THE TOP 10 CAUSES OF UNPROFESSIONAL CONDUCT

Transcription

1 THE TOP 10 CAUSES OF UNPROFESSIONAL CONDUCT PRESENTATION TO THE SPRING CONFERENCE 2005 OF THE COLLEGE OF LICENSE PRACTICAL NURSES OF ALBERTA APRIL 29, 2005 James T. Casey, Q.C. Field LLP 200 Oxfrd Twer Street Edmntn, Alberta T5J 3G1 Phne (780)

2 2 The Tp Ten Causes f Unprfessinal Cnduct Based n my experience ver the years with hundreds f unprfessinal cnduct cases in a brad range f prfessins, the fllwing is my unscientific list f the tp ten causes f unprfessinal cnduct. In n particular rder: 1. Failure t maintain currency f prfessinal knwledge and cmpetence: Prfessins and the health care system evlve. Prfessinals must keep pace with the change. There are many cmplaints f unskilled practice abut prfessinals wh nce were very cmpetent but wh have nt maintained their cmpetence. That s hw we did it when I was trained 20 years ag, is nt a valid defence. What yu can d: Maintaining cmpetence n an nging basis is a central tenet f prfessinalism. Maintain a current knwledge base. Cntinuing Cmpetence Prgrams are ideal tls. Use them. Take advantage f cntinuing educatin pprtunities. Be familiar with yur emplyer s plicies and prcedures. Understand the standards f practice fr yur prfessin. Be active in prfessinal rganizatins; read prfessinal publicatins. 2. Failure t seek assistance r make apprpriate referrals. Prfessinals may encunter difficult situatins fr which they d nt have the necessary skills. Unprfessinal cnduct may ccur where the prfessinal plughs ahead withut getting assistance. What yu can d: Recgnize that we all have limitatins. Realize that seeking assistance is nt a frm f weakness; it is a sign f prfessinal strength. Where necessary seek assistance frm trusted clleagues r frm yur supervisr. Dn t be afraid t ask a clleague fr a secnd pinin. Where apprpriate, refer the patient t smene with the necessary skills.

3 3 3. Difficulties in a prfessinal s persnal life affect their wrk-life. We rarely have water-tight cmpartments in ur lives. Our wrk can affect ur persnal and hme-life and difficulties in ur persnal and hme-life can negatively affect ur wrk. Persnal difficulties might be related t prblems with marriages, relatinships, children, finances, r depressin. It is cmmn fr serius persnal difficulties being experienced by a prfessinal t spill-ver int the wrkplace giving rise t a risk f unprfessinal cnduct. What yu can d: If yu are experiencing serius difficulties in yur persnal r hme-life, then realize the ptential fr the spill-ver effect. Als realize that yu might nt be the mst bjective persn with respect t whether yur wrk is being adversely affected. If yu are having difficulties cping with prblems in yur persnal life and there begins t be a spill-ver t wrk, then get help. Seek ut family, friends, trusted clleagues. Cnsider taking sme time ff wrk. Cnsider cunselling thrugh Emplyee Assistance Prgrams. 4. Alchl and drug addictins Alchl and drug addictins are the rt cause f sme f the mst serius cases f unprfessinal cnduct. What yu can d: Keep yurself well. Realize that addictin t prescriptin drugs is a danger fr health care prfessinals because f easy accessibility. Many prfessinals with substance abuse prblems have destryed their entire prfessinal career because they have either refused t seek help r sught help t late. Get help. Seek cunselling. Cntact Emplyee Assistance prgrams. There are addictin recvery prgrams in Alberta specially designed fr health care prfessinals.

4 4 5. Pr cmmunicatin Many unprfessinal cnduct cmplaints are caused by pr cmmunicatin between the prfessinal and the patient r between a prfessinal and their clleagues. What yu can d: Appreciate that part f being a true prfessinal is being a gd cmmunicatr. Ask yurself: Are yu a really gd listener? Culd yu be a better cmmunicatr? Wuld it be useful t take an effective cmmunicatin curse? Realize that effective cmmunicatin is at the heart f the infrmed cnsent prcess. Cnsider hw yur remarks are perceived by thers. Avid cavalier r smart-aleck cmments in the presence f patients. These types f cmments tend t startle and alarm patients and may prmpt a cmplaint. Many cmments that are apprpriate when made nly in the presence f clleagues are nt apprpriate in the presence f patients. Dn t wash yur dirty laundry in public. Yu care abut yur patients. D yur patients understand that yu care? D yur actins and yur verbal and nn-verbal cmmunicatin demnstrate that yu care? Retain prfessinal distance and demeanur but demnstrate t yur patients that yu d care. Hw wuld yu want t be treated if the situatin was reversed and yu were the patient? What wuld yu expect if the patient was ne f yur family members? Very few patients file unprfessinal cnduct cmplaints abut health prfessinals wh they perceived t be caring. Patients wh leave a health care facility feeling, N ne cared abut me, are mre likely t file cmplaints. 6. Failure t apprpriately address patient cncerns. A patient r a family member with a cncern abut a patient s care r a prfessinal s cnduct will typically first apprach the prfessinal r a manager abut their cncerns. Many unprfessinal cnduct cmplaints are filed because the persn felt that their cncerns were nt taken seriusly by the institutin r the prfessinal.

