The importance of ‘ways of knowing’ approach in healthcare

As a health care professional, certain values were instilled in me that have been beneficial to me throughout my profession. That is caring for the aged, in particular, giving palliative care to the aged. The value that has driven me to this level is because society tends to forget that the aged are part of the society and regardless of the fact that their lifespan or impact is relatively low as compared to other age groups.

Taking less care to them is a form of injustice, and no health care professional is supposed to engage in such an undertaking. In addition to that, I embrace and become pleased dressing in my medical attire attending to the aged in a fair or rather just, non-discriminately and ethical manner. This for a long time has formed part of my policy when attending to patients and the aged in not only hospitals or health centers but also in residential aged cares

The reason that justice or fairness and work ethics are so useful in my practice is that with the increase in the activities and more people coming for residential aged care. It is common to notice the mistreatment that the aged undergo as far as the provision of health care is concerned. Therefore, one is tempted to stand by their side and speak out on how the residential aged care facilities do not care so well to the aged as it ought to be.

In addition to that, hospitals have become congested with the increases in population making it not likely for the aged to be as energetic as the younger generation. In addition to that, there are challenges that come with dealing with the aged, which has also inculcated in me certain values that are essential in the practice of health care (Rolfe, 2014). This involves honoring the will of the aged. In most cases, the aged people are more realistic in regards to death; therefore, some of them can resist medication or prefer to be treated at home as per their wishes. Therefore, it becomes of great importance that I apply ethics in the practice of my professionalism.

The values that defines my practice and the caring of the aged, involves ethical principles which define whether a person is doing what is morally right or wrong. In my practice, the first thing that I consider is beneficence. It suggests that I have to try as much as possible and avoid any harm that may arise during delivering services to the aged. There, as most health care professional join the practice with the aim of helping people, it is also in me, and required by any other health care provider to prevent any form of harm to the aged.

On the other hand, and as I mentioned earlier, the aged may resist treatment because of certain beliefs, it is therefore not in order for me to forcibly treat them. Over several years, this has taught me to embrace the value of autonomy, such that, patients are free to make their own choice regarding treatment (Herring, 2014). It is therefore important that the aged, irrespective of their frail condition to be given that right to decide whether treatment should be conducted to them, or not, this in many ways will be part of the many ways of respecting the aged people’s autonomy. They are the values and conditions that have shaped my professionalism and which I believe many other health care professionals need to embrace.

Analyzing an event in healthcare using Barbara Carper’s ‘Fundamental Patterns of Knowing in Nursing’

Reflection of an event in my practice

Practicing as a health care professional, I have witnessed various instances that are both motivating and others which are discouraging. However, some instances need to be corrected or rectified. In mid-June last year, two women came to the hospital seeking treatment, and due to the long queue that was in the doctor’s waiting room, they had to wait. However, what is displeasing is that other young people continue to come late and pass them by the queue because they were not strong enough to rise and move as the doctor raised his voice to call for the next patient waiting.

They stayed there for long until I noticed and moved for help. In addition to that, there has been a tendency in which the aged are not given the opportunity to decide whether a medical intervention should be conducted in them (Moody, 2006). In my practice, I have noticed many aged people seeking medical interventions, however, the nurses or physicians administering this treatment to them do not explain what form of treatment it is or even elaborate what kind of effects that the treatment might cause them. Even though the aged people are frail and can in my ways lose their ability to choose what is right or wrong or precisely, not be in a mentally fit situation to make a decision (Miola, 2007). It is still not justifiable or ethical for the medics to make such an assumption about their conditions.

Putting the Case in the context of Rolfe model, I am tempted therefore to ask myself several questions. Firstly, is the question of what, so what and now what?  All the three questions can be helpful in generating the most important elements in discussing the event. Firstly, what helps me to answer or ask several questions, in the case that I witnessed in the events of mistreatment, I therefore would think of what is the problem that is presenting itself. Also, I need to think of my role in such situation (Nelumbu, 2015).

In addition to that, I need to ask myself about the actions that I took, the response that my actions had on others and the feeling that my actions seems to have caused to other people. Lastly, I am to present the situation in a manner that elaborate whether the experience was good or bad. As far as the event is concerned, the problem is that there seem to be injustice and unethical code of conduct against the aged (Pattinson, 2006). My role in the situation is that I have observed the cases and it has changed not only my practice but also committed to establishing how best to help the aged. The treatment that I saw on the aged is displeasing and one that can be termed as bad to associate with.

As to the second question, or rather, Rolfe Model, “So What”, tries to explain the bases that resulted to my actions. Also, I think that I should have stepped in earlier to solve the situation, either by explaining to the people that I work with that the aged need to be a given an opportunity to decide whether to be treated or not but not a presumption that they are frail to decide. Also, I know understand that the queue that is usually in the waiting room is does not necessarily represent a correct way to arrange people as per who come first, but rather, older people face competition from the young (Ekebergh, Lepp, and Dahlberg, 2004).

Reflecting on the exercise and how it influences the author’s thinking about their practice

The event have also taught me to behave an ethical manner, such that it is not in order to treat the aged without providing them with the necessary information that they need, In addition to that, I thought that watching alone is not good in a case that one person is being violated, as I saw the aged waiting in silence, my I thought I need to act and stop looking at the mistreatment of the aged. Also, I think that I called upon my colleagues to work in a manner that embraces fairness and respect to the aged.

