Saturday, March 23, 2013

What will it take for us to achieve wholeness in the healthcare system?

Call-Lights Are On - Are Caregivers Distracted?
You can read about Willard Shaw here!
He demonstrates how well Home Care
and healthcare can work.

In this essay, co-authors Hugh MacLeod and Paula Davies-Scimeca discuss the growing danger of presenteeism coupled with the risk of distraction associated with new technologies. Although absenteeism is often used as the measure for lost productivity, it does not reflect the full scope of the problem. The term presenteeism describes the losses in productivity and quality attributable to the walking wounded — be they impaired physically, cognitively or emotionally by illness, injury or workplace culture.

I read this essay. It was thought-provoking. However, we must differentiate between professional and non-professional caregivers. As a family caregiver, I was terrible at it. I had no support, Primary Care neglected to tell me about hospice volunteers. Now that I am a professional, albeit volunteer caregiver, I know so much more. I know whom to ask for information. I know how to do research. Furthermore, all of us are more distracted with all of the technology around us. All of us must deal with this issue.

What will it take for us to achieve a new, dynamic wholeness in the healthcare system?
I believe that technology puts us at great risks with errors, but no more so than ignorance, stupidity, or lack of action on the part of Primary Care staff has done presently, or in previous eras.
They claim presenteeism can be a danger, which is, of course, true. The question: how pervasive is it? Yes, mistakes are made, but they are not the norm.

What I believe it will take for the healthcare system to become "whole, dynamic and to respond more to the needs of patients and families", is for front line staff, Primary Care, to respond by working better within the system. They must learn to work well with those who provide care. They must be collegial, accountable, to admit errors and correct them, and to improve the ways in which they care for patients.

The excellent physicians work well with nurse practitioners (NP), the NPs work well with RNs, RPNs work well with the real front-line workers, the personal support workers (PSW) who do the practical work for patients. It has taken 30 years for midwives to become more common, although they are not fully accepted. It will take NPs many years to become accepted by physicians. I don't think we will ever have nurses respected by physicians.

I have long responded to claims that the 'healthcare system is broken', with the conclusion that the system works. There are millions in Canada who receive excellent care. Most of my hospice clients die a peaceful death. Most of my clients have their pain managed, their cases dealt with adequately, if not well, by harried, overworked staff at all levels of the hierarchy. For healthcare to be successful, it must be safe, effective, patient-centred, timely, efficient, and equitable.

What will it take to build a system that is cohesive, flexible, interconnected, cost-effective, orderly and that values the patient voice?
There is too much conflict between staff. With the addition of healthcare workers who check tweets and smartphones every few minutes, it will take peers and supervisors, and staff, to speak truth to power. There is too much competition between staffing levels, with clients bearing the brunt of this conflict. What we need are checks and balances, humans who will speak truth to power. Workplace culture has been tainted by that pedestal on which physicians have been placed, as well as they way they perceive the rest of us, as participants as self-advocates.

I think we need to ensure that all staff are well-trained, but also receiving in-service, professional development. Keeping on top of evidence-based practices, and looking after patients, and family members, in a client-driven, holistic model is key. Much research has been done in the name of improvements to front-line healthcare, but many in Primary Care ignore much of it, as well.

Physicians must recognize when they need to retire. I've seen too much harm done by those doing a good job badly. Nurses must be able to be the check and balance that doctors need, as they run from patient to patient.
The differences between RPNs, RNs, and NPs, is not well grasped by we civilians. Sometimes, nurses do not understand the complex chronic conditions patients must face. Nurses need to know what they know and what they do not know.

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