The ethical problems in nursing.
After three months of medical training, I am now working stationary in a hospital ( in the department for ENT) as an intern as part of my gap year before I start my medicine course in October. After three weeks of observing the work of the nurses I work with, I must admit that I was naively blinded all those years by the medical and health sector. I have always believed that those that work in the medical domain oblige themselves in order to care for and cure their patients. However, from what I have seen, this is not the case. In the following article, I want to expound some of the problems of nursing and what implications it can have on the patients and their healing process.
But first of all: what are actually the tasks of a nurse? According to job-descriptions, a nurse must have both medical, technical, social and organizational skills in order to fully master her job. Nurses are the connecting link between the doctor and the patients and it is their task to care for, supervise and observe patients on a physical, psychological and social level in order to identify and assess different problems and possibilities. Their tasks vary from distributing food to the giving of medicine, to small surgeries as well as a lot of paper and desk work (e.g. fever charts and health plans). It is stressed repeatedly that nurses should aim for individual care which also comprises communication with relatives of the patient.
And this is exactly what I haven’t seen in those last three weeks! The nurses that I work with do not treat the patients as individuals… and even worse sometimes even not as whole people. They do not see the scared grandpa in room 12… they only see the throat (cancerous) that they have to treat and care for. That is why they indeed do the medical care very well… but they completely miss out on the social aspect of their job.
I believe that it is vital in the medical sector (both for nurses and doctors) that we stop perceiving patients as diseased objects that have to be processed, but rather as individual people. Because only by seeing patients as individual people with a history, dreams, hopes, aspirations, problems etc. we will be able to actually cure people and make them healthy… because real health is only achieved when body and soul are in harmony.
Another problem that I have observed is stereotyping. In the medical sector it is an asset when we can assess the state of distress and condition of a patient when he/she arrives (we can for example use factors like sweating, nervousness, difficulty to speak, breathing, dressing etc. to assess a patient's general well-being and habits, the condition that he might suffer from, and if it is an urgency). However this skill (it is really a skill that has to be learned!) often quickly carries over into a judgement of character and personality as well as stereotyping of age, weight, race, socioeconomic status and gender. This prejudice can have a huge effect on the diagnosis as it affects the way we interpret data (shocking I know!) and the way the patient is treated and cared for (even more shocking!). A US Health and Retirement study published in the American Journal of Preventive Medicine in 2015 has shown that from 1500 queried patients 17% felt vulnerable to prejudice. The effect that this feeling has is remarkable: patients that feel judged are more likely to not follow medical instructions as they increasingly mistrust the doctors and nurses. They therefore also tend to have worse general health.
I appeal to all of those that are or want to work in the medical and health sector to eventually stop placing patients into boxes of diseases, symptoms and social groups because it is simply counterproductive. We should also separate ourselves from the unreasonable belief that there is only the one right remedy for every symptom. We should rather aim to see our patients as whole individuals that need individual care, counselling and devotion.
Sources:
http://www.pflegeberufe-gesetz.de/krankenpfleger/berufsbild.html
http://www.doccheck.com/de/document/2646-aufgaben-der-krankenpflege
https://www.nursingtimes.net/nurses-see-patients-as-diseased-objects/5035392.article
https://www.sciencedaily.com/releases/2015/10/151020091344.htm
http://www.nytimes.com/2011/06/21/health/views/21cases.html
http://www.kevinmd.com/blog/2014/04/patients-stereotypes.html