Health Equity and Social Justice - NACCHO
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Nel Noddings In Noddings published Caring, in which she developed the idea of care as a feminine ethic, and applied it to the practice of moral education. Drawing conceptually from a maternal perspective, Noddings understood caring relationships to be basic to human existence and consciousness.
Noddings located the origin of ethical action in two motives, the human affective response that is a natural caring sentiment, and the memory of being cared-for that gives rise to an ideal self. Noddings rejected universal principles for prescribed action and judgment, arguing that care must always be contextually applied.
The former stage refers to actual hands-on application of caring services, and the latter to a state of being whereby one nurtures caring ideas or intentions.
She further argued that the scope of caring obligation is limited. The caring obligation is conceived of as moving outward in concentric circles so enlarged care is increasingly characterized by a diminished ability for particularity and contextual judgment, which prompted Noddings to speculate that it is impossible to care-for everyone.
She maintained that while the one-caring has an obligation to care-for proximate humans and animals to the extent that they are needy and able to respond to offerings of care, there is a lesser obligation to care for distant others if there is no hope that care will be completed.
These claims proved to be highly controversial, and Noddings later revised them somewhat. In her more recent book Starting From Home, Noddings endorsed a stronger obligation to care about distant humans, and affirms caring-about as an important motivational stage for inspiring local and global justice, but continued to hold that it is impossible to care-for all, especially distant others.
Other Influential authors Although many philosophers have developed care ethics, five authors are especially notable. Baier specially underscores trust, a basic relation between particular persons, as the fundamental concept of morality, and notes its obfuscation within theories premised on abstract and autonomous agents.
She recommends carving out room for the development of moral emotions and harmonizing the ideals of care and justice.
Virginia Held Virginia Held is the editor and author of many books pertaining to care ethics. In much of her work she seeks to move beyond ideals of liberal justice, arguing that they are not as much flawed as limited, and examines how social relations might be different when modeled after mothering persons and children.
Premised on a fundamental non-contractual human need for care, Held construes care as the most basic moral value. She describes feminist ethics as committed to actual experience, with an emphasis on reason and emotion, literal rather than hypothetical persons, embodiment, actual dialogue, and contextual, lived methodologies.
In The Ethics of CareHeld demonstrates the relevance of care ethics to political, social and global questions. Conceptualizing care as a cluster of practices and values, she describes a caring person as one who has appropriate motivations to care for others and who participates adeptly in effective caring practices.
She argues for limiting both market provisions for care and the need for legalistic thinking in ethics, asserting that care ethics has superior resources for dealing with the power and violence that imbues all relations, including those on the global level. Specifically, she recommends a view of a globally interdependent civil society increasingly dependent upon an array of caring NGOs for solving problems.
Ultimately, she argues that rights based moral theories presume a background of social connection, and that when fore-grounded, care ethics can help to create communities that promote healthy social relations, rather than the near boundless pursuit of self-interest. Meyers, is one the most significant anthologies in care ethics to date.
In Love's LaborKittay develops a dependency based account of equality rooted in the activity of caring for the seriously disabled. She argues that equality for dependency workers and the unavoidably dependent will only be achieved through conceptual and institutional reform. Employing expanded ideals of fairness and reciprocity that take interdependence as basic, Kittay poses a third principle for Rawls' theory of justice: She more precisely calls for the public provision of Doulas, paid professional care-workers who care for care-givers, and uses the principle of Doula to justify welfare for all care-givers, akin to worker's compensation or unemployment benefits.
In this article, and in her later book of the same titleRuddick uses care ethical methodology to theorize from the lived experience of mothering, rendering a unique approach to moral reasoning and a ground for a feminist politics of peace. Ruddick's analysis, which forges strong associations between care ethics and motherhood, has been both well-received and controversial see Section 6, below. Joan Tronto Joan Tronto is most known for exploring the intersections of care ethics, feminist theory, and political science.
She sanctions a feminist care ethic designed to thwart the accretion of power to the existing powerful, and to increase value for activities that legitimize shared power.
