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8 January2013
Universal healthcare: Professionalism in medicine
First of all it is important to emphasise on the fact that being employed in the healthcare
establishment is a responsible and stressful work and that is why, a set of factors should be taken
in account in the process of making a decision of being the doctor or physician.
Tschudin consider that the selective approach towards the personal features of the
healthcare professionals should be applied in the beginning of their career - in the process of
their entry to the educational establishments due to the fact that there are some personal features,
which cannot match with the professional activity of the physician. Among such personal
features, authors outline the following issues: dysfunctional tendencies (dysfunctional
personality characteristics); high levels of anxiety; negative approach towards examination
process; inclination for inadequate behaviour in stressful situations; lack of self-confidence and
self motivation; deficits of the social skills; constant fear of failure; communicative problems etc.
(Tschudin 16).
In addition, author considers that there is a probability of negative impact of the
following dysfunctional tendencies as inclination for sexual harassment, suicide, substance abuse
etc.
I would like to pay additional attention to the substantial abuse due to the fact that this is
the problem of our current society. The other name of substance abuse is drug abuse. Scientists
consider the substance abuse as the maladaptive pattern of use of some remedies, which do not
cause dependence if they are applied according to the manual. There are different definitions of
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the drug abuse and this term is widely applied both in medical and in non-medical practice. For
example, there are such contexts of substance abuse using as psychoactive drug or performance
enhancing drug. Generally it is possible to consider the drug abuse as the negative effect of drug
using (in comparison with the positive aspects of its medical applying - responsible drug use)
(Walther 56)
Another wide applying of the substance abuse term is associated with tobacco, alcohol,
cocaine, opioids, benzodiazepines and barbiturates. In all above listed cases the negative impact
on the health condition, causing the criminal responsibility and suffering from the social and
psychological harm that all are unfavourable aspects of the substance abuse. Currently, in
accordance with UN statistical data, more that 50 million people worldwide are regular users of
heroin, cocaine and synthetic drugs. This problem is very urgent for the nowadays youth and it is
obvious that the future doctors are also under the risk of being substance abused that us why the
selective approach towards their employment and even entering to the educational
establishments should be applied.
That is why authors have developed the model for these features evaluation in the process
of interview in the entry to the educational establishment, this model is developed in the form of
mini-interview protocol, which consists of a set of short OSCE-style stations. The key task of
such approach is evaluation and correction of the deviations, which do not feet the basic
requirements of the health care professionals activity.
Other scholars consider that it is almost not possible to correct the personal features of
the individual, which have been formed in the beginning of the life by parents, social
environment and other factors. Patrick Duff considers the humanity to be the core value and the
professional attribute of the physicians. That, in turn, means that such issues as inappropriate
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sense of entitlement and arrogance should be eliminated from their personal features even in the
case of professional success, development and occupation of the high positions in the educational
establishments hierarchy.
Patrick Duff considers that the worst feature in communication with the patients for the
doctor is the hubris even if this negative feature is combined with the excellent competence in
the area of activity and with the clinical skills. That is why it is possible to draw a conclusion
that the doctor is required to have the high rate of morality, competence, empathy and respectful
attitude towards the problems of their clients- patients (Duff 115)
The next important feature is the fair treatment due to the fact that in some cases the
physicians integrate their professional activity with the business and are tending to make money
from the vital problems of their patients- they recommend them the high const treatment, which
is not the best solution for their disease treatment etc. That is why the honesty in the light of
intellectual and personal features is the second attribute of the physicians professionalism.
Patrick Duff defined the honesty as the initial bedrock of creating the set of professional features
of the doctors. This feature provides the doctor with the creditability and creates ones
reputation. (Lucia 39).
The next features, required for the professional activity of the medical staff imply the
responsible attitude towards all the actions and decisions, made by the doctor, ones reliability,
and accountability. Additional attention of the doctor should be paid to ones own spiritual and
physical health in order to be able to make fast and correct decisions, to be adequate and
objective towards the circumstances and to keep the balance between the own-family life and the
daily responsibilities at the hospital. For this approach it is rationally to apply the maxim-
Physician, heal thyself (Tuckett 24).
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Such personal features as respectfulness, tactfulness, sensitivity, compassion, altruism
and loyalty are the attributes of professionalism for the healthcare workers.
In order to achieve the level when the majority of doctors have such features, the special
training programs and workshops with the case studies should be implemented into the practice
along with the initial evaluation of the personal features of the future physicians. The respectful
attitude, based on the core principles of the ethical behavior should be inherent to the personnel
of the healthcare establishments in all spheres of their professional activity- whether it is the
communication with the colleagues, patients or with the students. The last aspect
(communication with the students) is very important because the pattern of the future doctors
behavior in the healthcare establishment is forming in the process of their education though the
direct observation of their supervisors; behavior, attitude, communicative skills and personal
features and approach towards their professional activity. Such behavior should be formed on the
sublime level- only in such case it is possible to reach the level of the high professionalism
combined with the personal features and respectful attitude towards all the people (Duff 89).
In addition, I would like to support this point of view with the evident examples of the
violation of the basic rules of morality, ethics and responsibility on the working place. First of
all, the beginning of such violation lies in the irresponsible attitude towards the educational
process. Secondly, arrogance and disrespectfulness occur due to the fact that the student or the
resident gets the inappropriate sense of entitlement. Among other negative features of the doctor,
it is possible to consider the prerequisites to the discrimination, whether it is based on sexual,
gender or racial issues and is directed to the patients or to the colleagues.