5 5 What yu can d: Take all cncerns and cmplaints seriusly. Actively listen t the persn making the cmplaint. Be careful f labelling a patient as a whiner r a cmplainer. Patients, and their families, can ften be difficult and smetimes unreasnable. Hwever we must remember that the patient and their family are ften under significant emtinal and physical stress in an envirnment which they d nt fully understand. An individual wh feels that a prfessinal r an institutin has been dismissive abut their cncerns is much mre likely t file a frmal prfessinal cnduct cmplaint. Understand the pwer f the 15 secnd aplgy acknwledging the feelings f the persn cmplaining. Example: I am s srry that all f this has resulted in yu being distressed abut yur daughter s care. I will advise my manager f yur cncerns. Yu can ften effectively address a persn s cncerns withut getting int a lng debate abut wh was wrng r right. Persns wh feel their cmplaint was taken seriusly and effectively addressed rarely file a cmplaint f unprfessinal cnduct with a regulatry cllege. Fr mst peple, filing such a cmplaint is a last resrt when they perceive that nthing else has wrked. 7. Envirnmental Factrs Varius envirnmental factrs can be a cntributing cause t a prfessinal engaging in unprfessinal cnduct. Fr example, there may be excessive wrk demands, a lack f mentring and supervisin, r inapprpriate wrkplace practices. A prfessinal may als be assigned tasks by their emplyer which the prfessinal is nt cmpletely cmpetent t perfrm due t inexperience r lack f training in a particular area. What yu can d: Remember that regardless f the envirnment, it is the prfessinal s persnal bligatin t ensure that their wn wrk meets prfessinal standards. If yu have failed t maintain prfessinal standards, a defence f that s hw we all d it at wrk is unlikely t be successful. If yu have cncerns abut the envirnment s effect n yur ability t practice in a prfessinal manner, seek advice frm trusted clleagues. Raise the issue with yur supervisr. If yu d nt btain any assistance frm yur supervisr, seek the advice f yur prfessinal rganizatin.

6 6 8. Persnality cnflicts escalate t unprfessinal cnduct. It is nt unusual fr the rts f unprfessinal cnduct t be in a persnality cnflict between a prfessinal and a clleague, between a prfessinal and his r her supervisr, r between a prfessinal and a patient. A serius persnality cnflict can cause a prfessinal t lse their bjectivity and a minr dispute which shuld have been reslvable may escalate t a majr cnfrntatin. What yu can d: Understand that there will always be clleagues, supervisrs, and patients with whm it is difficult t get alng. Hwever, this des nt alleviate yu f the central bligatin f maintaining a prfessinal demeanur and prfessinal interactins. If yu are experiencing a persnality cnflict, ask yurself hnestly whether it is affecting the quality f yur wrk. Are yur interactins still meeting prfessinal standards? If yu are experiencing a persnality clleague with a clleague, deal with the issue privately and nt in the presence f patients. If there is a serius persnality cnflict with a patient, cnsider arranging fr the patient s care t be prvided by a different persn. If yu have been assigned t prvide exclusive care t the patient, then yu shuld btain the patient s cnsent t the transfer. 9. Cmplacency abut prfessinal standards Sme prfessinals with a great deal f experience becme cmplacent abut prfessinal standards and begin t develp slppy practices. What yu can d: Remember that a cmmitment t prfessinalism is a life-lng cmmitment. Prfessinal standards apply as much t a new graduate as a prfessinal with 30 years experience. Regularly wrk n refreshing yur understanding f prfessinal standards. Dn t cunt n yur experience and senirity t help yu get away with slppy practices.

7 7 10. Prfessinal Dcumentatin A failure t adequately chart r dcument causes significant prblems fr prfessinals. If yu have acted prfessinally and apprpriately, then prper dcumentatin will be yur best defence. Many unprfessinal cnduct cmplaints are referred t a hearing because f significant disagreements abut what actually happened. If a case cmes dwn t, He said, she said, then yu are at risk. Apprpriate dcumentatin can bjectively demnstrate what really happened. What yu can d: Fllw prfessinal charting and dcumentatin practices.. Understand and fllw yur emplyer s dcumentatin practices with respect t critical incidents, patient cmplaints, etc. Dcument in accrdance with prfessinal standards: write legibly, write accurately, recrd cncisely, recrd events chrnlgically, recrd infrmatin immediately r ASAP, ensure all dcumentatin is dated and signed r initialled, write in ink, use unifrm terminlgy and crrect errrs in dcumentatin penly and hnestly. When yu knw that cncerns are being raised by a patient r family member, ensure that every step yu take is adequately dcumented. Prfessinalism is nt abut perfectinism. All prfessinals make mistakes. Hwever, we all need t ensure that we learn frm ur mistakes. By being alert t sme f the rt causes f unprfessinal cnduct we can d ur very best in ensuring that we act as true prfessinals. James T. Casey, Q.C. Field LLP 2000 Oxfrd Twer Street Edmntn, Alberta T5J 3G1 Phne (780) jcasey@fieldlaw.cm