She identifies moral boundaries that have served to privatize the implications of care ethics, and highlights the political dynamics of care relations which describe, for example, the tendency of women and other minorities to perform care work in ways that benefit the social elite.
See Sections 2 and 8 below. Definitions of Care Because it depends upon contextual considerations, care is notoriously difficult to define. As Ruddick points out, at least three distinct but overlapping meanings of care have emerged in recent decades—an ethic defined in opposition to justice, a kind of labor, and a particular relationship4. However, in care ethical literature, 'care' is most often defined as a practice, value, disposition, or virtue, and is frequently portrayed as an overlapping set of concepts.
This definition posits care fundamentally as a practice, but Tronto further identifies four sub-elements of care that can be understood simultaneously as stages, virtuous dispositions, or goals. Tronto's definition is praised for how it admits to cultural variation and extends care beyond family and domestic spheres, but it is also criticized for being overly broad, counting nearly every human activity as care.
Other definitions of care provide more precise delineations. Diemut Bubeck narrows the definitional scope of care by emphasizing personal interaction and dependency. She also holds that one cannot care for oneself, and that care does not require any emotional attachment.
While some care ethicists accept that care need not always have an emotional component, Bubeck's definitional exclusion of self-care is rejected by other care ethicists who stress additional aspects of care. For example, both Maurice Hamington and Daniel Engster make room for self-care in their definitions of care, but focus more precisely on special bodily features and end goals of care Hamington, ; Engster, Hamington focuses on embodiment, stating that: Although these definitions emphasize care as a practice, not all moral theorists maintain this view of.
Alternatively, care is understood as a virtue or motive. James Rachels, Raja Halwani, and Margaret McLaren have argued for categorizing care ethics as a species of virtue ethics, with care as a central virtue Rachels, ; McLaren, ; Halwani, Some ethicists prefer to understand care as a practice more fundamental than a virtue or motive because doing so resists the tendency to romanticize care as a sentiment or dispositional trait, and reveals the breadth of caring activities as globally intertwined with virtually all aspects of life.
Criticisms A number of criticisms have been launched against care ethics, including that it is: Care Ethics as a Slave Morality One of the earliest objections was that care ethics is a kind of slave morality valorizing the oppression of women Puka, ; Card, ; Davion, The concept of slave morality comes from the philosopher Frederick Nietzsche, who held that oppressed peoples tend to develop moral theories that reaffirm subservient traits as virtues.
Following this tradition, the charge that care ethics is a slave morality interprets the different voice of care as emerging from patriarchal traditions characterized by rigidly enforced sexual divisions of labor. This critique issues caution against uncritically valorizing caring practices and inclinations because women who predominantly perform the work of care often do so to their own economic and political disadvantage.
To the extent that care ethics encourages care without further inquiring as to who is caring for whom, and whether these relationships are just, it provides an unsatisfactory base for a fully libratory ethic. This objection further implies that the voice of care may not be an authentic or empowering expression, but a product of false consciousness that equates moral maturity with self-sacrifice and self-effacement.
Gilligan has been faulted for basing her conclusions on too narrow a sample, and for drawing from overly homogenous groups such as students at elite colleges and women considering abortion thereby excluding women who would not view abortion as morally permissible.
For instance, Vanessa Siddle Walker and John Snarey surmise that resolution of the Heinz dilemma shifts if Heinz is identified as Black, because in the United States African-American males are disproportionately likely to be arrested for crime, and less likely to have their cases dismissed without stringent penalties Walker and Snarey, Sandra Harding observes certain similarities between care ethics and African moralities, noting that care ethics has affinities with many other moral traditions Harding, Sarah Lucia Hoagland identifies care as the heart of lesbian connection, but also cautions against the dangers of assuming that all care relations are ideally maternalistic Hoagland, Thus, even if some women identify with care ethics, it is unclear whether this is a general quality of women, whether moral development is distinctly and dualistically gendered, and whether the voice of care is the only alternative moral voice.
