The Need For Medical Ethics Training:
As a veteran Nurse for twenty years and someone in the medical field for thirty years, I am consistently concerned and taken aback each time I encounter the lack of professionalism in my own field.
Nursing school taught professionalism in all acts and responses for the nurse, but long before I entered school, I worked in many medical provider environments: hospitals, radiology and dermatology clinics, and doctor’s offices and was exposed and held to to the requirement of professionalism.
The absence of professional behavior
Behavior and self representation I see as commonplace today in these professional atmospheres would not have been tolerated some 15–20 years ago.
Medical reception and office duties are extremely important tasks to be taken seriously. How the staff presents themselves to patients in dress, attitude, and conversation is the actual representation of the physicians and the care to be delivered to the patients.
At least, that is how the patients see it.
It is not an old fashioned notion to assume that patients schedule their yearly prostate exam or an appointment to exam a new breast lump with the full expectation that the medical staff involved at that appointment are wearing appropriately fitting clothing, speak in and about respectable tones and topics only, and possess an air and environment of integrity.
Professionalism demands the presentation of such and not the preferred dress or behavior of another environment.
The medical environment is not the place for personal expressionism, but rather one of the performance and carrying out of the mission of compassion and quality healthcare.
Nurses, Medical Assistants, or other medical staff are hired to provide a compassionate, patient focused service to the community. Gratuitous and explicative speech and conversation are not welcome and should not be tolerated in the medical or any professional environment.
Where is personal integrity and concern for one’s job that our patients and professionalism demands?
Rude and improper behavior says one thing to patients: “I don’t respect myself, nor do I respect you.”
Bad mannered, impersonal practices such as loudly demanding monies from patients at the counter before an appointment, (politely requesting that necessary fee is not difficult) or arguing with an elderly patient who does not understand their Medicare plans over a co-pay or pre-procedural fee they were not expecting to pay is inconceivable to me…and this is commonplace, almost expected.
A decline in expectations
The pragmatic observation of these practices and behaviors illuminates the decreased or nonexistent professionalism tolerated by today’s society.
Human beings as a whole are experiencing the detrimental trend of a downward spiral of self expectations, personal accountability and lack of empathy and compassion toward one another.
Healthcare is a community struggling with many issues, but above all, should be a safe haven for individuals to feel secure in their worth as a person…worthy of compassion, competent and thorough care and the expectation to be treated with respect.
My perspective on a positive and lasting solution to this subject stems from both my Nursing experience within the various specialties and environments and in the different roles I have been employed in and in my own experiences as a patient.
One obvious origin of the issue
I am convinced that the problem of unprofessionalism and lack of empathy in the medical field originates in large part with finance planning in the individual institutions and offices.
It appears that a surplus of budget creators do not hold it a priority to train or to consistently express and demand quality expectations with staff because, of course, it costs money to properly train.
The irony is, to hire unsuspecting individuals to operate in professional jobs without professional ethics training costs more money than the training as the offensive type of dress, behaviors and conversation cause many patients to dismiss themselves from that office or institution.
Moreover, staff that are not properly trained, whether in ethics or hands-on-tasks or otherwise, do not vest themselves in that job. They do not give concerted effort, whether knowingly or unknowingly, because they were not invested in by that institution.
Well-educated staff such as nurses, office managers, etc. are not exempt from needing ethics training, either. I have, myself, endured the sarcastic and impersonal comments of the office RN who just could not have cared less about my needs or questions and rudely brushed me off for me to leave without my needs being met.
The patients in any medical setting are there to get their needs met: this is job One for a medical provider.
My professional and personal opinion is that medical ethics training for staff in all medical environments would greatly change employees’ perspective of their roles and responsibilities in their particular positions.
It would also increase both their appreciation for the type of field they are in and their understanding of the duty of healthcare in general.
A position in healthcare is not “just a job.”
Patients immediately benefit from staff’s increased education on proper ethics and behaviors, when put into practice, because patients’ trust is restored in their providers and patients regain the expected civility, and perhaps even genuine compassion, from providers.