In some cases the physicians overevaluated sense of self-importance leads to the
abrasive interactions with the colleagues or with the patients. As a result of such behavior, the
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lack of responsibility for own decisions and actions may occur and that is not acceptable in the
practice of the physical due to the fact that it puts the health and life of the patient under the risk.
As an economical example of an inappropriate behavior of the doctor, it is possible to
consider the fiscal irresponsibility of ones actions, such issue may imply the high cost
laboratory tests, which are not required by the current situation, integrating the selfish
expansionist ends with the healthcare activity and getting the extra incomes from such activity
etc.
In some cases, the doctors are not tending to update their knowledge with the latest trends
and effective achievements of the medical science and that in turn, may be considered as the lack
of the commitment to self-learning. It is obvious that the medicine requires lifelong learning due
to the fact of the constant scientific developments and inventions in all its areas. Finally, it is
possible to consider the personal excesses the negative example of the physicians conduct.
That is why it is possible to make a conclusion that it is hard to overestimate the role of
the ethical and responsible behavior for the doctors and for the future doctors professional
activity due to the fact that it is the basics for their professional success- it disciplines, it develops
the new approach towards the professional activity and the life quality in whole, it develops the
positive features of the character- such as responsibility, honesty and reliability and finally, it
makes the contributions to the image of the nowadays doctor, who is competent, highly
appreciates the moral values of the society and may be considered as the pattern of behavior for
the future generations of the professionals in the area of healthcare.
The next issue to be discussed in the scopes of this paper is the core principles of ethics
and morality of the nursing area, which are applied as the bases for the nursing legal issues. It is
important to rely to the fact that the ethics mainly deals with the standards of professional
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behaviour and, consequently, with the moral judgment. That is why the core principles of the
healthcare ethics imply upholding the ethics in all the situations, which are related to the
autonomy, beneficence, nonmaleficence, and justice. In this context, Beneficence implies
promotion or doing good.
The main purpose of nurses professional activity is promotion of their clients with the
best interests and in addition- striving in achieving the optimal outcomes of their professional
activity. The next principle of the nurses work is the Nonmaleficence, which in turn, means that
the nurse should do ones best in order to avoid harm to their patients. In other words, the
competent practice level should be maintained by the medical in order to avoid causing suffering
or injuries to their patients. In addition, the reporting suspected abuse issue is covered by the
nonmaleficence principle. The core objective of reporting suspected abuse implies prevention of
the further victimization of the client and ones protection from the chemically impaired nurses
and other practitioners in the healthcare area. Finally the autonomy in the healthcare ethics and
legislation implies the right of the patient to be independent and self-directed. In other words the
clients are provided with the right to be self-determinate and to get the complete information
about their disease, that is why the competent adult patients have the right to decide whether the
particular treatment would be applied to them or it would be refused completely or particularly.
The clients; wish should be respected by the employees of the healthcare establishment even in
the case if the professionals of the healthcare area do not agree with the omissions of their clients
(White 10).
The last requirement of the justice is equal and fair treatment of all the clients despite
their financial status, race, gender, religion and other discriminative factors. The issues of justice
are practically applied by the nurses in their daily professional activities. On the primitive level,
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it is possible to outline the example when the nurses should allocate their time, needed to be
spent on each particular client, while talking in account the needs of client and making a decision
in the fair distribution of available sources between the patients.
There is a need for the nurses to make a difference between the professional ethics and
justice and their personal life values. The personal values cover the issues, which are true and
significant for them and the professional ethics implies the set of principles, which should be
applied by the nurses in the process of their professional activity in all the variety of situations.
At the same time, it is important to put an emphasis on the fact that the nurses should
avoid the application of their personal judgments to the client care bias. The medicals are
required to be fair and honest with their clients and consequently, their professional activity and
behavior should be mainly directed to the meting the interests of their patients and for showing
the respectful attitude towards them.
To conclude, it is important to rely to the fact that the clients with the high-level-needs in
combination with the short staffing may increase the risk and probability of failure, at the same
time, the nursing liability may be minimized by nurses while applying the risk management. In
addition, the continuing education courses, related to the risk management may be accomplished
by the professionals of the healthcare area. The risk management courses are required to be
accomplished by nurses in some states in order to be licensed for the first time or to renew the
existing license. In Florida the course on reducing medical errors is required. Additional
advantages of the nursing risk management courses may also imply some monetary advantages
for nurses, who have accomplished these courses.
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Works cited
Duff, Patrick Teaching and Assessing Professionalism in Medicine. The American College of
Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins. 2004.
Print.
Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. "Chapter 1 Performance in
Nursing". Reviews of Human Factors and Ergonomics (2009)5: 140. Print
Tschudin, Verena Ethics in Nursing: the caring relationship (3rd ed.). Edinburgh: Butterworth-
Heinemann. 2003.Print
Tuckett, Anthony "Truth-Telling in Clinical Practice and the Arguments for and Against: a
review of the literature". Nursing Ethics (SAGE Publications) (004. 11 (5): 500513.
Print
Walther n. K. A. Van Mook, Simone l. Gorter, Willem S. De Grave, Scheltus J. Van Luijk,
Valerie Wass, Jan Harm Zwaveling, Lambert W. Schuwirth &Cees P. M. Van Der
Vleuten. Bad apples spoil the barrel: Addressing unprofessional 2010
behavior<informahealthcare.com by>
White, Lois, Gena Duncan, Wendy Baumle Foundations of Adult Health Nursing. Cengage
Learning. 2010. Print