Health professionals don't always act that way
The intent of this message is to remind my health care colleagues how crucial it is for us to value constructive feedback and conduct periodic self-assessments of our own practice. I also wish to let patients and families know more about what they can and should expect from us as caregivers.
My 40-year career as an RN included experience in critical care, operating room, patient and staff education, and administration. And, I have served as an advocate for my widowed sister, also an RN and a former nursing professor, who has been receiving treatment for a life-threatening disease off and on over the past eight years. During this time, I have often felt frustrated by a number of troubling incidents, and, as a result, I feel compelled to speak out. Because of my long nursing career and the fact that I have been married to a physician for over 30 years, I have a broad perspective on the responsibilities, challenges and rewards of our field. Of course, we all fail to do our best at times. Nonetheless, it is our duty to address these situations.
I have chosen to name my concerns through the local newspaper in order to reach a broad audience. Please be assured that in every anonymous incident cited below, the professional involved and/or their supervisors were given private, specific feedback, despite the fact that when we are sick, anxious, or in pain, it is exhausting, and even a bit intimidating, to express concerns to our caregivers. Also, every opportunity was taken to give positive feedback to caregivers and supervisors.
As a nurse, a definition of professional competence in health care formulated in the 1980s by Stanley Skillicorn, MD, former chief of neurology and director of medical affairs at San Jose (Calif.) Hospital has always resonated with me and continues to be relevant today. In Dr. Skillicorn’s framework, professional competence consists of both clinical competence (i.e. a solid knowledge base, keen diagnostic skills, strong clinical skills) and behavioral competence (i.e. effective communication/listening skills, collaboration, mutual respect, responsiveness to the needs of patients, families, and colleagues). Skillicorn's contention was that both clinical and behavioral competence are required to provide truly excellent care.
Over the years, I have applied this definition of professional competence to my observations at several California hospitals and major medical centers, as well as all three hospitals and several outpatient facilities and offices in Jackson County. Much of the time I have been satisfied with what I have seen. Unfortunately, on many other occasions, I have been disappointed and even appalled at the level of professional competence I have witnessed. Here are just a few examples:
- The physician who spoke in a rapid-fire manner during an initial appointment and, when asked for clarification by a family member and later by the patient, answered with, “I already told you that."
- The nurse who did not keep his gloved hands clean while performing a procedure and, when requested by the patient receiving the chemotherapy to correct his technique, did so grudgingly while telling the patient, “It's not a perfect world."
- The laboratory technologist who, when asked to wash her hands before donning gloves to draw blood, responded dismissively that the gloves are to protect her, not to protect the patient, when, in fact, gloves are used to protect both patient and caregiver.
- The hospital nurse who dropped something on the floor, picked it up, and put it on the patient’s bed, instead of discarding or cleaning the item before using it on the patient.
- The plastic surgery resident who, despite several requests by a family member, did not wash his hands before examining the patient, after an extensive surgery.
It is a privilege to be with others during their times of vulnerability, stress, and pain. It is a sacred trust to provide the best care possible and avoid causing unnecessary stress or complications for our patients. Therefore, I strongly encourage patients and families to ask questions, if they see something they don’t understand or that makes them uncomfortable. Caregivers should accept your right to ask questions and be willing to explain.
My hope is that the health care professionals who read this message will accept it in the spirit in which it is written and will take a moment to evaluate their own professional competence. Is it what you would want for yourself and your family? If not, make some changes. You, and your patients, will be glad you did!
Joy Dobson Way, RN, MSN, lives in Ashland.