Saturday, April 2, 2011

"The fine line between abuse and neglect"

K Tree over at K. Tree, CNA blog had a post that I sort of resonate with, called "How Pushy is Too Pushy?"

This paragraph in particular:
We're constantly walking a fine line between abuse and neglect. I don't care what you say, it's true. 40 minutes cajoling and slipping little bites of medicine in a resident's mouth could be construed as abuse. Not giving her the medication could be construed as neglect. Same thing with a resident who doesn't want to be bathed even though she clearly needs it. If you force her to be bathed, even with a bed bath, it could be abuse. If you let her lay in her own filth, you are guilty of neglect.
I think this relates to the awful NY Times article I posted before. I think this fine line K.Tree is describing is really demoralizing for healthcare workers cos you get into this frame of mind that

- The state (the power that monopolizes any conversation about healthcare, safety, resident/patient rights) isn't serious about patient safety cos it switches so easily back and forth between Neglect and Abuse, with no understanding of the conditions and circumstances that we work under.

- The state with its wishy washy definitions of Neglect and Abuse become a tool of management to put down any workers dissent -- my own experience speaks to this.

- Makes healthcare workers feel like we always have to cover our ass -- it's a mentality, a mindset of needing to force residents to do stuff regardless of their own desire or will, because we need to NOT get into trouble. This leads to objectification of residents

- This is a deeply moral and ethical question and needs to be tackled as such through debate, discussion, clarifying the lines of debate between patient autonomy and healthcare institutions definitions of safety. In the absence of such debate, it becomes a very crass form of paternalism toward our residents/patients.

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