Professionalism in Healthcare - Essay Example

Professionalism in Healthcare Introduction: The healthcare practice is one of the most dynamic fields of practice. It is composed of different health professionals with varying contributions to the delivery of care. These health professionals have the knowledge and expertise in healthcare which ensures that the patients get the best care possible. In the actual practice, these professionals have the knowledge and training which can help ensure improved patient outcomes. Each health professional has his own area of practice and he acts in a way which exemplifies his role in the health care delivery. This paper shall discuss what it means to act professionally, based on my career as a nurse. Firstly, this paper will define professionalism in the context of health and human services delivery. Secondly, it will present an explanation of what it means to provide quality nursing care and services within a safe, ethical and legal context, in an individual and interprofessional framework. Finally, it will identify the mechanisms by which nurses’ behaviours are monitored, and how they may contribute to quality improvement mechanisms. Discussion: Professionalism is defined in different ways. According to Bhugra (2010, p. 103) professionalism “may be defined as a conglomerate of separate elements, such as honesty, empathy, reliability, self-awareness, competence, and so forth”. In this instance, professionalism is described as a combination of various elements and attitudes which are often needed in order to successfully establish a beneficial relationship between clients and nurses. In some ways, professionalism is also viewed as a complete ethical concept with almost no boundaries. With the different issues which nurses currently face, especially those which relate to conflicts of interest and market-place competition, professionalism helps ensure the competence “across an enlarging corpus of medical knowledge and technical skills” (Bhugra, 2010, p.103). In considering its more specific applications to health care delivery, a health professional is one who has a primary technical and specialized knowledge and who advances and implements standards based on service rather than profit (Reiff, 2010). The health professional has cognitive and moral characteristics which can be familiarly couched in the Hippocratic Oath through the words, “I will practice my art with purity and holiness and for the benefit of the sick” (as cited Orme-Smith & Spicer, 2001, p. 251). Professionalism in nursing largely implies a responsibility to serve and care for others, beyond monetary considerations. Consequently, professionalism in nursing is about showing commitment and responsibility “so that peers and students are exposed to and learn the kinds of behaviours that constitute professionalism” (Reiff, 2010). Professionalism is basically the nurse’s contract with society, and in order to preserve such contract, it is important to highlight strong patient relationships as foundations of patient care (Reiff, 2010). It is also about adhering to the laws, the mandates of the courts, including statutory laws, common laws, and the different legal principles laid out for nurses (Nikolopoulos, 2010). The nursing practice is also governed by registration boards which oversee their general conduct. These boards ensure that the nursing responsibilities and functions are carried out and that violations of these responsibilities would be punished accordingly (Oates & McKinstry, 2010). These practices carried out in the name of professionalism help contribute to the overall health outcome, which in effect implies a change in the health of the individual or of a group of people credited to an intervention or to several interventions (Williamson, 2010). Various attempts at specifying what professionalism means to nursing care have been made by various academics and health practitioners. In the United Kingdom, studies indicate that the most likely elements of professionalism include the areas of significance “related to structure, process, and outcome Maxwell’s six dimensions: effectiveness, acceptability, efficiency, access, equity and relevance” (Taylor, 1996, p. 626). These approaches determined the different strengths and weaknesses in the delivery of services. These six areas are often integrated in the health practice through the different standards defined by each profession. For the nursing profession, the professional nursing code lists the minimum standards of the practice as supported by the nursing governing bodies and legal mandates (Polkinghorn & Townsend, 2010). Professionalism in nursing care has been discussed in the United States in terms of implementing health care reform. Blumenthal (1994) discusses how professionalism should not be conceptualized in terms of autonomy because it is not a divine right given to nurses or medical professionals alone; instead, it is a “legal, institutional, and moral privilege granted by society and that must be earned by health care providers through observing certain standards of behaviour” (Blumenthal, 1994, p. 253). These standards of professionalism are specified as: “altruism, commitment to self-improvement, and peer review” (Blumenthal, 1994, p. 253). Altruism helps to define and achieve improved levels of professionalism by providing financial security to all Americans (Blumenthal, 1994). Altruism is about extending concern for the well-being of others (American Association of Colleges of Nursing, 2007). In the practice, it is expressed by expressing an understanding of the culture, beliefs, and viewpoints of others; by being advocates for clients, especially those who are vulnerable; by taking risks for clients and colleagues; and by mentoring and assisting other professionals (American Association of Colleges of Nursing, 2007). Professionalism can also be seen in healthcare