News and Commentary Macy Faculty Scholar Lisa Day on Teaching Professional Values

As a Macy Faculty Scholar, Lisa Day, PhD, RN, CNE, of the Duke University School of Nursing will design an interprofessional course for nursing and medical students.

What are you working on as a Macy Faculty Scholar and why is it important?
I am developing an interdisciplinary course that focuses on teaching professional values, including standards of compassion, empathy, and service as well as discipline-specific values.

Medicine and nursing are service professions, and many of the miscommunications in practice are based on misunderstandings of each other’s professional values. If we can help students talk about the values they hold and how they put them into practice, and if they can share stories about how those values inform their practice, then I think we can improve communication and work environments overall.

How did you come across this issue?
A real world example that really stands out for me, and is perhaps the easiest way to explain what I’m hoping to do, occurred when a student nurse I was working with was treating a patient with a bone tumor that was very painful. The student worked with a nurse to request more pain medication from the patient’s doctor, but the doctor was not responding. Because the doctor didn’t respond, the student concluded that the doctor didn’t care that the patient was suffering and was too busy to deal with the problem.

When we investigated further, we found out that the doctor cared very much. The patient had previously overdosed on morphine and responded badly, so the doctor, who had this information, was understandably hesitant. The doctor had not communicated this to the nurse, and didn’t respond because he didn’t see a need to explain himself. The doctor and the student nurse were coming from the same place of care and compassion, but they didn’t see that in each other and even made some negative assumptions. They were both looking out for the patient’s best interest, but there was this miscommunication in the way, and the nurse had to try and treat the patient without knowing what the doctor knew.

What are you hoping to change with this project?
I’m hoping this course shows that if health professionals execute patient care with the understanding that they value the same things, even though their professional perspectives may be different, that there will be benefit in that for both themselves and the patient.

There are lots of initiatives to improve communication skills and the technical practice of team-based care, but that’s not what this project is about. I want us to step back in that relationship and help medical and nursing students understand their own values better and each other’s values better.

How will you asses your impact?
We are hoping to pilot the new IPE course in fall 2014. In terms of assessment, we hope to find that we change practitioner’s minds about each other and that they tell us they understand each other better. We will ask students how their relationships have changed, how their job satisfaction has changed and down the road, see if patient satisfaction was impacted by this as well. We will also want to find out how students took what they learned from the course and applied it in their everyday practice (i.e. Do they feel they better understand their colleagues?).

Ultimately, I’d like to see all health professionals spend more time wishing each other well and supporting each other instead of misunderstanding one-another. That would make for better care for our patients.

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