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Chapter 7 Professionalism in health care
By Jahangir Moini, M.D., M.P.H. and Morvarid Moini, D.M.D., M.P.H.
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Overview Professionalism is of the utmost importance
This means caring competence Helps ensure patient confidence about treatment Everyone represents their health care team Primary goals: Consistent quality of care Customer satisfaction
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Professionalism Developed with skill, training, judgment, and behavior to perform a job well Communicates understandable: Knowledge Diagnoses Treatment options Includes: Confidentiality Continuity Compassion Honesty Trust
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Professionalism Hard skills Soft skills (people skills)
Technical and operational abilities in your field Coding, scheduling, interviewing, taking vital signs Soft skills (people skills) What you do that enhances performance Integrity, dependability, patience, good attitude
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Figure 7-1: A medical assistant taking a patient’s blood pressure
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Professionalism Altruism: concern for patient and provider welfare
Understanding beliefs, cultures, and perspectives Remain objective rather than emotional with patients who are Upset Rude Angry Fearful In pain
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Professional behavior
Good attitude, caring competence When patients are dissatisfied: Poor outcomes are more likely to occur Good health care increases patient loyalty Excellent job attendance Being on time
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Communication Careful observing, listening, writing, and speaking
Always required, and involves: Politeness Respect Tact Good communication affects all health professions
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Respect for patients Patient autonomy:
Capacity to make decisions based on their own reasons and motives Also called self-determination Information allows making informed choices Patient care must be based on individual needs
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Respect for patients Confidentiality is crucial
Care must be sensitive to the patient’s culture Health care professionals must be patient advocates
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Comprehension How we learn, process, and remember information
“Teach-back” methods Used to ensure patients comprehend communications Always observe and listen closely Ask questions regularly Continually educate yourself about your job
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Professional distance
Must be kept between health care workers and patients Demonstrates professionalism Patients are not personal friends They are people you professionally serve Not all patients can be pleased
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Steps used in maintaining professional distance
Explanation Addressing the adult patient Use only the last name unless given permission to use a first name Addressing the pediatric patient It is okay to use the child’s first name Friendliness Always be friendly, but avoid excessive friendliness Humor Use only if tasteful and appropriate Meeting outside the health care office Do not meet patients outside the office unless you were previously acquainted before seeing them professionally Money Avoid giving or accepting money from the patient
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Acceptance of constructive input
Take responsibility for actions at work Accept constructive input properly, to improve Attempts to counsel or advise, not insult Never be defensive about it Do not blame others
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Growth Health care professionals must continually:
Learn Improve Be educated about latest advancements Join related professional organizations Continuing education units (CEUs): Increase knowledge and practice
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Judgment Critical thinking Good judgment is an essential skill
Decisions made based on analysis and evaluation Good judgment is an essential skill Be organized Manage your time Prioritize
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Steps used in health care problem solving
Situational example Identifying the problem Identify what is wrong with the patient. Identifying its effects What effects are symptoms having on patient’s health? Identifying the desired outcome and objectives What is the goal of treating these symptoms? Identifying possible solutions Which treatments are likely effective? Analyzing the possible solutions What are possible results of treatment options? Implementing the best solutions How is treatment option best implemented? Evaluating the outcome Was the treatment totally, partially, or not effective? If not, what is the next option?
