by Daisy’s bedside and helped her whenever she wanted anything. This is best way she could have helped Daisy, since there was no else who could have helped her.
The nurse showed professionalism by working with the doctor to ensure that Daisy gets well. This cooperation was achieved when Daisy was diagnosed with amyotrophic lateral sclerosis, the doctor decided on the treatment which would help alleviate the problem. The nurses acted in a professional manner since they should ensure that they carry out treatments which have been prescribed by the doctor. For instance, a doctor might prescribe bed rest, therapy or surgery. The doctor will carry out some of treatments, for instance, surgery. The nurse is the one who offers a bulk part of the treatments (Ferguson, 2009). The nurse monitored Daisy’s progress to ensure that she recovered and minimize chances of developing complications. Since nurses have frequent contact with the patients compared to other staff, they often discover problems ahead of anyone else.
After becoming emotionally attached, the nurse gave in to her wish to end Daisy’s suffering. This was unprofessional. In as much as Daisy was going through difficult moments in her life, the decision to settle for mercy killing was unprofessional. She should have found out ways of dealing with her emotions so that she could effectively achieve the function of fast-tracking Daisy’s healing process.
According to Wood & Cantillon (2011) professionalism should be introduced early in the learning curriculum and it should consistent with increasing levels of complexity throughout a student’s school life. Giving one or two lectures is not adequate to ensure that students have acquired professional skills. It should be taught and learnt explicitly so that all students can understand it properly. Learning professionalism can be facilitated through lecturers that intend to offer frameworks, provide definitions, and refresh curiosity. Small discussion groups help in exploring personal interpretations and biases. Issue-based learning format which makes use of case studies as the stimulus.
However, putting focus on cognitive base is not enough because professional identity emanates from having an extensive experience in one’s field. In addition, it entails one having deliberate reflections on the experience. Learners should be offered with situational learning in which they can face practical dilemmas and challenges, which will be encountered during practice. They should reflect upon those occurrences in a professional context. Real-life clinical contexts are obviously more powerful, however not all learners can be exposed to each aspect of professionalism through this method. Small-group discussions which involve case vignettes, narratives, video clips, role-plays or any other educational methods ought to be structured in order to ensure various sides of professionalism are experienced (Cruess et al, 2008).
In a nutshell, professionalism takes a long time to be achieved. It should be developed right from the time one steps in a medical institution. The process should be regular so that students can adequately integrate the various methods. For instance, students can be encouraged to review experiences they had before their current lesson. This enables them review the contextual issues that are faced by the medical fraternity in a practical setting. This is a better model compared to when past experiences are not taken into account. In the first model the doctor gave his patient an overmedication. This can be a good example in which the doctor should review his past experience so that he avoids making such mistakes again. This may prompt the doctor to be careful next time when he is diagnosing patients. As a result, the next time, the doctor will conduct thorough tests on the patient to establish the source of the ailment and determine proper medication to enhance her healing process. In the second model, the nurse should have maintained her emotions. The two models show how it is important for medical professionals to consistently uphold their medical integrity and professionalism. Adherence to one’s work ethics and maintaining emotional stability provide are critical areas that need to be emphasized in future learning sessions.
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