However, authors like Marilyn Friedman maintain that even if it cannot be shown that care is a distinctly female moral orientation, it is plausibly understood as a symbolically feminine approach Friedman, Care Ethics as Theoretically Indistinct Along similar lines some critics object that care ethics is not a highly distinct moral theory, and that it rightly incorporates liberal concepts such as autonomy, equality, and justice. Some defenders of utilitarianism and deontology argue that the concerns highlighted by care ethics have been, or could be, readily addressed by existing theories Nagl-Docekal, ; Ma, Others suggest that care ethics merely reduces to virtue ethics with care being one of many virtues Rachels, ; Slote, a; b; McLaren,Halwani, Although a number of care ethicists explore the possible overlap between care ethics and other moral theories, the distinctiveness of the ethic is defended by some current advocates of care ethics, who contend that the focus on social power, identity, relationship, and interdependency are unique aspects of the theory Sander-Staudt, Most care ethicists make room for justice concerns and for critically scrutinizing alternatives amongst justice perspectives.
In some cases, care ethicists understand the perspectives of care and justice as mutual supplements to one another. Other theorists underscore the strategic potential for construing care as a right in liberal societies that place a high rhetorical value on human rights. Yet others explore the benefits of integrating care ethics with less liberal traditions of justice, such as Marxism Bubeck, Care Ethics as Parochial Another set of criticisms center around the concern that care ethics obscures larger social dynamics and is overly parochial.
Critics worry that this stance privileges elite care-givers by excusing them from attending to significant differences in international standards of living and their causes.
Noddings now affirms an explicit theme of justice in care ethics that resists arbitrary favoritism, and that extends to public and international domains. Other care ethicists refine Noddings' claim by emphasizing the practical and moral connections between proximate and distant relations, by affirming a principle of care for the most vulnerable on a global level, and by explicitly weaving a political component into care theory.
Care Ethics as Essentialist The objection that care ethics is essentialist stems from the more general essentialist critique made by Elizabeth Spelman Following this argument, early versions of care ethics have been faulted for failing to explore the ways in which women and others differ from one another, and for thereby offering a uniform picture of moral development that reinforces sex stereotypes Tronto, Critics challenge tendencies in care ethics to theorize care based on a dyadic model of a care-giving mother and a care-receiving child, on the grounds that it overly romanticizes motherhood and does not adequately represent the vast experiences of individuals Hoagland, The charge of essentialism in care ethics highlights ways in which women and men are differently implicated in chains of care depending on variables of class, race, age, and more.
Essentialism in care ethics is problematic not only because it is conceptually facile, but also because of its political implications for social justice. For example, in the United States women of color and white women are differently situated in terms of who is more likely to give and receive care, and of what degree and quality, because the least paid care workers predominantly continue to be women of color.
Likewise, lesbian and heterosexual women are differently situated in being able to claim the benefits and burdens of marriage, and are not equally presumed to be fit as care-givers. Contemporary feminist care ethicists attempt to avoid essentialism by employing several strategies, including: Care Ethics as Ambiguous Because it eschews abstract principles and decisional procedures, care ethics is often accused of being unduly ambiguous, and for failing to offer concrete guidance for ethical action Rachels, Some care ethicists find the non-principled nature of care ethics to be overstated, noting that because a care perspective may eschew some principles does not mean that it eschews all principles entirely Held, Principles that could be regarded as central to care ethics might pertain to the origin and basic need of care relations, the evaluation of claims of need, the obligation to care, and the scope of care distribution.
On principle, it would seem, a care ethic guides the moral agent to recognize relational interdependency, care for the self and others, cultivate the skills of attention, response, respect, and completion, and maintain just and caring relationships.
However, while theorists define care ethics as a theory derived from actual practices, they simultaneously resist subjectivism and moral relativism. Feminine and Feminist Ethics Because of its association with women, care ethics is often construed as a feminine ethic. Indeed, care ethics, feminine ethics, and feminist ethics are often treated as synonymous. But although they overlap, these are discrete fields in that although care ethics connotes feminine traits, not all feminine and feminist ethics are care ethics, and the necessary connection between care ethics and femininity has been subject to rigorous challenge.
