When we think about mass casualty events, we usually think about natural disasters, such as tornadoes, hurricanes, wildfires, and earthquakes. As noted in my blog on bioterrorism, we healthcare management educators tend not to dwell on or prepare for these and other disasters, such as chemical, biological, radiological, nuclear, and civil unrest. Living in Baltimore, Maryland, recent events have brought the matter home to our healthcare organizations in a way we have not seen since 1968. Peaceful marches and protests simmered in rage and boiled over into violence and fires. Currently, all the players—politicians, gang leaders, pastors, and community members are struggling to pull together to keep our beloved city calm and to support community members who are suffering from mental health issues associated with this tumult. As it became evident that mass casualties could occur, local hospitals were put on alert to receive injured protestors and police officers. But were they prepared?
With the return of Ebola to center stage in world health and the much heralded and anticipated start of vaccine trials for this disease in West Africa, it is easy to forget old diseases and debates. Vaccinations created by man, not by natural disease processes, have historically engendered controversy. According to Link (2005, p. 38), "vaccines are counterintuitive. What sense does it make to inject a well baby with a potent, biologically active vaccine that contains elements of the very disease it is supposed to prevent?"
Ask a faculty member about how the customers are doing in her course and you are likely to receive the following responses: confusion, disbelief, and annoyance. Much like waving a red flag at a bull, calling students customers in front of faculty can induce raised voices and anger. Often when this term is used, faculty members will expound on student entitlement and demands for unearned grades. In their minds, student expectations have outstripped reality in higher education. Sometimes it can be difficult to step back and recall our own educational choices.
Many years ago in the late 1970's when I was an intravenous (IV) therapist at an upstate New York academic health center, a patient who worked with rabies virus in the New York State Laboratory across the street was admitted through the Emergency Department. The admitting resident physician, who was a friend, told us the patient presented with seizures, photophobia, and "foaming at the mouth." However, because the patient had been vaccinated against rabies, the physician felt there was "no way" the patient could have the disease. I disagreed.
Four years ago, I posted a blog asking the question, "Are health care professionals prepared for disasters?" and closed with the following:
Each fall, as we return to classes we have an opportunity to reflect on previous successes--and failures. One of the more persistent failures we seem to have with our students is instilling a sense of integrity in their academic work. The same students who would be mortified if you accused them of shoplifting have been known to lift entire works from other authors and other students. Sometimes, their boldness can leave you breathless and scratching your head, wondering if they had only put that much effort into their work, they would have passed the course without cheating. The following is an example of such audacity.
As part of the capstone experience in our graduate program, students are required to interview a minimum of three executives or healthcare managers using a structured interview format published in Career Opportunities in Health Care Management. At the completion of the interview, the student identifies and indicates the healthcare management leadership competencies the executive noted during the interview and the competencies needed to conduct the interview. In addition, the student reflects upon what insights the interview provided about his or her own career development and continuing education plans.
Almost daily, it seems the media is filled with reports of violence, so much so that we almost become numb to them. An active shooter in a popular mall. A disgruntled employee returns to his former place of employment armed to kill. A student with mental health problems murders a favorite teacher, a classroom full of students, or goes on a campus rampage. However, when violence hits in healthcare settings, we are shocked and ask, How did this happen? These institutions, these sacred places, are supposed to serve and care for our loved ones. Yet in many instances they cannot protect our loved ones because of the nature of the settings themselves. As the incidence of violence rises, we are doing a disservice to our students by not talking about this elephant in the room, violence in health care settings. The purpose of this blog is to provide a brief overview of violence in healthcare settings, raise your awareness of this phenomenon, and encourage faculty to include it in their courses and curriculum.
Many years ago when I was an Intravenous (IV) Therapist in training at a major teaching hospital, I sat down to a thirty minute dinner break with my fellow IV team members in the hospital cafeteria. One of our team mates was late. She rushed to the table with her tray, and raced to tell us why she was delayed. Not only did she provide the team with chapter and verse of the patient she last saw, but also told us the patient's diagnosis, the tragedy surrounding the patient, the little boy she was leaving behind, and her youth.
Upon graduation, health care management students are expected to be confident, competent, reflective practitioners. We are also expected to provide data to support our assertion that we have accomplished this feat. Measurements of confidence can be obtained through student self-assessments. Assessments of competencies can be conducted via course work and face to face observations. What is a "reflective practitioner" and is this something we can objectively assess and document?