Development of the Professional Role: Medical Professionals - Essay Example

Development of the professional Role Introduction Professional health workers' perspectives on professional development are determined by a number of factors such as the individual professional's tasks and the nature of the professional environment. This is true even in the case of a student nurse as is the case with this writer. As such the student's attitudes and perceptions have a greater impact on the outcomes. The leadership perspective as determined by the professional's functional environment is qualitatively influenced by what the professional or student brings to bear on their professional practice or performance. Despite a big amount of literature on the subject organizational influences such as the management and organizational culture, structure and style on the outcomes related directly to the professional development, have received very little attention. Therefore this paper would make a fair effort to identify those elements and apply the principles thereof to delineate the related learning outcomes. The episodic experiences of the professional have a very far reaching impact on these outcomes. For instance this writer's learning experience as a trainee/student nurse has been influenced by a number of episodic experiences related to the administration of Cardiac pulmonary Resuscitation (CPR) in the learning environment. The question of delegation of power, authority and responsibility played a very significant role in this context. As this writer experienced it the willingness to delegate power, authority and responsibility has a very far reaching impact on the related outcomes. In other words the level of motivation of a team of professionals or students is directly correlated to the level delegation. This is none so well articulated and presented than in the professional setting where the relative significance of each variable such as success rate of CPR and other activities is determined by the individual student's attitudes and capabilities. As the currently available literature on the subject suggests there is a positive correlation between motivation and delegation of responsibility. This is much more important when it comes to CPR in critical situations. There is also the undeniable involvement of the professional or the student in the decision making process thus influencing the learning outcomes. The extent to which the professional is able to carry through this process in advancing career development is not so easily obvious though. In fact the student might as well make difficult decisions in respect of quality and finances. These developments have a greater bearing on the outcomes of the student's career development process. The scope for such advancement is constrained by a number of other factors though. These factors include the level of motivation and the level of education and training. As a student nurse this writer has been exposed to a variety of professional settings such as the clinical setting and the ultimate health care delivery setting in the hospital environment 2) Description An adverse situation and individual involvement Medical students such as trainee/student nurses should be capable of assisting in managing adverse situations such as when a patient is receiving Cardiopulmonary Resuscitation (CPR). CPR is an emergency measure when someone is in cardiac arrest or, in some situations, respiratory arrest. CPR is carried out in hospitals as well as in pre-hospital settings. This particular trainee/ student nurse was once called upon to help a senior nurse to administer CPR process on a cardiac arrest patient while there was virtually no professional help that could be summoned. The person was involved in an accident on a trunk road where a head on collision took place. The sudden shock had a terrible impact on the person and I was dispatched with a senior nurse in an emergency ambulance to fetch the victim to the hospital. As soon as the victim was placed on the stretcher and put into the ambulance I had to help the senior nurse to start the resuscitation process. I realized that the man had a better chance at a successful resuscitation due to the fact that his pulse was beating fast and above all was of a robust physique. The first thing I did was to listen to his breath and assist the senior nurse in administering CPR. The victim did not respond. However I did not have second thoughts for the feeling it would be now or never was uppermost on my mind. The CPR process was continued for the second time by the senior nurse with no success. I was becoming frustrated. We tried for the third time with no success. I was becoming desperate. The senior nurse wanted to give up. But I was adamant that we should try once more. We tried for the last time. We were all surprised when he started breathing. He was brought to the hospital and immediately referred to the emergency room. 3) Thoughts and feelings It is with much relief and contentment that I say that the patient recovered from that horrible accident after two months. I have been involved in emergency situations before but this was a new experience for me. Since it was a holiday there weren't many paramedics available in the hospital on that day. Therefore I was dispatched in the ambulance that day. During my practical training sessions I have been serving in hospital wards but not dispatched to the scene of an accident. I will never forget the horrible sight that we encountered when we reached the scene and the fact that it was raining heavily made matters worse. The doctors attributed the victim's survival partly due to our quick actions in administering CPR immediately. As such this is the incident that strikes my mind most when I look back and reflect on my short career as a trainee/ student nurse. It is with much contentment that I reflect upon this incident. 4) Evaluation The capacity of the health professional or student to make an immediate assessment of the situation is a positive factor. In a grave situation as described by this trainee/ student nurse above, health practitioners instinctively know how to react properly in such a situation. Their practice, training and experience have helped in this regard. The assessment of adverse situations can be influenced by personal prejudices and biases of the health professional. For instance if the health practitioner did not like the way his father treated his mother, and if the victim happened to resemble his father this could hamper him from making a proper judgment of the situation. Even years of practice and experience will not help much in such a situation as the prejudices and biases engraved in the mind will come to the fore front. 