The idea that there may be a distinctly woman-oriented, or a feminine approach to ethics, can be traced far back in history. Attempts to legitimate this approach gained momentum in the 18th and 19th centuries, fueled by some suffragettes, who argued that granting voting rights to white women would lead to moral social improvements. Central assumptions of feminine ethics are that women are similar enough to share a common perspective, rooted in the biological capacity and expectation of motherhood, and that characteristically feminine traits include compassion, empathy, nurturance, and kindness.
But once it is acknowledged that women are diverse, and that some men exhibit equally strong tendencies to care, it is not readily apparent that care ethics is solely or uniquely feminine. Many women, in actuality and in myth, in both contemporary and past times, do not exhibit care. Other factors of social identity, such as ethnicity and class, have also been found to correlate with care thinking.
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Nonetheless, care has pervasively been assumed to be a symbolically feminine trait and perspective, and many women resonate with a care perspective. What differentiates feminine and feminist care ethics turns on the extent to which there is critical inquiry into the empirical and symbolic association between women and care, and concern for the power-related implications of this association.
Alison Jaggar characterizes a feminist ethic as one which exposes masculine and other biases in moral theory, understands individual actions in the context of social practices, illuminates differences between women, provides guidance for private, public, and international issues, and treats the experiences of women respectfully, but not uncritically Jaggar, Slote develops a strictly gender neutral theory of care on the grounds that care ethics can be traced to the work of male as well as female philosophers.
Although he acknowledges that women are disadvantaged in current caring distributions and are often socialized to value self-effacing care, his theory is feminist only in seeking to assure that the basic needs of women and girls are met and their capabilities developed.
While cautious of the associations between care and femininity, they find it useful to tap the resources of the lived and embodied experiences of women, a common one which is the capacity to birth children. They tend to define care as a practice partially in order to stay mindful of the ongoing empirical if misguided associations between care and women, that must inform utopian visions of care as a gender-neutral activity and virtue.
Complicating things further, individuals who are sexed as women may nonetheless gain social privilege when they exhibit certain perceived traits of the male gender, such as being unencumbered and competitive, suggesting that it is potentially as important to revalue feminine traits and activities, as it is to stress the gender-neutral potential of care ethics. As it currently stands, care ethicists agree that women are positioned differently than men in relation to caring practices, but there is no clear consensus about the best way to theorize sex and gender in care ethics.
The most pre-dominant of these comparisons has been between care ethics and virtue ethics, to the extent that care ethics is sometimes categorized as a form of virtue ethics, with care being a central virtue.
The identification of caring virtues fuels the tendency to classify care ethics as a virtue ethic, although this system of classification is not universally endorsed. Some theorists move to integrate care and virtue ethics for strategic reasons. McLaren posits that virtue theory provides a normative framework which care ethics lacks McLaren, The perceived flaw in care ethics for both authors is a neglect of justice standards in how care is distributed and practiced, and a relegation of care to the private realm, which exacerbates the isolation and individualization of the burdens of care already prevalent in liberal societies.
McLaren contends that virtue theory provides care ethics both with a standard of appropriateness and a normative framework: Feminist critics, however, resist this assimilation on the grounds that it may dilute the unique focus of care ethics Held, ; Sander-Staudt, They are optimistic that feminist versions of care ethics can address the above concerns of justice, and doubt that virtue ethics provides the best normative framework.
Similar debates surround the comparison between care ethics and Confucianism. Philosophers note a number of similarities between care ethics and Confucian ethics, not least that both theories are often characterized as virtue ethics Li,; Lai Tao, Additional similarities are that both theories emphasize relationship as fundamental to being, eschew general principles, highlight the parent-child relation as paramount, view moral responses as properly graduated, and identify emotions such as empathy, compassion, and sensitivity as prerequisites for moral response.
