How would we know the level of our own competency when we are prone to overlook our faults more easily than others? Would we seek further training or continue to bluff our way through it, hoping we don't screw up in a way that it will backfire? Would you eat crow to admit that you don't know something that you probably should.? Are you an incompetent nurse? Truthfully.
Interesting article I picked up on the web.
Are We Really Incompetent?(self-awareness and self-management in the health care industry)
Healthcare Review, March 19, 2001, by Margaret J. Palmer
Among the issues of conflict that pervade healthcare, one that stings considerably is the indictment of a person as incompetent. Nurses claim that physicians are incompetent and should not be practicing. Physicians claim that nurses are incompetent, a result of the shabby nursing educational systems currently in place. Both accusations are made openly and with certainty by the author. Are we really as incompetent as the accusations suggest?
Quality improvement processes have become a normative standard in healthcare systems, allowing close scrutiny of providers' clinical acumen. If there really were cause to believe that gross incompetence has overtaken our healthcare delivery systems, quality teams would find and eliminate it.
How can it be possible for such skillful effort demonstrated during a crisis to become incompetence during a lull in the activity? Is it possible that we have misdirected our responses to the changes demanded of us? Are we mature enough in our interpersonal skills that we can discriminate between real incompetence and our own underlying anger and frustration resulting from stressful work conditions?
Blaming others for errors, poor communication, or lack of perfection has been a fairly common characteristic of the healthcare culture. Claims of incompetence are a serious matter in any industry; in healthcare, incompetence implies action that can result in serious consequences.
Psychologists have named this phenomenon "horizontal violence" - the hostile action that is taken within a group of colleagues that shares a strong camaraderie. Physicians and nurses fall into this category. Because of the unique training each of these groups experiences, there is an imposed isolation that separates them from the other healthcare disciplines. A certain strength is gained by becoming a member of the nursing profession or becoming a physician, creating a strong bond surrounding the profession, giving it definition and uniqueness.
This boundary embraces like-minded and similarly trained individuals who support each other, however it also creates a barrier that prevents anger and frustration from leaving the group. Group members soon realize that the only safe forum in which to be understood is within your own professional group. Finding resolution to difficult issues outside of one's group is often met with misunderstanding and confusion. Therefore, keeping within the group is efficient and becomes the natural place to seek counsel.
As in a family, the familiarity and comfort that builds within a group encourages freedom of expression. A significant negative factor emerges, then, as your group receives the brunt of your frustration. The safety of one's professional group also supports the internally directed violence.
Nurses fight among themselves, especially across departments and between shifts. Incompetence is often sighted as the reason charts are not completed correctly. Medication errors are assigned to incompetent nurses. -
Physicians rarely describe each other as incompetent" due to its credentialing implication. But, the direction of incompetence from physician to nurse is common. Little understanding and tolerance exists between the two when situations unfold differently than expected. Many healthcare hours have been spent investigating incidents of alleged incompetence, often revealing a result quite different.
Healthcare providers are adept at reducing interpersonal issues to clinical problems. This is done so regularly that clear, honest communication is a rarity. Therefore, incompetence might really be a cover for a relationship in need of assistance.
This is not to suggest that incompetence does not exist. It does. In fact, we work diligently to remove it from all aspects of healthcare delivery. But, the common place occurrences between individuals and groups are likely to be based in weak interpersonal communication.
The Remedy
How do we shift ourselves from the willingness to write off others as incompetent to accepting responsibility for our professional behavior? The answer is simple, but the shift may require large doses of temperance, understanding, and introspection. A true willingness to become self-aware precedes any attempt we might make to behave more professionally. That which we so easily assign to others is likely to be the same issue that we present and, in fact, dislike about ourselves. Are we strong enough to do that introspection?
Next issue: Self-Awareness-The Precursor to Self-Management.
Margaret Palmer, PhD, is president of the Healthcare Management Consulting Group, a firm specializing in consultation with physician executives and managers regarding management issues, and with hospital administration regarding leadership development and problem-solving. Her practice includes e-consulting to physician executives and managers.
COPYRIGHT 2001 Healthcare Review
COPYRIGHT 2001 Gale Group
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