through the different methods of self-improvement that nurses adopt. Self-improvement can be gained by acquiring new knowledge about the practice and the profession. Such new knowledge also increases confidence and “adds to its hope that untreatable illness will be manageable in the future” (Blumenthal, 1994, p.4). Consequently, research plays an important role in professionalism because it updates knowledge and techniques in nursing care and helps ensure that the latest and most efficient health services are made available to patients. Peer supervision is also an important manifestation of professionalism in healthcare. Peer supervision is about setting forth a sense of responsibility among nurses; it is about giving a sense of local autonomy to nurses in order to ensure that their efforts in supervising are valued (Blumenthal, 1994, p. 3). In this case, peer supervision implements the use of guidelines which help reduce the cost of health services and if the peers would hold themselves accountable, they must also accept these guidelines as a starting point for practice standards, not an end in themselves (Blumenthal, 1994). Peer review as a function of professionalism helps ensure that the nurses would allow their actions to be scrutinized and professionally reviewed by their colleagues. In this case, the review helps maintain quality and safety in the ethical and legal context. In the field of ethics, there are four basic principles which are used in order to ensure the professionalism. These principles are: beneficence, nonmaleficence, autonomy, and justice (McCormick, 2008). When applied in the resolution of ethical dilemmas and ethical issues in the practice, professionalism in nursing care can be secured. First and foremost, the respect for autonomy specifies that nurses should respect patient’s preferences in their care. In this regard, an informed consent must be sought before any type of care is administered to the patient (Williamson & McKinstry, 2010). Secondly, the principle of nonmaleficence requires nurses to embody the statement, “above all, do no harm.” This principle is affixed over and above the principle of autonomy, especially when a person’s life (or other people’s lives) is in danger. This brings us to the third principle – that of beneficence. Beneficence is about basing one’s actions on what would benefit the patient, not what would bring harm to him (Breen, 2007). Professionalism is about putting the patient’s best interests over and above other considerations, especially, considerations which may bring the patient great harm. Finally, justice is also another means of ensuring professionalism in the practice. This principle is about giving a person what is due him (Aschcroft, Dawson & Draper, 2007). People are entitled to quality health care; they deserve to be treated with respect; and they deserve to be given access to healthcare regardless of their race, religion, gender, and station in life. Healthcare spending has been reduced in recent years due to the economic crisis. Consequently, this has also caused lower rates in employment offers for medical personnel. This has led to staff shortages and longer working hours for nurses (Gallagher, 2001). Due to heavier workloads for nurses, higher safety concerns have been seen. With more stressed and more overworked nurses, higher incidents of errors in the practice have been feared (Grosso, 2008). Nevertheless, these fears have not been fully justified. Even as the possibility of higher rates in errors has been anticipated, a good majority of health workers, including nurses have been able to provide quality care (Leonard & Masatu, 2007). In applying an interprofessional approach, safety advocates point out that a shift from individual caregiver to a collaborative effort among the members of the team is the most appropriate approach to health care delivery. These safety experts also point out that the possibility of committing an error is always an ever-present threat; therefore, safety nets must always be in place in order to reduce their risk and their impact on patients (Grosso, 2008). These safety nets come in the form members of health care teams which serve as professionals and who act as each other’s safety nets (Grosso, 2008). The Occupational Health and Safety (OHS, 2010) standards also help prevent musculoskeletal disorders in promoting health and safety through health education, incentives, workplace inspections, investigations, prosecutions, and penalties for failure to comply with the safety laws (OHS, 2010). The safety principles and risk management principles also help ensure that nursing practice is carried out through regulations on physical hazards, prevention of falls, confined spaces, hazardous substances, and hazardous industries (Oakman, 2010). Safety standards in the practice also call for the adoption of infection control measures on the part of the nurse – in preventing self contamination and in transferring microbes from one patient to another (McLaughlin & Holdsworth, 2010). In further illustrating interprofessionalism in the healthcare practice, the study of D’Amour, et.al., (2005) set forth collaboration is an important factor in the activities which help upgrade the health services delivered to the general population. It is crucial for collaboration to be understood because even as various health issues faced by health professionals are drawing them towards each other, the healthcare system still does not have enough knowledge of the complications involved in these interprofessional relationships (D’Amour, et.al., 2005). In the process of their research, the authors were able to establish that collaboration can be understood in terms of sharing and interdependency. Based on researches gathered by authors, no significant efforts were made to integrate the client into the health care team “despite the fact that patients are