The professional behavior

MAM Ibnouf, FRCSEd

Rationale: With development communities tend to

have:1- changes in the Free Market policies, 2- socioeconomic, 3- ethnical, 4- gender and 5- religion diversities. 6- increased interference of the public

press, 7- more awareness of cost effective and

safe services

These have led to great stress and demand for developing new trends toward medical care.

What do you need to know before you join

the hospital staff?

OUTLINES

1- The importance of respect2- How we put this respect into

actions:3- Special emphasis on a- Collaboration b- Honesty c-Evidence for group-work

1- Respect of others

1- You need to know the hospital procedures

2- You need to know what your rights are?3- You need to know what should you

expect?4- You need step by step help. 5-You need a member of hospital staff to

answer your questions and 7- you need to appropriately to answer

your patients’ questions. So, You need to respect all hospital

staff.

2- Patient rights

1- Right to be treated2- “ ”” “” “” in privacy3- “ ”” “” “” to consider their

dignity 4- “ ”” “” “” to consider their

respect5- To be protected against abuse 7- “” “” “” “” harm8- To accept and/or refuse their treatment9- Not to disclose their secrets

10- Rights of the procedures: e.g. The right drug in the right dose in the right site at the right time

Observing these rights will minimize litigations

3- Respect of doctors image

5- You need a guide.6- You need to know about safety: a- your personal safety b- your patient safety, c- the safety of the environment

So,1- So, You need to respect all hospital

staff.2- Wash your hand to protect yourself,

your patient and the environment to be well

respected

4- Health advocacy

7- As a junior, you need to have an advocate for you

and you yourself through your deeds should be an advocate for your patient as well. 8- You need to have some beside you for

support and explaining things. The hospital is a busy place.

So, you need to 3- work in a group. The medical practice is not a single person

show.

5- Professional behaviorself-regulation & lifelong learning1- Dress tidily, talk kindly (avoid nagging

and harsh statements) to be your own advocate to be well respected

2- Be honest, polite and show kindness to others

particularly your patients

3- Show empathy for your patients

3- Dedicate yourself to your a- patients b- professional future

6- Professional behavior

Show due respect to your colleagues, senior doctors, nurses and other workers in the health profession you are going to work in.

Professional behavior Improve your personal image

Unprofessional attitudes:

• 1-Arrogant• 2-greed• 3-misperception• 4-lack of conscience• 5- Impairment• 6- Conflict of interest

7- Professional behavior: teamwork • Be an active and effective

member of your group• The team work reduces

morbidity and mortality• The team members work in an

integrated maner

The effective team

1- Clear purpose2- Good communication3- Mechanisms for resolving conflicts4- Has the patient at the centre of its

focus 5- Has trust on each other faithful

engagement 6- the team coordinate and collaborate

to improve patient care enhance patient safety and reduce staff burnout

The effective team

The professional collaboration of the integrated work of the teams in the hospital and the primary care system, the consultants, junior doctors, sisters. Physiotherapists, etc leads to:

1- Patient satisfaction when morbidities are

reduced2- Public satisfaction3- Members satisfaction 4- improves the inter-professional collaboration5- Better retention of the jobs 6- Justified use of financial resources 7- Fulfillment of the social contract

The evidence

So far there is no enough evidence to support that once you have done something to improve the team work the out come improves because of:

1- The complexity of the inter-professional communication and collaboration2- One of the big challenges is between the

professionals who like to work in integrated inter-disciplinary groups and the policy makers who would like to reduce costs of management and money spent in training

Patient safety

• An emergency case may have a wrong procedure or wrong drug.

• For this patient patients are encouraged to become part of the health care team

Tips to the patients SPEAK UP

1- Speak up with questions and concerns2- Pay attention to the care you are

receiving 3- Educate yourself 4- Ask a friend or a family member to be

your advocate5- Know what medications you take and why6- Use a medical facility committed to safety and quality7- Participate in any and all decisions about

your treatment

The SPEAK UP campaign

Every one has a role in improving the patient condition and safety but the patient involvement in in the health care team according to the centres of Medicare and Medicaid

Apologizing effectively

• If something went wrong:

• The patient and his guardian may feel worried

• What do patients and his guardian want? Patients want to know what is going on

What is the right thing to do?

The right thing is to:1- be honest and tell him and/or

his guardian what happened 2- Explain why it happened3- Apologize for that 4- Tell them what is the next step

to be done

Avoid

1- blaming the others (doctors or nurses)

2- Tell the truth and 3- Tell him you will find out why it

happened and you will feed him back 4- tell him what is the next step

to be done

What is the consequence of apologizing

1- most likely the patient will respect your honesty and will withstand for the next step of management

2- even if he complain the compensation will be much less than when you dismiss your responsibility

3- this is because it is known that medical errors are un-intentional and also it is believed that people who go to medical schools are:

a- intelligent, b- hard working , and c- the community needs their service d- they are just helpers in healing

Honesty Honesty of professions:Annual Gall Pull updates Americans views:Nurses 83%Grade school teachers 74% Pharmacists 71%Military officers 65%Medical doctors 64%Layers 15%Congressmen 9%Car salesmen 5%Lobbyist 5%

USA Today /Gall Poll Nov-Dec 2007

In conclusion

Professionalism: Aspiration towards altruism,

accountability, excellence, duty, service, honour, Integrity (honesty), compassion, self-effacement (self-judgment) and self-sacrifice.

Bioethics

The 4 principles of bioethics: Nonmaeficence

Autonomy: individuals make

their own decisions

Nonmaleficence: Avoid causing

harmJustice:

Benefits and risks should be

fairly distributed

Beneficence: take actions to help others

Do and don’t do

1- Be professionally compassionate and keep a distance for the patient to understand that you are this kind doctor

Avoid to become a friend, he may give you something to influence your decision

2- Do pleasant with parents first then with kids.

Avoid giving children incentives. This may act as the wrong massage.

Do and don’t do

Usually medical staff sustain a lot of stress, and may easily triggered to become angry.

Develop a habit to speak politely Never act in a rude, offence

unprofessional manner

Management of disruptive behaviour

Such incidence may not be passes as isolated incidence

Should be managed as follows: 1- Systematically 2- Collegially 3- Effectively the result you will be saving

a good doctor for a bright future

Management

• Provide periodic feed back• Measure performance against

expectations • Set measures for communication

and performance and expectations

• Appoint excellent physicians