In normal circumstances, I would approach this topic with breaking down the terms, and drawing the relationship of these terms. And over white paper this would be good use for black ink, however this is a reflective post. So I won’t begin with an introduction, body and conclusion appeasing a single person marking but sharing a view of my observations and self-critique, I will be sharing a process that happens in my mind.
Welcome to my world.
What are the norms and values of the profession? Where do they come from? Why do you have them? I don’t want to throw a whole lot of articles and descriptions on you so this is a summarized standard that the American Medical Association has put together. The following principles for professionalism were highlighted (Epstein & Hundert, 2002):
Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes a self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development.
Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practises.
Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities.
These principles should be ones we use in our everyday lives. The profession is the industry we go into. We represent that profession when we are in our communities and when we communicate with people. To have respect for ourselves and our capabilities allows us to respect our profession because of the confidence we have in making a difference in it. To have compassion in our understanding and reasoning, opens the opportunity to have heart in growing the profession for the people, according to needs. By having the self-integrity sets the foundation for one to have integrity when working with any patient, colleague and superior. Don’t see professional behaviour as something far or set apart from yourself. If you are a representation of your profession, you are a reflection of it wherever you go, it’s a relationship, a balance.
Professionalism is using the above mentioned principles and incorporating that into our practice and treatment of people. WHO highlights that these principles are to be used ethically, despite age, gender, race, nationality, politics, and religion or health status. Ethics representing an innate knowledge of right/wrong distinction and practicing that responsibly.
How does one become a professional? Surely it cannot only be because of a certificate? A certificate cannot change ones ideals, perception, bias, and behaviour, so why do we demand others to treat us differently because of that certificate.
Physiotherapy is capable of change, and of changing another’s life. We have such a beautiful profession that is so in tune with the human body, and when one has respect for that and for its worth one is able to display that through one’s work. Passion.
Don’t get me wrong, we are using that certificate to treat the patient. It has given us the opportunity to “decide” certain aspects of a patient’s life and progress when that patient is with us, our assessment, diagnosis and treatment. This is because the patient walks in trusting us fully with their body, even while in pain. The patient has done their part by asking for help, therefore we have a responsibility to ensure the holistic, professional and ethical treatment of the patient, specifically to them. Equity.
Here are a few questions:
-What is professionalism?
-How do you think a professional behaves?
-Do you respect people, the life of the person that you have an impact on?
-Do you play that role of a professional daily in your life or just when you go to work?
-Do you respect your profession?
-Do you believe in the benefits and advances of your profession?
-Do you challenge your profession or conform?
-Do you treat all back pain patients, for example, the same?
-Are you repeating intervention because of habit?
This is my case:
There is a patient, Unknown, no one knows who he is and how he got into the hospital. The patient suffered a traumatic brain injury at some point and now is unable to speak. He must have been living on the streets because of the condition of his body. He could not move, or do much by himself. Finding information about the patient’s history was a huge struggle, especially information pertaining to taking care of him and understanding previous function or medical or social components. Treatment however commenced as to benefit the patient.
We had good sessions, during treatment I would speak to him, try and explain small details such as: why we are doing the treatment, what the weather was, news events or anything interesting.
The patient was named Unknown, so during one of our sessions, we came to an agreement of a temporary name for him, Gift. One day after treatment had been completed and I was getting ready to leave, Gift propelled himself forward, and screeched to get my attention. Concerned, I rushed back to see what could have been wrong. To my shock Gift said his first words since being admitted. He looked me right in the eyes and said “Thank you”.
Treatment continued as per usual and still we were trying to get information about him. It was not until one of the nursing staff recognised him and reported his identity to the staff that we could finally get his history. The patients past was not an easy pill to swallow, not at all. This is where I found myself in a predicament, an ethical dilemma.
The following day I went back to the ward finally, knowing Gift’s history which tested my values, my spirit, my heart and soul, and my professionalism. Many different scenarios played in my mind of how best to handle the situation, but this was a test I wanted to go through. As it was this test that would allow me to observe and reflect on my raw feelings and methods of handling situations. After much contemplation I decided to allow myself to be as I always am with Gift and my other patients. I tried not to put up walls nor have pre-set ideas or judgements. I just wanted to understand myself more.
It was after my treatment session with Gift that I realised that I had succeeded in dealing with that situation as best as I, Genevieve Gani, felt I could. I realised that despite knowing the information I did, I really had no bias at all when I was at work. I treated the patient genuinely and in the same light because at the end of the day he is a person, in a hospital, in need of physical therapy.
This has made me realise that we will constantly be placed in situations where our morals and professionalism is tested, and it will be in those where the grey area is the fine line. We are, well we will be qualified physiotherapists soon and we represent our profession wherever we may go, we also need to realise that a person, in need of our help, is someone we need to set our bias aside for. This is not an easy thing to do. This is why it is necessary to understand your raw method of handling dilemmas so that you can work on you.
I can say upon reflection that I am proud of my profession, I have respect for it and I have found a passion in it, because of my passion for people; I seek to find advances in physiotherapy because of my love to change and help people; I am not the best physiotherapist but I am the best version of myself in my profession and I strive to be my best self in my profession going forth each day and for every person that is in contact with me, I represent my profession.
Professionalism and ethical morality does start with understanding the definition and role, the values that construct it and executing that at work, but that is just the tip of the iceberg. The profession is based and respected by the representation you are for it, daily. It is therefore within you as a person, your values and respect for what you do, it is your worth reflected into your practice when no one is looking over your shoulder. Integrity.
Bowerbank, P. (2004). The South African Journal for Physiotherapy – 80 Years On. SA Journal of Physiotherapy, 60(4).
Edwards, I., Braunack-Mayer, A., & Jones, M. (2005). Ethical reasoning as a clinical-reasoning strategy in physiotherapy. Physiotherapy, 91(4), 229-236.
Epstein, R., & Hundert, E. (2002). Defining and assessing professional competence. Journal of American Medical Association, 287(2), 226-235.
Kirk, L. (2007). Professionalism in medicine: definitions and considerations for teaching. Baylor University Medical Center Proceedings, 20(1), 13-16.
Wiggleton, C., Pertusa, E., Loomis, K., Tarpley, J., Tarpley, M., O’Gorman, M., & Miller, B. (2010). Medical students’ experiences of moral distress: development of a web-based survey. Academic medicine, 85, 111-117.