The Legal Environment is very important to our profession of Dietetics. As Paula explained in class, it "is important for governing in groups or society, and providing them with the guidelines which determine how they will operate within the society." I think that people need rules and guidelines to keep them in check. However, as we discussed in class, people lose site as to why the rules were put in place. For instance, in the new reality TV show, Jamie Oliver's Food Revolution, the foods that our children are getting at their schools are not healthy foods. The guidelines that were put in place originally with the Child Nutrition Act, were not implemented so that our children would be fed almost all processed foods. Over the years, the budget for foods at schools got tighter and children's food preferences changed-included more processed, convenient food items with high calorie densisty, and less produce, and nutrient dense foods. This change in children's food preferences is, in part, due to the changes in lifestyle and food intake of their families. Because children's food preferences have changed, I believe they don't like the taste of fresh or unprocessed foods. Now, we are in a situation where congress is willing to budget more money, but it will be a HUGE challenge to change the food preferences of the kids. The kids on this show could not even identify a fresh tomato!
Healthcare reform will also have a big impact on our profession. We hope that it will present us with the opportunity to provide more preventative services rather than nutrition therapy for a disease state. It will be interesting to see what takes place.
Without some of the state and federal funded programs, such as WIC, there would not be an opportunity to help those in need. I feel the government has our best intentions at heart, but not always the means to give us everything we need. And sometimes, I feel that they lose site of why they implemented the programs in the first place. Maybe I am just naive, but I still have faith in our political system...at least for now.
How we can impact our legal environment at a local level is by seeking out opportunities to share our knowledge and worth. Also, I have found that the administrators at my facility are some of my biggest advocates. It they feel you are invaluable, then they will tell the community so. At a state and federal level, one of the best ways to impact the legal environment is to contact your state representative--writing letters, making phone calls. Attending public policy workshop is one of the best things that we can do for our profession.
Getting involved in the legal environment is an idea that overwhelms me and rather scares me. I feel that there is so much that I need to learn within politics and the legal environment. This class has definitely opened my eyes to the importance of such issues, however. Life brings us many overwhelming situations and I do not want to rely on other Dietitians to do my dirty work. I need to "suck it up" and get involved. Public policy should be every Dietitian's job, mine included.
Tuesday, March 30, 2010
Tuesday, March 2, 2010
Ethics in Dietetics Practice
Ethics impact our lives on a day to day basis in ways that we are not even aware. We are tempted to be unethical daily. Whether our temptations be to not speak up when a cashier gives back too much cash or to tell our boss a "half-truth" to make ourselves look better. I consider myself a Christian. Many of the beliefs that come from being a Christian are considered ethical- for instance, honesty, integrity and fairness. Principle 1 of the American Dietetics Association Code of Ethics states: The dietetics practitioner conducts himself/herself with honesty, integrity, and fairness. As I grow in my Christian faith, I am made aware of situations that may not be considered "Christian" but are considered OK socially. I am thankful that I have the Bible to turn to and to learn from to keep me on track. As humans, it can be easy to sacrifice our beliefs because "everyone else does it." I believe we need boundaries and rules to stay on track. If we, as a society, did not have standards as to what is socially acceptable and what is not, our world would be even more disorderly than it is.
Because this is our human nature, I am also thankful to have been educated at an ethical University. I had the opportunity to learn under ethical professionals. If I had been taught unethical practices as a young, impressionable student, this could have had a very negative impact on me as a Dietitian. I am glad we have the Code of Ethics to turn to to hold us accountable. If the Code of ethics did not have these principles in place to hold us accountable, and consequences for unethical practitioners, who knows what situations would be acceptable in our Dietetics society.
As I was reading and studying for the assignment this week, one of the unethical scenarios from the ADA's videos was about a Nutrition Support Dietietian who lacked confidence to confront the other members of the Nutrition Support team about how the team's previous recommendations were not documented in a patient's chart and therefore not carried out with this patient. This is unethical based on principle #8: recongnizes and exercises professional judgement within the limits of qualifications and collaborages with others, seeks counsel, or makes referrals as appropriate. This really stood out to me because as a fairly new RD (1.5 years) and a fairly new RD to Wright Memorial Hospital, the physicians and other health professionals at the hospital are not used to having access to a full-time RD. They did not utilize me very much at first. Because they were not open to my recommendations and techniques at first, I was not confident in approaching them with my recommendations. I almost dreaded having to approach some physicians, and still do at times. Because I feel this way, I sometimes am tempted to not approach the physician at all. It is tempting to only do what is "required"- solely an assessment within 72 hours of admission. In order to make the physicians aware of my recommendations, I cannot simply leave my recommendations on my assessment notes becauase they will not read them. I have to communicate with them in different ways. One physician absolutely hates it when there are notes left on a patient's chart for him. This is how I communicate with most of the physicians, however with this particular physician, I either need to call the Doctor's nurse and leave a message or speak directly to the Doctor. This is a time consuming process to do this with all physicians, but if I do not do it, my recommendations will not be carried out. It isn't convenient, and it is tempting for me to think, "oh the patient will be discharged in a few days anyway" just so I don't have to communicate in one more way with a physician, but this would not be ethical because I am not putting my patient's needs before my inconveniences. Situations like this come up a lot in my job and I just remind myself that I have higher expectations for myself and that I am not only representing myself, but my profession and I am striving to prove my worth at my facility and I think I am slowing making progress.