4) Analysis Clinical Decision making Clinical decision making arising on cardio-pulmonary resuscitation (CPR) in healthcare settings have been discussed with reference to policies and legislation in the UK while the health professional practice and intervention in the clinical setting have received much less attention due to the prevailing situation of confusion as to what extent such clinically-based health professional initiatives would be able to set priorities in this significant health care sphere (Harbison, 2007). Thus CPR is the appropriate intervention to sustain respiratory and circulatory functions in patients with diseases that are potentially reversible, while CPR is unequivocally inappropriate for patients with terminal diseases when there is a consensus of medical opinion that is no reasonable likelihood of meaningful survival. CPR is usually not recommended practices and it need to be discussed with the patient. However the approach to clinical decision making has been recommended by the researchers to the patients' situation to one of three care phases such as, curative/restorative, palliative or terminal. In fact patient would move from one category to another during their illness. National Health Service (NHS) Plan is not necessarily a legal document but it sets the standards to be followed by health professionals in meeting the standards in respect of all national health services. In practical application patients and their families seek guidance based on understanding (Kerridge, et al 1998). The decision not to resuscitate remains a reasoned medical judgment. In some condition, transferring the patient with terminal diseases to an alternate physician or institution is ultimately respectful both for the patient and of physician. The consequences of this lack of policy direction could be seen in how patients have been subject to a variety of institutional and treatment mishaps. But nonetheless recently many researchers have suggested the significance of evidence-based professional intervention on CPR with pre-designed metrics of success measurement. As at present those commissioning bodies that have been set up by trusts are responsible for the putting in place of evaluation criteria (Department of Health, 1999). These criteria serve as standards for the NHS Executive's policy evaluation efforts. While health professional interventions on CPR have been advocated on two specific fronts - clinical support and education in creating awareness among patients - there have been parallel efforts too to identify and adds the various needs and pressures of patients in both formal and informal contexts (NHS Executive, 1996). Leadership/ Management and Teamwork The relationship between the hospital management and the subordinate has been brought into sharper focus here owing to the very important decisions involving training and quality management and above all the existence of a dichotomy between the theory and the HRD approaches shows that indisputably international HRM practices under cultural diversity have to be adopted in a variety of healthcare contexts (Plsek, & Wilson, 2001). This is none so well borne out than by the fact that where there are international culturally diverse HRM practices in organizations there is a precise tendency to define HRM strategy in keeping with long term organizational goals. This is in sharp contrast to the inefficiencies associated with less culturally diverse workforces elsewhere where health organizational outcomes and goals tend to be synonymous with inward looking local practices. CPR is a teamwork activity in the treatment practice. Leadership and teamwork approach of the health practitioner would directly affect on success and the quality of the CPR. Thus it is influenced by behavioral issues of the team performance (West, & Poulton, 1997). Behavioral rating included leadership, task distribution, information transfer, and conflicts. Therefore leadership style plays a much more pivotal role here. The transformational leader motivates his followers by setting an example to his subordinates. However transformational leadership style isn't always typical of such HRD environments. In the first place the democratic and transformational leadership qualities when combined together would ignore such overriding concerns for meeting targets so that it would instill a sense of permanency in the minds of employees thus reducing absenteeism and redundancy. This type of HRD approach can be desirable in the hospital industry. A demotivated workforce might underperform and then cause conflicts in the workplace. This is apparent in some organizational settings including health organizations where persistently underperforming health staffs come to be treated as a liability by the management. Such friction between the health manger and employees in culturally diverse healthcare settings would be regarded as one of the most negative factors in falling productivity in healthcare organizations where mangers tend to be autocratic and diverge from norms. In other words health practitioners have to be recognized before they are rewarded. The transformational leader does recognize these positive elements in the culturally diverse workforce (Caulfield, 2005). Such leadership qualities have a positive cumulative impact on the long term organizational outcomes. Therefore what's essentially noticed in hospitals is an international strategic HRM environment that functions basically with a highly regulated work environment along with democratic leadership norms that stretch even beyond the work environment and sometimes extend up to otherwise indeterminate culturally diverse social settings in the backdrop of the hospitals. This aspect of the HRD strategy of hospitals acquired a much greater dimension concerning workplace based norms. Further employee motivation, skills development and training strategies at healthcare sector and labor turnover figures are interconnected in such a way that staff members have particularly been affected by a lack of concern for their negative experiences while dealing with patients. Absence of leadership behaviour and absence of explicit task distribution were associated with poor team performance (Whitehead, Weiss, & Tappen, 2009). Failure to translate theoretical knowledge into effective team activity appears to be a major problem. This study has clearly identified a positive set of outcomes related to HRD practices and motivation at hospitals particularly in UK and others in general. The theoretical posture of the paper is based on the fact that HRD practices at hospitals have acquired a greater dimension of integrity at the inner-house operational level on par with positive employee motivation and in-house HRD strategy. Delegation and Supervision of others Delegation can be defined as the assigning the responsibility to another person of team to carry out specific activities. Thus on CPR situation it requires delegation of authority on resuscitation training, cardiac arrest prevention, patient transfer, post resuscitation care to the cardiac arrest team and individual to handle the specific situation and resuscitation equipments. Staff with patient contact should be given regular resuscitation training appropriate to their expected abilities and roles. Clinical staff should receive regular training in the recognition of patients at risk of cardiopulmonary arrest and the measures required for the prevention of cardiopulmonary arrest (Weiner, Shortell, & Alexander, 1997). Resuscitation equipment should be available throughout the institution for clinical use and for training. Supervision can be identified as a critical watching and directing as of activities, thus supervision does not require to physically presenting at the situation 100% and supervisor must be able to critically watch and direct the course of action. For instance considering on CPR procedure in hospital settings it requires both the delegation of activities and also continuous supervision by the healthcare professionals. However the amount of supervision is directly related to the health professionals' or students' personal and professional experience, skills, and abilities and the healthcare needs of the situation. Ethical standards setting efforts on the part of the healthcare manager has also been a positive feature in motivating the health staff. Like any other relationship or transformational leader the healthcare manager needs to identified a set of achievable goals and defined the limits for each activity. For instance his own concern for the welfare of the health staff has been centered on creating a convenient functional environment in the healthcare environment. While the staff members' contribution to the overall success of the health organization is acknowledged by assigning more responsible tasks to team members, the healthcare manager has set some good examples in his behavior in general as well. Social responsibility receives priority here on the ground that both duties and obligations tend to interact with each other in a manner to influence organizational goals and outcomes. Irrespective of these goals and outcomes ethical or moral standards have received such great attention from the healthcare manager that very little is done without reference to prior standards. Quality Assurance The current debate on healthcare has never been so intense, as per its emphasis the importance of quality assurance in healthcare (Department of Health, 2008). Yet again what has so far transpired on quality assurance and training issues are centrally focused on the future of the healthcare delivery level at the healthcare environment. Thus the quality and performance of health professionals would lead to a new dimension both in the sphere of motivation and performance. The current treatment regimes in CPR would be overhauled to include health professionals' discretion as a norm in quick actions and commencement of treatment. The current practice of putting the patient through a CPR process or procedure would come to an end thus ensuring both higher quality and patient safety at each and every level of the treatment regime. New technologies would definitely be there to increase the quality of healthcare and patient safety. For instance in an emergency procedure of CPR activity would require advanced life support equipments as well as fully equipped mobile hospitals (Renwick, 1992). Thus the theoretical and empirical analysis of this paper is based on the available literature on the subject at a global level along with hospital's own training and quality improvement practices. This study basically draws on the hospitals' policy based convergence/divergence parameters for the continuous analysis for a proper articulation of the TQM strategy at broader level though its theoretical underpinnings are based on the need to focus attention on the evolving environment of competition. In fact some of the healthcare organizations are focusing their attention on innovative ways to overcome some of the challenges in healthcare sector including create safety environment for patients and efficiency of the service delivery (Donabedian, 2002). Thus Six Sigma strategies also can be used to enhance the quality of the service in the hospital by reducing the errors and variability in healthcare process especially in the emergency situations on CPR. Therefore it can be used as a quality management method within the hospitals with sequence of steps to achieve desirable objectives such as improving the quality of the service, efficient service delivery, patient safety, reducing the cost and increasing the profits and so on. As a result hospital sectors are experiencing positive outcomes on patients, staff and the bottom line. Continuing Professional Development According to the current literature continuous professional development (CPD) is that health professionals maintain, improve and broaden their specific knowledge and skills and develop personal qualities in order to use in their professional practices (Fraser, 2009). Thus health professionals and students must keep their knowledge and skills up to date throughout their career. Specially, they should take part regularly in educational activities which maintain and enhance their capability and performance. Medical professionals are responsible for keeping themselves up to date in all areas of their practice. Revalidation will mean that they must show that they are up to date and fit to engage in their profession. For instance when revalidation was introduced in 2005 onwards, all doctors were required to show often that they are doing this. CPD allows doctors to demonstrate that they are maintaining their skills