recognized as the ultimate justification for providing collaborative care” (D’Amour, 2005). In an attempt to evaluate the behaviour of the healthcare delivery services, the Australian Institute of Health and Welfare (2010) has created means of monitoring hyperlinks to various sites which also set-up evaluation in the following areas: medical indemnity claims and information on safety and quality of healthcare; international data on safety and quality of healthcare; and additional safety and quality resources (Australian Institute of Health and Welfare, 2010). The Australian Commission on Safety and Quality in Healthcare is the main monitoring government agency. Through this agency, the behaviour of the members of the healthcare team is monitored and the framework on standards of care is set forth. It leads and coordinates the efforts towards safety and quality in healthcare through the identification of issues and policies which impact on the delivery of patient care. Conclusion: Professionalism is about following the overall terms of one’s profession and it is about acting within the bounds of the nursing practice. This professionalism is achieved through the application of quality and safe practices in nursing care. More importantly, it is about the collaboration of the members of the health services delivery team. In effect, professionalism is seen in practice through self-improvement processes, quality monitoring measures, and strong peer evaluation techniques. Through such measures, professionalism helps achieve the best possible nursing services for patients. References: Ashcroft, R., Dawson, A., & Draper, H. (2007) Principles of health care ethics. Massachusetts: John Wiley & Sons. Bhugra, D. (2010) Professionalism in Mental Healthcare: Experts, Expertise and Expectations. New York: Cambridge University Press. Blumenthal, D. (1994) The Vital Role Of Professionalism In Health Care Reform. Health Affairs, Retrieved 12 October 2010 from http://content.healthaffairs.org/cgi/reprint/13/1/252.pdf. Breen, K. (2007). Medical professionalism: is it really under threat? The Medical Journal of Australia, 186 (11): pp. 596-598. Brennan, T. (2002) Physicians’ Professional Responsibility to Improve the Quality of Care. Academic Medicine, volume 77, number 10. Retrieved 12 October 2010 from http://innovationlabs.com/r3p_public/rtr3/pre/preread/Professionalism%20and%20QI.Brennan.2002.pdf. Gallagher, S. (2010) Beyond Safety and the Nursing Shortage: A Threat to the Heart of Nursing. Ostomy Wound Management. Retrieved 12 October 2010 from http://www.o-wm.com/article/1205. Grosso, M. (2008) Patient safety, quality of care, and physician professionalism: Do these goals conflict? Adjusting our traditional concept of the professional self to the new systems-based reality. The Family Practice, volume 57, number 6, S17-S19. D’ Amour, D. (2005).The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. Journal of Interprofessional Care, pp. 1: 116 – 131. Leonard, K. & Masatu, M. (2008) Professionalism, Latent Professionalism and Organizational Demands for Health Care Quality in a Developing Country.University of Maryland. Retrieved 01 October 2010 from http://www.arec.umd.edu/libcomp/Areclib/Publications/Working-Papers-PDF-files/08-10.pdf. McCormick, T. (2008) Principles of Bioethics. University of Washington. Retrieved 12 October 2010 from http://depts.washington.edu/bioethx/tools/princpl.html. McLaughlin, Y. & Holdsworth, M. (2010) Enquiry 2: Working Safely in an interprofessional environment (Lecture Week 8). Health Science. Bundoora: La Trobe University. Nikolopoulos, N. (2010) Enquiry 3: Practising ethically, legally, and professionally: Introduction to enquiry. Legal framework for professional practice (Lecture Week 11). Health Science. Bundoora: La Trobe University. Oakman, J. (2010) Enquiry 2: Working Safely in an interprofessional environment (Lecture5&7): Risks and hazards for consumers and professionals. Health Science. Bundoora: La Trobe University. Orne-Smith, A. & Spicer, J. (2001) Ethics in general practice: a practical handbook for personal development. London: Radcliffe Medical Press. Oates, M. & McKinstry, C. (2010) Enquiry 3: Practising ethically, legally, and professionally: Bringing it all together: standards, registration and professional competencies (Lecture Week 12). Health Science. Bundoora: La Trobe University. Polkinghorn, R. & Townsend, R. (2010) Enquiry 3: Practising ethically, legally, and professionally: Introduction to enquiry. What is an ethical approach to practice? (Lecture Week 10). Health Science. Bundoora: La Trobe University. Reiff, M. (2010) Healthcare: The meaning of professionalism. Helium. Retrieved 13 October 2010 from http://www.helium.com/items/241885-healthcare-the-meaning-of-professionalism. Safety and quality of health care (2010). Australian Institute of Health and Welfare. Retrieved 11 October 2010 from http://www.aihw.gov.au/safequalityhealth/index.cfm. Taylor, D. (1996) Quality and professionalism in health care: a review of current initiatives in the NHS. British Medical Journal, 312 (626). Retrieved 12 October 2010 from http://www.bmj.com/content/312/7031/626.full?login_referer=http%3A%2F%2Fwww.bmj.com%2Fcontent%2F312%2F7031%2F626.extract . The legislative context of OHS (2010) Health Science. Bundoora: LaTrobe University. White Paper on The Role of the Clinical Nurse Leader (2007) American Association of Colleges of Nursing. Retrieved 12 October 2010 from http://www.aacn.nche.edu/publications/whitepapers/clinicalnurseleader.htm. Williamson, D., & McKinstry, C. (2010). Consumer perspective on interprofessional communication (Lecture 4). Health Science. Bundoora: La Trobe University. Williamson, D. (2010) Enquiry 1: Being a health, education and human services professional (Lecture 3): Strategies for evaluation and quality improvement. Health Science. Bundoora: La Trobe University. Read More