Ren is often translated as love of humanity, or enlargement. Several authors argue that there is enough overlap between the concepts of care and ren to judge that care ethics and Confucian ethics are remarkably similar and compatible systems of thought Li, ; Rosemont, However, some philosophers object that it is better to view care ethics as distinct from Confucian ethics, because of their potentially incompatible aspects.
Feminist care ethicists charge that a feminist care ethic is not compatible with the way Confucianism subordinates women. For similar reasons, Lijun Yuan doubts that Confucian ethics can ever be acceptable to contemporary feminists, despite its similarity to care ethics. Daniel Star categorizes Confucian ethics as a virtue ethic, and distinguishes virtue ethics and care ethics as involving different biases in moral perception According to Star, care ethics differs from Confucian ethics in not needing to be bound with any particular tradition, in downgrading the importance of principles versus merely noting that principles may be revised or suspendedand in rejecting hierarchical, role-based categories of relationship in favor of contextual and particular responses.
There are also refutations of the belief that care ethics is conceptually incompatible with the justice perspectives of Kantian deontology and liberal human rights theory. Care ethicists dispute the inference that because care and justice have evolved as distinct practices and ideals, that they are incompatible.
Some deny that Kantianism is as staunchly principled and rationalistic as often portrayed, and affirm that care ethics is compatible with Kantian deontology because it relies upon a universal injunction to care, and requires a principle of caring obligation.
An adaptation of the Kantian categorical imperative can be used to ground the obligation to care in the universal necessity of care, and the inconsistency of willing a world without intent to care. Other theorists compare the compatibility between care ethics and concepts of central importance to a Kantian liberal tradition.
Wilson, personal communication, October 1, Conclusions The staff at South Bend Memorial has developed patient care to an art. It is a skill honed with much practice. They have learned that the respect shown for the patients and the personal contact with the patients and their families gains co-operation and speeds up recovery time Evelyn Wilson's family doctor was a victim of overwork.
He relied on the fact that so many of his patients were not taking care of themselves; he lumped her into the same category. He treated her with the same techniques he used for everyone else. He forgot that each patient is an individual and the treatments must be tailor-made. The emergency room attendants were so dependant on their machines that they did not pay any attention to the classic heart attack symptoms that were displayed on her earlier visit to the hospital.
She could have died because of their inattentiveness. By becoming so used to dealing with patients as if they were parts on an assembly line and relying ever more on advanced technology, the medical profession is looking more and seeing less.
They need to stop, take the time to look at, and listen to the patient. Therein might even be the solution to the patient's troubles.Build don't break relationships with communication - connect the dots - Amy Scott - TEDxQueenstown
The importance of the nurse-patient relationship. British Journal of Nursing, 13 4Davidhizar, R. Improving Your Bedside Manner. The Journal of Practical Nursing, 48 1 News and World Report, 11 We say the everyday expression "how are you?
Forgetting birthdays, kid's soccer games and other important dates if it doesn't show up on our agenda of things to do. Fighting just to make first place and in result, we end up knocking others down just to put a few dollars in our pocket. Time is so short that we must not consider individuals around us, but ourselves. This issue has affected the medical world as we know it today.
Doctors rushing from one room to another, while keeping conversation short as possible. There is power in such a paper, and the Pharmacist is the only one able to translate such jargon. Doctors and nurses are so busy with their everyday patient assignments, that they cannot form strong relationships with patients, causing them not to be fully restored back to good health. Time restrictions on nurses and doctors have caused clinicians not to form a relationship with there patients.
George Castledine, Professor and consultant of General Nursing, emphasizes that giving enough time to get to know a patient is hard because of lack of time. He writes, "In hospitals it is difficult to find the time to sit and talk with patients" Castledine, pg. Even though they try to find time to form relationships, the restriction of time in this profession makes it almost impossible. Peplau, who wrote, Interpersonal Relations in Nursing, stresses, " Interpersonal interaction between a patient and a nurse doctor often have more of an effect on the outcome of a patient's problem than many routine technical procedures" Castledine, pg.