in their practice. It also allows medical professionals to develop professionally and to learn from more informal experiences that are not part of the revalidation process (Golding, 2006). Medical professionals should engage in lifelong learning to make sure that they remain knowledgeable in their practice. Recent literature on the CPD related programs suggest that properly designed and planned programs would have the desired outcomes especially in emergency situations on CPR. In order to determine the success of the mentoring relationship health professionals should develop an evaluation survey based on difficulties, effectiveness, collaboration and recommendations about the mentor program for future development. However, the survey results would not always turn out to be positive (Grimshaw, & Russell, 1993). Continuous process of similar developments in the hospital curriculum design and planning programs implemented by the healthcare organizations can be affected by a series of positive outcomes. However the HRM function which occupies a very important place in the whole continuous professional development process. The healthcare sector has been careful enough not to strain its staff at each level of operations, including physicians and nurses (Brown, & Libberton, 2007). On-the-job Training and Development of skills at the average organization with a multicultural workforce is oriented towards meeting international quality standards. Strategic operational and competitive environments of such organizations are characterized by some strategic shifts away from the homogeneous cultural environments' HRM practices. 5) Conclusion In the conclusion it must be noted that medical professionals and students should concentrate upon such aspects as Clinical Decision Making, Leadership/ Management and Teamwork, Delegation and Supervision of others, Quality Assurance and Continuous Professional Development to successfully develop their career. Medical professionals and students have a responsibility to ensure that their knowledge and skills are up-to-date. The General Medical Council (GMC) provides guidance on Continuing Professional Development (CPD), which lays out the values on which continuous professional development should be based, and the responsibilities of the relevant organizations involved in its delivery. Being a medical professional is a continuous learning process that goes together with formal undergraduate and postgraduate education and training. It involves health professionals to maintain and enhance their standards across all areas of their practice. They should also make it a point to keep up to date when they are not practicing. The task of formulating a diagnosis is called clinical decision making. The clinician uses the data obtained from the medical history and physical and mental examinations to come up with a list of possible causes of the disorder, called the differential diagnosis. The clinician then makes up his mind on what tests to order to help refine the list or identify the specific disease responsible for the symptoms. Small groups consisting of individuals work together throughout the health care profession, in intensive care units (ICU), operating rooms, labor and delivery wards, and family-medicine practices. It is of paramount importance that physicians, nurses, pharmacists, technicians, and other health professionals and students organize their tasks, if safe and efficient patient care is to be a achieved. Teams make less mistakes than do individuals, and this is particularly the case when every member of a team is enlightened of their teammates' duties as they are their own. Medical professionals are responsible for supervising those to whom they have delegated duties. Most of the time they entrust tasks such as nursing tasks to other team members, and they are responsible for the decision to entrust and for the adequacy of care administered to the patient, given that the person to whom the task was assigned performs the task as told and delegated by the delegating medical professional. The medical professional maintains accountability for the outcome of delegation. The training and practice of doctors and medical professionals has always been highlighted by the necessity to meet strictly defined criteria regarding systematic work, documentation and the evaluation of the results of their practice. These are also the main features of what is known today as "Quality Assurance" (also quality improvement or quality management). Quality assurance by considering and adjusting performance in medical practice is an ethical obligation for every medical professional throughout the whole professional career. As the learning experience of this writer demonstrates CPR technique has become the most significant episodic intervention in the writer's training period. 6) Action Plan It can be inferred from this paper that the training and development related issues for medical professionals and students in the healthcare sector where both government and private organizations have poorly identified not only the immediate issues such as resource constraints but also have failed to address a number of pressing training needs of the staff to bring about improvement in quality. Technical staff and paramedics in the healthcare sector in Britain have received much less focused training while on the job. For example radiologists and counselors are not well trained to achieve organizational goals. However this is a general observation of an otherwise particular problem. More should be done towards training medical professionals and students in such aspects as clinical decision making, working together as a team and taking responsibility upon one's shoulders as a leader, delegation and supervision of tasks and responsibilities to others. More emphasis should be laid on Quality Assurance in the medical profession. Medical students should be trained so as to ensure that they select the best quality medicines, machinery and equipment in their profession. This is of paramount importance as the health of an individual is of paramount importance and the best quality care should be provided to him. The NHS policy decision has suffered due to its failure to asses situations in the long run. It should be more actively involved in devising plans for such matters as developing a plan for professional intervention on CPR in health environments. REFERENCES 1. 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