Over the last two years, reflecting on my own ethical and professional practice has not come across as something I needed to do. I always believed that my own moral and ethical values would suffice. Now, at the end of my final year in Physiotherapy and having taken this particular course, I believe that having critically reflected on my professionalism as well as my ethical values has been beneficial.
According to Delany & Watkin (2008), experiential learning (that is the type of learning where students gain learning opportunities by watching what experts or clinicians do) may not be enough to meet the need where health care professionals need to be understanding and aware of different perspectives and to be flexible around these perspectives. They go on to say that critical reflection is fast becoming an important framework to help understand the intricate nature of the health system (Delany & Watkin, 2008). I now understand what this means. Being able to reflect critically on my ethics and professionalism has helped me to see the flaws in how I was working with patients and within my environment over the last two years. In doing so, it has almost matured my level of thinking towards my profession and towards the health care system.
In my first blog post, I talked about how I did not give certain patients the care they deserved because I found it challenging to treat patients in palliative care and often a terminal unresponsive state because I thought the treatment was boring and was not going to be effective anyway because of the patients’ terminal state. When sitting back to think about those actions and that line of thought it was an eye-opener to the realisation that I was wrong. I was wrong to believe that critical reflection of professionalism and ethics would do no good. Being able to reflect on such behaviour has helped me to realise why I am in this profession as well as help me to start thinking more seriously about moral values and professionalism. Delany & Watkin (2008), state that one of the benefits of critical reflection is increasing the reflexivity of one’s professional practice. I believe that is exactly what this year has done for me in terms of my ethics and professionalism. It also allowed me to sit back and think of how I was going to do to address my challenges. Personally I found that prayer, and taking my faith into consideration helped a great deal to give me the courage I needed to face my challenges. It did not take me long for my mind set to change and realise that no matter what state the patient is in, the best care possible is the only care I should be giving that patient because I thought: what if that were me in the bed? How would I feel if I was not being taken care of properly regardless of my state of health? It was not long before I looked forward to treatment sessions that consisted only of passive movements. I spoke to the unresponsive patients as if they were having a conversation with me and I believe that because of this I will never have the same mind set as before the critical reflections. I am a better physio because of it.
I have thought about how my ethical and professional self has improved or even matured over the last two years and I have come to realise that being an inexperienced student has a lot to do with how I handled (or avoided) ethical dilemmas. Diving deeper into the subject, in third year and in the beginning of my clinical experience my ethical principles were run purely on the basis of what was right and wrong. Now as a final year student I can ask myself “what is considered right and wrong?” and “how can different perspectives, scenarios and other personal views change the context of right and wrong in a clinical setting?”.
Being a student in third year in 2015, I did not feel like I had the competence to deal with such situations because I was simply a student and what did I know? Who would listen to me? I have found this to be true in many clinical setting where patients almost try to manipulate you because you are a student. Now, however, as a final year student with more experience, some insight into the health system and slightly more competent, I have found that I am able to assert myself and deal with issues that arrive with much more confidence. The clinical experience helped me to gain confidence in myself and the clinical reflection of ethical dilemmas has allowed me to cement my idea of what kind of professional I want to be.
When working in the clinical setting, I found that the most challenging thing for me over the last two years was finding a way to professionally and respectively approach a clinician who I believed was not treating her patients with patience and respect. As a student, dealing with patients is one thing but a clinician is another matter completely. This person was responsible for my passing or failing. Once again being a student may not have done the situation any good so I left the matter. Now on the other hand, I feel like I have the confidence and the correct manner to deal with a situation like that. I have spoken to fellow colleagues, received advice and feedback, and researched conflict management and together with my own morals I believe that should I need to address a fellow colleague on professionalism again I am well prepared. Of course I will no longer be a student so that challenge is effectively almost gone but these challenges experienced whilst being a student I believe have helped me create a foundation for ethical dilemma management in the future.
Whilst researching this topic, I found Fornari’s (2004) “model for professionalism that identiﬁes honesty and integrity, responsibility and accountability, self-improvement, self-awareness and knowledge limits, collaboration, respect for others, compassion and empathy as professional behaviours” (Grace & Trede, 2013, p. 793). These are values that I want to have and improve on to optimise my clinical ethics and professionalism. There is one more value I think all health professionals should have and that is patience (Kumar & Jim, 2010). I believe that all health care professionals should adopt this model for professionalism or at least have some of the tributes mentioned. Together with Fornari’s model for professionalism, the American Physiotherapy Association (n.d.) states there are seven core values for physiotherapy being accountability, altruism, compassion/caring, excellence, integrity, professional duty and social responsibility. Some of these overlap Fornari’s model and that just shows the importance of these core values. Every physiotherapist should strive to uphold these values whether you have been studying for three years or practicing for thirty years. I have every intention of upholding these values now I am experienced enough to understand what they mean in the context of physiotherapy.
The last two years have been thick in learning opportunities not only practically but also professionally and ethically. Being able to critically reflect on my own ethical and professional principles has helped me to grow as an emerging physiotherapist clinician and general all-rounded person. Being able to see and feel the difference in my development has giving me confidence in my abilities for the future as a health care professional and while the specific experiences may not always stay with me, the lessons I have learned over the last two years in the clinical setting will not be forgotten. I will continue to improve where I can to make sure that I am the best physiotherapist I can be for my future patients and community.
American Physiotherapy Association. (n.d.). PROFESSIONALISM IN PHYSICAL THERAPY: CORE VALUES. Retrieved from http://www.marquette.edu/physical-therapy/documents/APTACoreValues.pdf
Delany, C., & Watkin, D. (2008). A study of critical reﬂection in health professional education: ‘learning where others are coming from’. doi:10.1007/s10459-008-9128-0
Grace, S., & Trede, F. (2013). Developing professionalism in physiotherapy and dietetics students in professional entry courses. Society for Research in Higher Education, 38(6), 793-806. Retrieved from http://dx.doi.org/10.1080/03075079.2011.603410
Kumar, S. P., & Jim, A. (2010). Physical Therapy in Palliative Care: From Symptom Control to Quality of Life: A Critical Review. Indian Journal of Palliative Care, 16(3), 138-146. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3012236/