Peplau's reason for nurses or doctors to have a relationship is very important, the relationship is vital for the patient's well being. Castledine argues, "There is a desperate need to encourage nurses to listen to patients and respect the patient's need for empathy" Castledine, pg. Listening to the patient and truly tending to their needs will cause fewer problems and build better relationships.
Even though time may cause an affect on this important relationship, it is very clear that the clinician needs to from one. Martha Buckingham, a retired nurse, explains how she is not pleased with the way clinicians treat their patients.
She wrote, " I go into hospital to visit friends, I do get a little frustrated with the way in which some nurses by no means all address the patients in their care" Buckingham, pg.
Dealing with the patient's needs, beyond physical, can truly help then come out of the hospital with better outcome.
Christina Fisher, a student studying pre-optometry and a major in psychology, is the subject of my research at hand. Over a six-month period she was going to a chiropractor in the case that she had gotten into a car accident. Her experience wasn't very good, which caused her to discontinue her visits, even though she was still in pain. This individual was a good choice of subject because she proves that clinician- patients relationships has a lot to do with the outcome. I had talked to this young lady over the telephone, at 9: I asked her questions about her experience as an outpatient, with the doctors and the nurses, my questions were: What was your first encounter like with the doctor?
Did the same nurse receive you almost every visit? If yes how, if not how and was each visit different? Can you describe the relationship you formed with your doctor? Did he help you with your medical problem?
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If not how not, If yes how so? Do you think if you had a better relationship with the doctor the outcome would be different? I asked Miss Fisher to explain her first encounter with her chiropractor. She pointed out, " The doctor spent about twenty minutes with me during our first visit.
He had to ask me a lot of questions about the accident, for insurance reason. For example, when I got out of the car how did I position myself? He made me feel very comfortable and I truly felt the need to return" C.
Fisher, personal communication, September 25, To get the full feel of the atmosphere of the clinic, I asked about the service she received from the nurses. She observed, that only two nurses would greet her every time. She said, "One nurse will take the x-ray and the other will setup the massage table. They would usually ask me how I am doing, and that would be about it.
No, relationship came about, they didn't act extra nice or anything" C. I then asked her to explain her relationship with her and the doctor. She paused, "Hmmmm, to tell the truth I can't even remember his name. We really didn't have a relationship and there was no connection. If he saw me today I really don't think he would even remember me. He didn't spend that much time with me like he did the first time. He just kept the visits about my medical problem and that was about it" C.
I asked her whether or not he helped her with her medical problem. Fisher, personal communication, September 25, The last question I asked was, do you think if you had a relationship with the doctor the outcome would have been different?
Fisher believed that it would have. She emphasizes, " I know that the outcome would be different. He should have known that I wasn't getting any better. I know that it had a lot to do with money, and caused a waste of time for me. I don't think my health was in the better interest of the doctor" C. After the findings of my results, I conclude that outcome of the patient's health depend on the relationship formed by the clinician.
I noticed that this lack of good bedside manner is not just observed outside the medical field, but also within. My results show that the health care profession is not helping the patients to the best they can and it is unacceptable.
My interviewee made it very clear that she was not pleased with the service she received from her doctor.
Health Equity and Social Justice
The health care industry needs to focus more on proper bedside manners and how to manage time more appropriately.
At this moment it is hard to place confidence in the health care industry with the state at which it stand in providing compassionate health care. The concern that I have gained from my research is the health of the patients that have to deal with such poor bedside manners. Not a real medical center. Nurses must take time to talk to their patients "Nurses' bedside manner: British Journal of Nursing, 13 4 Case Study Kelly Chichester The appeal of bedside manner has been on the decline in recent years due to increasing demands on nurses, doctors, and other caregivers.
Though being a medical professional is a demanding career, there is simply no excuse for inadequate care and blatant disregard for patients. If good bedside manner is crucial in some cases it can even accelerate the recovery process of some patients and helps improve communication between doctors and patients, why is this all too important aspect of the medical world getting the cold shoulder all of a sudden?
