Friday, November 06, 2009
Health care isn't just a product
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Darrell K. Shomaker
Shomaker, of Pearisburg, teaches bioethics and critical thinking at Jefferson College of Health Sciences in Roanoke.
The economic recession in the United States appears to be drawing to a close. Despite that encouraging news, the nation's economy continues to lose jobs in traditionally strong sectors such as manufacturing and construction. The health care sector, on the other hand, is adding jobs.
Throughout the course of the recession, the health care industry added an average of 8,800 new jobs every month. Consequently, the industry has become known as the "recession-proof" sector of the U.S. economy where displaced workers and recession-motivated career switchers can find good-paying positions with benefits, and most important, job security.
Of course, most health care positions, even those at the entry-level, require some education beyond high school. Regionally, our universities, colleges, technical institutes, and business schools have ramped up campaigns to recruit recession-motivated students interested in health care careers.
In the Roanoke and New River valleys alone, the training opportunities range from medical aide training spanning only a few weeks to associate degree programs leading to registered nursing positions to terminal graduate degrees in medicine. With such wide-ranging opportunities, Southwestern Virginia is a great place for displaced workers to begin new careers in health care.
Those of us who educate and retrain new students have a special responsibility to provide more than mere fast-track programs leading to recession-proof employment. Perhaps one of the most attractive features of health care work is the joy that comes from helping others.
New students entering health care from other areas of the workforce have skills and values that are transferable. Even so, working in the health care field is much different than working in manufacturing, construction, sales or customer service. As my nursing students sometimes say, forgetting to put a pickle on a burger is not a serious problem, but pushing meds into the wrong patient is a very serious problem.
All jobs require adherence to particular rules, regulations and ethical standards. Positions in health care are not different, except that health care employment requires one to care about the welfare of those they serve. Some may argue that health care can be reduced to mere "health work," whereby mastery of technical skills alone is adequate. It is reasonable to presume that some displaced workers entering the field may initially hold this view.
No matter how technical and scientific health care becomes, it is still an encounter between humans, one person counting on another to act on behalf of their welfare. Training students to become health care providers that patients can count on is as important a goal as being technically proficient.
However, it appears that many area programs exclude coursework in the medical humanities, bioethics and health care ethics. In fact, students can earn associate degrees from area community colleges and enter the field as registered nurses without ever completing an ethics course.
Certain universal ethical principles such as respect for patient autonomy and nonmaleficience (do no harm) are built into some nursing courses and training exercises, but today's patients expect more. Unlike decades ago when paternalism was the norm, health care seekers now look to form therapeutic alliances with their providers and actively share in decision-making processes.
In other words, patients want more and deserve more than a product or service delivered upon payment. Today's patient expects health care products and services to be delivered through relationships founded on mutual respect, ethical awareness and consideration for individual circumstances.
Unfortunately, this moral bedrock of health care is at the margins, not the center of health care training.