Lastly, the last Rolfe Model question in regards to the events that I was involved will makes me to think of various questions, which are the actions that I need to do to make the situation better. Also, the various steps that I need to emulate to make the situation better, and lastly, the consequences that might result from these actions (Thompson, and Pascal, 2012). In regards to the event in question, I think I need to share the ethical misconduct to my colleagues in order to try and establish whether it can be solved.

Also, I think that the top management need to implement policies that ensure that the medics follow strict ethical and professional code of conduct (Mantzoukas, and Jasper, 2004). In addition to that, the hospital can hire more workers and device a way to reduce or totally do away with the queue that are common in hospitals. They are among the many things that I think will be helpful in establishing a form of system that not only care for the aged, but present the hospital in good light as far as ethical code of conduct, or health care professionalism is concerned.

  In summary, the case scenario is of old people who, due to their inability to be as energetic as the young people are unable to get medical services at the appropriate time that he or she needs (Tuckett, Hughes, Gilmour, Hegney, Huntington, and Turner, 2009). So what is helpful in the sense that, and as far as the event is concerned, stipulates that there need to be fairness and equality in the provision of services in that, the old must access health care services at the same pace the young people irrespective of their age.

Lastly, the now what is that the government or health care need to change their policies or use another form of registering those who book an appointment for the medical checkup, for instance, the old should be put in a different place and not mixing with the young people who might (Reutter, and Kushner, 2010). Also, the idea that they are given the right to decide on their treatment on the basis that they are old or frail is something that needs to be looked or rectified.

The media show that the aged are not taken off as they ought to be taken off. As this group of people is vulnerable, the media item demonstrate that there is no need placing them under the same category as those that are healthier and more advanced as those that are not in the vulnerable state as the old or aged (Nelson, 2005). In addition to that, not proving medical care as it should be results to not only unfairness, but also unethical practice as health care professional must commit themselves in proving services to people irrespective of the age or sex, but one that is to greater good for most people. The news media is becoming instrumental in highlight some of the factors that leads to such unfair treatment.

Values and ethical principles in healthcare

The media and the health care issue

The ABC news media on 9^th May 2017 is on record in calling for a review on investigation of the health care that is being offered to the aged. The heading of the title of the argument was that maggots were found in a certain aged woman who was receiving treatment in a nursing home (https://www.abc.net.au/news/2017-05-09/jayne-carter-opal-raymond-terrace-gardens-nursing-home-maggots/8509290). According to the news report was that the woman was not being attended in the manner that aged people need to be attended and was left on her own to recover.

In addition to that, the media outlet stipulates that the woman had a maggot in her mouth despite the medical records that documented that she was recovering well. The aged care facility on the other hand offered an apology stipulating that all the necessary procedures that needed to be followed were not followed and as a result the woman that died had not been given all that is required for the aged in regards to medical intervention, or in a more particular form, palliative care (Coleman, and Willis, 2015). It is illustrative of the treatment that the aged receive in regards to palliative care. Again, the case that the ABC aired, depict that the health care providers were of the presumption that the woman was doing fine, but in reality, she was in fact receiving poor treatment.

News aired by the ABC, on 1^st may 2017 suggested that the government was committed to finding new ways of deal with the recent cases of the aged people being depressed and committing suicide (https://www.abc.net.au/news/2017-05-01/many-in-aged-care-suffering-with-depression-in-silence/8487028). It is also a pathetic condition to find that the aged, irrespective of the fact that there are numerous health care facilities may opt to commit suicide or suffer depression. One of the reasons that have been laid out as causes of depression and suicide is loneliness.  

I think therefore that it is order that the aged be provided or taken to health care facilities as other people as they are an important people of the community (Havighurst, and Richman, 2006). Abandoning the aged to their homes is not proper and does not in any way conform to the principle of equality in the provision of medical services. I think that the many residential aged care facilities that exist needs to be utilized by the aged which will reduce the number of suicide or depression.

Therefore, I see the media being instrumental in highlighting some of the challenges that faces the aged, in addition to that, the fact that the media channels that is information is a way of enlightening people who have no idea or tend to ignore the aged. In addition to that, the media ought to speak out on some of the ethical violations that the health care providers may impose on those seeking health care services (Arendts, and Howard, 2010). It is not just or ethical that one should not be given what he or she has gone to the health care facility for, like the case that appeared on ABC news, people may not be treated as it is required which is something that raises concern.

Example of mistreatment of aged patients in healthcare

Coherent approach to my practice

The issue of caring for the aged has some historical rooting in the sense that the old have been seen as not productive or as important as the young and the aged. In addition to that, the degree with which health care providers become busy with the congestion that exists in hospitals make it very hard to notice that the aged are not as properly treated as the other age groups (Luppa, Luck, Weyerer, König, Brähler, and Riedel-Heller, 2010). However, if health care professional put an emphasis on fairness or justice and include ethics in their practice, it is easy for the aged to receive proper treatment as that of other age groups (Holmes, 2006).

In addition to that, the government ought to set up a center or more residential aged care where the old can go and receive treatment irrespective of thus not competing with youngsters (Cuddy, Norton, and Fiske, 2005). Moreover, there is a need for society to embrace the aged and support them not only their economic needs but also social ones, for instance assisting them to access good medical care that is a must for every citizen or person that needs to be alive for a long time (Nelson, 2005).

Lastly, opening up more health care facilities and training more health care professionals ensures that all the people are in a position to access medical services including, and most importantly, the aged (Havighurst, and Richman, 2006). The government also needs to be a watchdog to check whther citizens receive medical services as stipulated or as required by the standard of practicing (Productivity Commission, 2008). The cases that emerge of health care facilities not offering the services as prescribed by their standard of practice is not encouraging in any way whatsoever.

References

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