The only way to know it is to figure out its foes. Opponents of Bedside Manner Understaffing Understaffing may be one of the biggest reasons why nurses practice poor bedside manner. Most likely, it is not necessarily that caregivers are unconcerned with the welfare of their patients but simply because there are so many people to care for that nurses cannot reach all of them at once and in equal amounts.
Schrof writes about Connie Cronin, a nurse who loves to work the overnight shift, was working one Christmas Eve all alone. Too busy to chat with a near death patient, she completely ignored the man why doing her rounds. When her shift was over the next morning, she left the hospital. In the middle of her drive home, overwhelmed with guilt, Cronin decided to go check on her forgotten patient when she went in for work the next night.
However, it was too late. The man had died alone and Cronin felt nothing less than awful. Cronin's story is not unique at all. In fact, it is quickly becoming the norm. In my family, several of my aunts are nurses, home attendants or doctors and frequently are placed on night shifts all alone.
What does this say about the medical profession? Are hospitals more concerned with saving money rather than saving lives? The main reason why hospitals, clinics, and medical offices exist is because the sick and downtrodden need healing.
When nurses are too busy to even say, "How are things going for you, sir? Demand for Increase in Education Nowadays, more and more medical professionals are returning to school to supplement previous knowledge and experience.
According to Gillian, "Some nurses and journalists have been insinuating that declining health care standards are due to nursing's pursuit of higher education p 22 " While this may appear noble, in reality it is a detriment to the medical field, which negatively affects its most important patrons, the patients.
Most of the time, the classes that nurses and doctors at this level are taking are almost completely devoid of bedside manner training. Medical professors and researchers deem more knowledge as the ammunition necessary to human disease. However, this is completely false. Yes, technicalities like expert knowledge of the heart is important for a cardiologist to know in order to care for his patients, however, if the doctor is not kindhearted in his dealings with his patients, he may be in danger of creating animosity between himself and his patients, which in turn makes an already difficult situation even more challenging.
Lack of Training Professors in medical schools and other healthcare training facilities are not offering a lot of classes that focus on bedside manners. This translates into a future workforce that is inadequately prepared for service in the medical industry. Galaites, a year-old Physical Therapy graduate student at Andrews University in Berrien Springs, MI cannot even recall having to take a course in bedside manner in her undergraduate program.
Galaites, personal communication, September 26, Bias Prejudice is everywhere. Unfortunately, it also rears its ugly head in the medical world.
Nurses especially who spend the most time with patientshave their own personal biases when it concerns certain patients. This is due not only because of socioeconomic status or ethnicity but simply because of the disease that the patient is infected with.
An article written by Vesey states that, "Whatever the attitude held by the nurse, it may interfere with the nurse-patient relationship p Considered as outcasts, drug users and gay men are treated with scorn, with the contraction of AIDS as their "punishment" for their "illicit and lewd" lifestyle. These beliefs are also carried by nurses and are manifested in the manner in which they care for these patients. However, this should not be the case.
The nurse must treat all patients individually," Vesey further adds p With more doctors relying on technological advances in medicine, in some cases, there is no need to even talk to the patient. This simply obliterates any opportunities for the doctor to develop a healthy relationship with his patient. Medicine needs to digress a bit and embrace the older practices that have worked for centuries-excellent, personalized care with a smile. So based on the information provided here, is there hope for the medical field?
Can bedside manner make a comeback and elevate the reputation of the medical industry from simply a moneymaking business to an actual service of society? I decided that it was important for me to know, but how was I to research this topic? I decided to conduct an interview with aforementioned year-old PT graduate student, M. Our conversation was very insightful and had proven to me that despite the destructive nature that the medical industry has taken, there are still people out there that really care and truly want to make a difference in humanity.
The Interview Prior to the interview, I found out that Galaties had experience volunteering at a facility for the elderly near her home in Toronto, Canada. Though she shared with me that she was required by her school to do the volunteer work, she remembers the experience as being very beneficial. Galaties' duties included spending time with the patients, entertaining them, as well as administering some drugs under close nurse supervision.
