My professional and ethical development in 2016
Challenges, struggles and growth in 2016
QAANITAH ISAACS 3220272
The year 2016 my 4th and final year of being a Physiotherapy student, this was the year with many ups and downs as well as achievements. I attended five different institutes for my clinical rotations, all being of different types (Neuro, NMS, ICU, General and Paeds). Within these five different rotations I was faced with many challenges and difficulties. This was the year where I was expected to show the best of my abilities as well as prove that I am worthy of becoming a Physiotherapist.
During this year I questioned myself, my knowledge and abilities quite often. Many challenges arose during my five clinical rotations, ranging from professionalism to my own personal feelings. The main challenges I encountered was dealing with a patients’ death, child abuse (neglect), having to treat criminals as well as finding it challenging to treat patients who are verbally responsive compared to those who are not.
During one of my clinical rotations I was assigned to treat a patient whom had a THR, he was doing okay, I treated him and a few minutes after I left his bed side he passed away. This was a challenging experience for me as I did not know what to do or how to feel. I blamed myself, felt traumatised and a feeling of guilt took over my body I also remember walking out of the ward with my eyes filled with tears unable to see where I was heading off to.
Feeling sad or upset by death of a patient has consistently been reported among the multidisciplinary health care team, nursing students reported that they would often cry in private rooms as they did not know how to express their emotions (Powell & Toms, 2014), this is what I did to express my emotions. A guilty conscious wrapped all around my body as I felt that this was my patient and I treated him, I killed this guy. It has been reported that feeling of guilt was experienced by health care workers as well as students having fears that they did not do enough for this patient or did not know enough (Powell & Toms, 2014). After my patient passed away I felt the exact same way, fearing that I did not do enough and I could have done better.
This situation was one of my challenges where it was clearly noted that here I struggled to be professional. I felt really unprofessional leaving the ward and going to cry in the Physiotherapy department, feeling unsure of what to do. According to Powell and Toms, 2014 students are left confused about their emotions and unsure on what to do. I addressed this issue by sitting down with my clinician and speaking about the incident which occurred and this was when I was reassured that this was not my fault. Literature states that clinical educators whom recognise a student’s response to death and enable a discussion with the student will thereby facilitate an ability for the student to cope (Powell & Toms, 2014). What I have learnt is that no matter how bad or guilty one feels, I should always act in a professional manner no matter what situation I am thrown into. As of this situation I now know how to act and respond if I am ever thrown into this situation or a similar situation again.
Treating criminals was one of my challenges I did not expect to encounter. I thought I was able to deal with any patient given to me but I was wrong. Treating patients who are “rude” and verbally abusive was something I thought I could handle but again clearly I was wrong.
Our morals and ethics are constantly being tested on our clinical rotations, well in my opinion it is. According to Lloyd 2000 Morality is understanding the distinction between right and wrong whereas Ethics is the philosophy of how that morality guides individual behaviour.
On many occasions I was faced with “rude” patients, they would shout, swear and say a lot of unprofessional and rude comments to me. I would think to myself why do I have to treat someone who has no respect for me? Someone who speaks rudely to me? As I treated the patient I thought to myself why am I doing this? Why am I treating him? But I continued to treat him but not to my best ability as he was so rude and just made me feel as if I was in a foul mood. While treating him I kept questioning myself as to why I was treating him. If I had a decision in life I would not even look at an individual who was rude to me.
Personally I felt that this patient was wrong and he does not deserve treatment and I did not want to treat him. A few days down the line I realised that I was too in the wrong and my morals and ethics were now being tested. Morally I was wrong as this patient still needed the best treatment possible as he was unwell even though he was rude, ethically I was wrong as everyone should be equally treated despite their actions. With this patient I had to ignore his misbehaviour and treat him to the best of my ability. I morally thought it was wrong to treat this patient, but then realised that this was the correct thing to do. This patient tested my morals and ethics but at the end of the day I came out stronger. As far as ethics was concerned, I had to treat this patient as I would treat all my other patients, I should put my personal dilemmas aside and treat to the best of my ability. Patients should not be discriminated against due to how rude or disrespectful they are (WHO, 2015).
Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values and reflection in daily practice for the benefit of the individual and community being served (Kirk, 2007). At my clinical rotations professionalism was tested in many ways, such as how we dress, how we address colleagues and patients, how we act in professional manners. According to Grace & Trede 2013 many students described professionalism as personal characteristics and behaviour, communication and punctuality. In my opinion being professional has many types and forms such as dressing appropriate, acting appropriate, knowing how to handle certain situations, speaking in correct tones, being punctual and striving to do the best we can.
As mentioned above in previous scenarios I had to be professional when it came to my patients death as well as when I had that “rude” patient. I have noted unprofessional manners when working with other health workers. They would speak about their personal lives or play with their phones while busy with a patient. According to Grace & Trede unprofessional behaviour is when students speak about their personal lives in the middle of the ward or use their mobile phones whilst on duty.
Throughout this year I can honestly say there were many times where I lacked being professional. I would always be dressed neatly and appropriately but I was often late. I bettered myself by going to sleep early at night and waking up early in the morning knowing I would be not just on time but before the time for work.
There were also many times like crying after a patient’s death, speaking badly about patients, laughing in the wards and not addressing patients correctly. I noted that those were unprofessional behaviour and needed to be addressed. I then sat down and made a list of everything I thought was unprofessional and ways to address those. I can now say I feel that I am better at being professional.
Through this year I have met many obstacles but with effort and practice I have overcome these struggles and came out better. I addressed all my challenges by going home and reflecting speaking to my fellow class mates and researching how I can better myself. I have changed a lot and it was noted when I got feedback from clinicians. Now I think first before I act. I think the situation through, run it by a clinician then do my thing. I feel personally that this year I have bettered myself in many ways. I always try my utmost best in whatever I di and take pride in what I do.
I can conclude by saying I have learnt a lot this year, due to every challenge thrown at me, I was able to overcome. Hard work and pride really works out in the end. All these obstacles I have faced will now make me better as I strive to be the best.
Grace, S. , Trede, F. (2013). Developing professionalism in physiotherapy and dietetics students in professional entry courses. Studies in higher education, 38 (6), 793 – 806
Kirk, L.M.(2007).Professionalism in medicine: definition and considerations for teaching proceedings. (Baylor University medical center). Baylor health care system, 20 (1), 13 – 16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 1769526/
Lloyd, D.F,.(2000). Distinguishing between morality and ethics. Vision. Retrieved from http://www.vision.org/visionmedia/ethics-and-morality/distuinguishing-between-morality-and-ethics/731.aspx
Powell, S. , & Toms, J. (2014). Passing Away: An Exploratory Study into Physiotherapy Students’ Experiences of Patient Death whilst on Clinical Placement. International Journal of Practice – based Learning in Health and Social Care, 2 (1), 108 – 121. Doi: 10.11120/pblh.2014.000.26
WHO/Health and human rights (n.d). Retrieved from http//::www.who.int/mediacentre/factsheets/f5323/en/