Let It Pour - Case Study

Abstract

In contrast of problems and dilemmas that plague health care, and those facilities that provide treatment, the solutions to these problems are omnipresent at the core of administration. That is, these administrations are tasked, or charged, with the evolutionary changes that stem from fiduciary, medical, and technical components of the industry that are designed to not only provide the highest quality in health care, but affordable, and competent health care professionals that strive to improve these services to a continuum of customer satisfaction using the foundation of a collaboration of vision, values, and integrity.

Let it Pour - My First Assignment as Executive Assistant

As I walked to the door of the conference room, I thought to myself, "Wow, I am off to a tough start." My brain was in information overload, but I had to produce, I could not fail at my first assignment as an Executive Assistant. I made my way back to my office, the "desk", and sat down to jot down the problems as I understood them.

The first problem was that staff members were not providing, or rather neglecting medical services to patients on the grounds that they violate patients' religious beliefs. My first thoughts on the matter were, how could anyone compromise their personal beliefs for their chosen profession, especially when it involves someone whose life may depend on those services? The reasoning is that if it is part of your job, not simply because we work in a hospital, but because we work in a hospital and the underlying mission is to help and care for those who cannot care for themselves, for whatever reason.

The second thing I noted was that there are a select few patients who are refusing certain medical services. These decisions may be a result of culture, or religion, or merely due to generation gaps between the patient and physician. In any event, this is an area if concern, and must be addressed accordingly.

Another issue of concern, and a major issue, is the Do Not Resuscitate order. Patient's rights should come before anything else, but an equal understanding is that hospital staff members must possess the wanton desire to do all they can to save lives. Because of some recent national issues regarding this, and because these issues are both of moral and an indisputable right to life, policies must be addressed with emphasis placed on matters such as a "Living Will".

The hospital also has pharmacists who are helping people by acts of generosity, more or less out of the goodness of their hearts, much to the dismay of the hospital's expense, by providing prescriptions to uninsured patients and accepting an unapproved payment plan.

Another issue of concern is that the hospital counseling staff has been found to be offering its services pro-bono as well. If the hospitals' position is to demand a 15% decrease in our fixed costs, this is certainly not the way.

Lastly, there is a young resident doctor who is requesting expensive, fruitless tests for patients that have no hope of survival. His thought has to be that maybe, just maybe he will run across something that a more senior, more skilled doctor may have missed.

I am starting to re-think my "Let It Pour" attitude from this morning. This assignment grows more and more daunting by the minute. I am just thankful that I am not the hospital CEO.

Solutions to the Problems

The first problem identified was the issue of the hospital staff not providing proper medical care to out-patients on the basis that some of the procedures may possibly infringe, or border on an infringement their religious beliefs. The hospital staffs, specifically doctors and nurses in a hospital have a core obligation to provide medical care to patients, regardless of their religious beliefs. When those obligations are compromised, liability issues arise on the part of the hospital.

All health professionals have a duty of care to all their patients. It is neither ethical nor professional to exclude any person or group from treatment because they do not conform to our religious or personal views (Tonbridge 2002). In cases of this complexity, staff member's actions reflective of insubordinate acts should be deemed totally inappropriate.

Another issue identified as problematic at the hospital are patients refusing medical care. As new immigrants flock to the United States each year, it becomes more challenging and important for health care professionals to be sensitive to cultural and religious traditions different from their own while still providing optimal care for these patients, but cognizant of that enculturation. Confounding the influx of unfamiliar cultures is the relative lack of knowledge among medical professionals about other cultural groups. This can, at best, lead to misunderstanding and, at worst, compromise the care and treatment of a patient (Brown 2002). Part of being a care-giver is to possess the innate ability to be compassionate by actions such as listening to your patients, trying to understand them, and becoming educated on and in their culture. By listening you can resolve possible problems that can crop up during treatment. On the same token, patients need to trust their care givers. That trust can be gained by learning as much as possible about the patient's culture, and by possibly learning their language. In some instances an interpreter is sufficient, but sometimes the meaning or feeling is lost in translation. In the future, more and more health care professionals will need to be multilingual.

As far as the Do Not Resuscitate orders go, this certainly is an issue that will continue to be hotly contested for reasons notwithstanding the obvious. As these issues intensify merely from recent government legislation, it has become apparent that visceral solutions may not be reached in this century. The argument on this will continue to be that this is a hospital and hospitals are designed with the sole intent to preserve life, not to decide moral issues. "There are still a fair number of doctors around who are uncomfortable with patients having Do Not Resuscitate orders," said Dr. David Clive, chairman of the ethics committee at University of Massachusetts Memorial Medical Center in Worcester. "It may be for personal or religious reasons or it may be their medical opinion that the patient is not sufficiently ill to warrant the Do Not Resuscitate order. But it's important to realize that if the patient is competent, they rule the day, not the physician"