More importantly, they begin to return home from a doctor’s office feeling cared for rather than dejected, ignored and most times, very angry.
The medical provider community benefits by regaining trust from its patients which ultimately leads to an increase in compliance of nurse and physician instructions for patients such as medication regimen compliance.
That sort of compliance alone decreases emergency room visits and at-home deaths.
Physicians also need guidance in this area as many see their busy days as so overwhelming that the two minutes they traditionally have per patient is not seen as time enough to offer patience or compassion.
Two minutes is actually not enough time to properly treat and assess problems (this is another issue altogether) but is time enough to smile and say, “Is there any other concern I can address for you?”
Proper, succinct training will create a warm and trusting environment in any medical facility or office.
Call me old fashioned, but I still expect the services I provide to the community and to individuals to be of highest quality, completely respectful, and to be completely thorough.
I still expect the services I receive as a community member and as a consumer to be both and I expect to be treated with respect.
These are fundamental guidelines that general humanity once traditionally taught and expected from its offspring, its community members and others.
Sentiments such as “To do a job, is to do it right” and the age old adage “Do unto others as you would have done unto you” remain cornerstone values in good business practices.
No person, patient, provider or staff member can escape the reality that they themselves are patients and could possibly one day also be vulnerable to negative circumstances and interactions surrounding a medical appointment.
The ironic fact that as a seasoned nurse and community member I have myself, been the brunt of some of the worst cases of discrimination, medical neglect and unprofessionalism.
Moreover, I have personally witnessed the horrific mistreatment of patients and explicitly unethical behaviors at the hands and words of other medical staff, many of whom are degreed or certified.
This type of experience is absolutely unacceptable for any patient.
These experiences are the inspiration for discussing the declining professionalism in medicine and offering a solution.
Summarizing the problem
In order for professionalism to return as an expected and required standard in the various medical environments that society seeks care within, medical personnel’s behavior must be held to a higher standard, achieving this through proper training and guidelines and increasing pay to honor trustworthy professionalism.
Gum smacking, obtrusive piercings, ill placed tattoos, loose and exposed body parts, profanity, inappropriate conversation, and the lack of expressed concern, compassion and grace do not have a place in the medical community.
Training in general workplace ethics, even without a specific emphasis on medical ethics, and empathy training, have shown to improve the medical workplace for all.
Some notable businessmen have a few words to say about professional expectation:
On business and personal expectations: “Be a yardstick of quality. Some people are not used to an environment where excellence is expected.” Steve Jobs, Innovator
On business practices: “It takes 20 years to build a reputation and five minutes to ruin it. If you think about that, you’ll do things differently.” Warren Buffet, billionaire
On customer service: “By putting the employee first, the customer effectively comes first by default.” Richard Branson, billionaire
Medical professionalism is the tangible deliverance of a specialized ethical and inclusive compassionate concern for meeting the needs of patients. It is accomplished in great part by and administered through the patient, loving speech and tone of one person to another, the acknowledgement of others worth and rights and necessity for superior healthcare and also through the conveyance of that commitment through appropriate presentation of oneself to the public.
I am openly encouraging physicians, office managers and all medical staff to take a second look at how your particular individual environment either enhances or deteriorates medical professionalism and consider or reconsider what your original goals were as a professional.
I am sure we all started out with a fire to change the world. After encountering the realities of the changes in humanity over time and the many sordid changes in healthcare, the fervency and commitment to upholding our professional training and personal values has really waned.
Medical ethics training is a necessity to accomplish Best Practices and must be implemented and upheld.
As a medical professional and certainly as a patient, I look forward to the expectation that the medical field hears and recognizes the need for improved patient treatment and ethical responses, so that patients, myself included, may be greeted at upcoming appointments by well groomed, knowledgeable and well spoken staff who address a prospective patient, not as an annoyance to their day, but rather as a respected human being worthy of the care they are about to receive.