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Persistence Work hard People rely on you to be persistent
Stay determined Overcome many obstacles Focus on completing work correctly People rely on you to be persistent Be proud, and try to achieve excellence Ask others for help when it is needed
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Teamwork Cooperation and assistance between workers
Increases patient and job satisfaction Also increases likelihood of achieving goals Health care professionals must assist each other Avoid gossip, impatience, and rudeness
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Figure 7-2: Two health care professionals working as a team
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Cultural diversity Respect for cultures is important
Regardless of ethnicity Learn about differences and similarities Avoid any bias or stereotypes Act as a patient advocate On behalf of a patient or the patient’s family
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Self-confidence Self-confident professionals put others at ease
Shows self-belief Others will integrate better Avoid overconfidence or excessive self-confidence Acceptable self-confidence includes: Being calm at all times Making eye contact Smiling
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Empathy Identifying with another’s feelings
Even though you may have never had the same situation in your life Demonstrates: Sensitivity Value of patient’s needs Support
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Empathy Recognize fear, anger, disappointment, grief
Imagine patient’s feelings Explain perception of the feelings Tell patient that feelings are legitimate Respect how patient deals with the feelings Offer support and partnership
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Flexibility Assist others in getting the job done correctly
You may need to do something you are unfamiliar with Ask for instructions and stay positive Flexibility improves success of your team
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Self-motivation Your own focused motivation, to achieve your employer’s goals Ask what else can be done Where you can assist What materials you can study Caring about the organization makes you a valuable team member
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Integrity and honesty Integrity Honesty
Following codes of laws and ethics Demonstrating honesty and trustworthiness No theft or cheating Honesty Tell the truth Document your work time Report others who are being dishonest Admit mistakes and correct them
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Enthusiasm Be passionate about your job Show initiative
Enthusiasm usually means better patient care Show initiative Performing tasks without having to be asked Anticipate what needs to be done Complete it correctly
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Accountability Accountability for your own actions:
Part of accepting constructive input Being self-critical in order to improve Improves skills and effective working Involves policies and processes that: Justify actions and take responsibility
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Appearance Communicates seriousness about work
Ensures confidence and respect Conservative clothing and grooming is essential Discouraged: Tattoos, piercings, dangling earrings Poor hygiene Excessive perfume Open-toed shoes Excessively long hair
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Figure 7-3: A professional appearance projects competence and increases the patient’s confidence
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Stress management Manage stressors so that your work is unaffected
Stress is a normal part of life and work Illness and disease may occur from unmanaged stress Good stress (eustress) leads to positive reactions Bad stress (distress) leads to negative reactions
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Causes of stress Excessive demands Inability to say “no” to others
Disorderly or chaotic lifestyle Unrealistic expectations Being inflexible Self-doubt Taking constructive input or problems personally
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Causes of stress Emergencies Physical signs of stress:
May be a regular part of work Life-and-death situations are extreme causes Physical signs of stress: Agitation Anxiety Depression Negative attitude
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Causes of stress Death of a spouse or family member
Divorce or separation Marriage or reconciliation Hospitalizations Loss of job, retirement, job change Significant personal success (job promotion) Problems at work
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Causes of stress Sexual problems Having a baby
Children leaving or returning home Significant financial changes Substantial debit Moving or remodeling your home
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Coping with stress Show that you care but remain objective
Learn to recognize your stress triggers “Unlearn” lifelong behaviors Unhandled stress = overload or burnout More stress eventually caused by: Drinking Drugs Overeating
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Coping with stress Simplify your life and work Use time management
Avoid procrastination Say “no” Set priorities Make lists of necessary and less necessary items Identify and reduce stressors Devise ways to simplify or eliminate them
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Coping with stress Divert focus away from stressors
Look at stressful situations as opportunities Ask for social support Take time to relax and renew every day Pursue enjoyable activities Take a break from stress
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Personal health Personal health must be good to provide quality care to others Get adequate nutrition, exercise, and sleep Diet must contain healthy foods to aid in: Stress reduction Proper weight Better health
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Personal health Aerobic activities strengthen your heart:
Running Cycling Swimming Non-aerobic exercises – not as much oxygen: Weight lifting Climbing stairs
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Group exercise Exercising with a friend or group is very motivational
Work out at least 3x per week 20 to 30 minutes each time
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Figure 7-4: Group exercise
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Personal health Adults usually need 8 hours of sleep per night
Factors that interfere with sleep: Caffeinated beverages in afternoon or evening Smoking – nicotine withdrawal occurs at night Drinking alcohol with dinner Foods that cause heartburn Too much food consumed at dinner
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Personal health Physiologic needs first, then psychological needs
According to Abraham Maslow: Physical safety Emotional security Esteem and recognition The ultimate need is achieving self-actualization Fulfillment of your own potential
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Personal hygiene Must be excellent
Patients’ first impressions are important Be clean, well-groomed, properly dressed Clothes clean, intact, well-pressed Shoes clean, appropriate, well-polished Jewelry must be plain and simple
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