Whenever nurses were too busy doing their rounds, Galaties was there as an emotional crutch to the elderly that lived in the residency. Though the responsibility of caring for the elderly can be tasking, Galaties took everything with stride, saying, "I enjoyed it!
After her time was done at the home she had volunteered there in the summer of for over 3 monthsGalaties believes that the experience only deepened her desire to study medicine, particularly, physical therapy. Obviously, empathy and compassion are natural aspects of Galaties' character. When she does finally graduate and begins to practice medicine, Galaties plans to change the perception of medical professionals who too often are seen as money hungry drug dealers and not healers.
Clearly, Galaites is a first-rate example of how a medical professional should be-knowledgeable in their field yet compassionate and genuinely concerned about the welfare of their patients. Wrapping Things Up Though the establishment of bedside manner is fast loosing its significance, all is not lost.
Fortunately, according to Schrofthere are medical schools that are beginning to require all of their students to take yearly courses focusing on bedside manner. Medical examiners are also predicting that in the near future, students will be tested on their bedside manner if they ever wish to be licensed to practice medicine p In conclusion, bedside manner in the medical world is just as important as medical advances in technology or knowledge.
It is the backbone of the medical profession and the reason why people visit the doctor. The "human touch" is absolutely essential to the effectiveness of proper patient care and may just be the only thing that really makes the difference in the lives of so many.
Nursing Times 95 4 Why doctors shouldn't touch that door handle. Prejudice makes a very poor bedside manner. World of Irish Nursing, 7 9: Case Study Valencia Derice Good patient and health care provider relationships are very crucial for the patient's well being and the hospital's environment.
Patients need to not only feel like their needs will be met as far as treatment is concerned, but they also need to feel the love and support from their doctors and nurses. Giving the patient tender love and care can determine how well the patient will progress. Humans respond more efficiently to human contact. George Castledine asserts, "So much can be gained by picking up clues expressed through the patients' eyes, voice, mood and body" 3.
That is the reason doctors should make an effort to build patient morale. But it is important that the health provider not get too involved with the patient. Becoming too involved can interfere with work performance.
It's important to give just enough where it does not interfere with the work and the patient still benefits form it. If such a thing were to happen where the nurse would get emotional over patients illness or death, the hospital should provide counseling.
We know that good patient care is important. But there are some health facilities that do not provide good patient-care. Gooderige declares, "I received excellent medical treatment, so it was a pity this was marred by the quality of nursing care, which left me feeling aggrieved to the extent that I considered taking action".
Like I mentioned before, doctors should stop treating the illness and start treating the patient with the illness. Situations like this cause the patient to lash out and complain. And it looks very poor on the hospitals part. Sincere communication aids the trust development in the patient. Schrof claims, "A clinician's biggest mistake, researchers say, is intimidating patients into silence by tapping a pencil impatiently or keeping one hand on the exam room door handle.
No visit should end without a doctors asking, "Is there anything else you would like to tell me"? If the doctor appears uninterested, the patients may hold back and are too afraid to say too much.
They develop something the doctors call "good patient syndrome". My friend Diana went to the doctor this morning so I decided to do an interview on her. Her shoulder was hurting since the day before and the pain started to go away until that night when she participated in one of the events on campus. She was so eager to participate that she forgot all about her sore. Then the next morning she awoke with an excruciating pain and with a swollen shoulder.
I tried to massage it but that wasn't working so we took her to the hospital. Since it was a small town and it was early in the morning the hospitals' atmosphere was quiet and desolate. When we got inside we spoke to the receptionist who was fairly kind.
Then we were sent to another person who took her insurance and other information. She was very quick and straight to the point. She barely smiled or even looked at Diana. The tone in her voice gave the impression like she was bored and the job was just getting to redundant. Before going into the doctors office Diana said, "I hope the doctor isn't like her, or I'm out" D.
Pastor, Andrews University student. Later on in her bedroom I asked her about how the doctor treated her.