Another ethical situation that arose at my facility was when one of the administrators at my facility approached me and explained that we were expecting a particular patient at our facility and gave me further details on the situation. She went on to explain that this patient was very important and we needed to do everything we could to make them comfortable and give them the best care we could. I relayed her message to my staff. It did not strike me as unethical until one of my staff members replied, "and we don't do this with every patient?" I don't think that our administration was encouraging unfairness, however, it could definitely be perceived this way. I learned from this situation and have been encouraging fair and equal treatment to all patients since. I never encouraged anything different, but in a small town, often your patients are people that you know and with that comes special treatment at times. Knowing your patients on a personal level opens up a whole new set of challenge for employees on HIPPA confidentiality. People in my town know I work at the hospital and will sometimes ask me questions about patients. Of course, I always respond that I am not allowed to discuss such matters.
Ethics is about doing the right thing, not the most popular thing. Doing the right thing can somethings be challenging, but worthwhile in the end.
Because this is our human nature, I am also thankful to have been educated at an ethical University. I had the opportunity to learn under ethical professionals. If I had been taught unethical practices as a young, impressionable student, this could have had a very negative impact on me as a Dietitian. I am glad we have the Code of Ethics to turn to to hold us accountable. If the Code of ethics did not have these principles in place to hold us accountable, and consequences for unethical practitioners, who knows what situations would be acceptable in our Dietetics society.
As I was reading and studying for the assignment this week, one of the unethical scenarios from the ADA's videos was about a Nutrition Support Dietietian who lacked confidence to confront the other members of the Nutrition Support team about how the team's previous recommendations were not documented in a patient's chart and therefore not carried out with this patient. This is unethical based on principle #8: recongnizes and exercises professional judgement within the limits of qualifications and collaborages with others, seeks counsel, or makes referrals as appropriate. This really stood out to me because as a fairly new RD (1.5 years) and a fairly new RD to Wright Memorial Hospital, the physicians and other health professionals at the hospital are not used to having access to a full-time RD. They did not utilize me very much at first. Because they were not open to my recommendations and techniques at first, I was not confident in approaching them with my recommendations. I almost dreaded having to approach some physicians, and still do at times. Because I feel this way, I sometimes am tempted to not approach the physician at all. It is tempting to only do what is "required"- solely an assessment within 72 hours of admission. In order to make the physicians aware of my recommendations, I cannot simply leave my recommendations on my assessment notes becauase they will not read them. I have to communicate with them in different ways. One physician absolutely hates it when there are notes left on a patient's chart for him. This is how I communicate with most of the physicians, however with this particular physician, I either need to call the Doctor's nurse and leave a message or speak directly to the Doctor. This is a time consuming process to do this with all physicians, but if I do not do it, my recommendations will not be carried out. It isn't convenient, and it is tempting for me to think, "oh the patient will be discharged in a few days anyway" just so I don't have to communicate in one more way with a physician, but this would not be ethical because I am not putting my patient's needs before my inconveniences. Situations like this come up a lot in my job and I just remind myself that I have higher expectations for myself and that I am not only representing myself, but my profession and I am striving to prove my worth at my facility and I think I am slowing making progress.
Another ethical situation that arose at my facility was when one of the administrators at my facility approached me and explained that we were expecting a particular patient at our facility and gave me further details on the situation. She went on to explain that this patient was very important and we needed to do everything we could to make them comfortable and give them the best care we could. I relayed her message to my staff. It did not strike me as unethical until one of my staff members replied, "and we don't do this with every patient?" I don't think that our administration was encouraging unfairness, however, it could definitely be perceived this way. I learned from this situation and have been encouraging fair and equal treatment to all patients since. I never encouraged anything different, but in a small town, often your patients are people that you know and with that comes special treatment at times. Knowing your patients on a personal level opens up a whole new set of challenge for employees on HIPPA confidentiality. People in my town know I work at the hospital and will sometimes ask me questions about patients. Of course, I always respond that I am not allowed to discuss such matters.
Ethics is about doing the right thing, not the most popular thing. Doing the right thing can somethings be challenging, but worthwhile in the end.
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