2012/08/23

Professional or Human Being? Can we be both?

For today's discussion there are three ideas to explore. The first area has come out of our 8/21 discussion of Aliens vs. Robots:
"Professionalism is about controlling emotions to appropriate expression.
Emotional expression is sometimes a burden on other people, and at the same time sometimes it's the most respectful thing."
For the following questions, I want to understand two things:
What's the standard cultural opinion as you understand it?
Do you have a different opinion on this than the standard cultural opinion?


When is emotional expression 'drama', and when is it 'authentic'?
When is emotional expression 'appropriate'? When is it not appropriate?
When someone can't avoid emotional expression in an 'inappropriate' situation, what is the person's responsibility in that situation? What are others' responsibility in that situation? Meaning, what is the appropriate way to handle it?

When does an emotional expression become a burden for other people?
In what situation does emotional expression make it harder for others to do their job/live well/survive?


The second area comes from a paper by Marit Helene Hem RN RPN MHSc and Kristin Heggen PhD RN, titled: "Being professional and being human: one nurse’s relationship with a psychiatric patient"
What is already known about this topic:
-One central ideal in psychiatric nursing is that nurses should use themselves as therapeutic instruments, which means that nurses should have both a professional and a human function.
-The ideal of being professional and human has an inbuilt potential for conflict because of the contradictory demands of creating an optimal balance between closeness and distance.

What this paper adds:
-It argues that when nurses themselves are ‘therapeutic instruments’, tensions are created because of contradictory demands deriving from role conflicts.
-It asserts that the ideal of psychiatric nursing being a balancing act between intimacy and distance, between human and professional ways of acting, appears to be too harmonious and too narrow.
-It argues that a nurse’s own vulnerability can be a constructive element in patient care and that there is potential for professional development if nurses are able to recognize their own vulnerability.

"The theory and practice of psychiatric nursing has two aspects. For patients, nurses are both health professionals and fellow human beings. In their therapeutic work, nurses must employ their diagnostic insights and precise knowledge of illness. At the same time, they must also be able to encounter patients as unique individuals. The profession bears the … traditions of both biomedical knowledge and humanistic psychology. It is expected that nurses have both a professionally objective, scientific stance and sensitivity to patients and their suffering. In short, inflexible schematic thinking must be combined with empathy. The ability to quantify must go together with the ability to be present as a fellow human being.

Many researchers and textbook authors in the field agree on the importance of psychiatric nurses being personally at patients’ disposal. This includes nurses’ readiness to become close to patients. However, if this personal relationship is to have a therapeutic function, they must also be professionally distant, and must be able to balance between human closeness and professional distance.
Our own clinical experience of psychiatric nursing supports the view that it is necessary to balance intimacy and distance. The notion of an optimal balance is a professional ideal. However, does this ideal have an inbuilt potential for conflict?
...
It is a problem if nurses become too intimate or too distanced from patients. However, there is a third and much more fundamental problem. This arises from the very ideal that a nurse should at all times have a clear notion of the therapeutically correct degree of intimacy, and be responsible for regulating the relationship. We can ask if there is a danger of such regulation becoming too simplistic or too technical and instrumental. In fact, it is often claimed that nurses themselves are ‘instruments’ in caring for patients. Does the use of this word imply that nurses should not behave like real individuals who are vulnerable and have real shortcomings (Fog 1998)? Are relationships understood as concrete and unique ones, in which nurses and patients mutually and meaningfully interact, or does the ‘instrument’ metaphor suggest a well-controlled and somewhat cold professional- ism? How do nurses experience the difficulty of being both intimate and distanced, in being a fellow human and a health professional? Such questions informed our empirical study.

Is there a danger in thinking of professionals as themselves being instruments or tools? Does this expectation alter the professionals own behaviour? (ie. giving them permission to act less like a human being?)
In English, one way to insult a person is to call them a 'tool'. This means they're being used by someone else, i.e. 'a tool of the Man' ('the Man' can mean gvt or corporations, or any kind of authority). After awhile 'tool' just became synonymous with 'asshole'.
I think this idea of calling sb a 'tool' as an insult, combined with increasing distrust of professions like lawyers or bankers or corporate managers and their perceived willingess to put aside personal ethics to carry out the will of a corporation or gvt is an interesting insight into how professionalism is perhaps not integrated enough with being a fully realized human being.

When you are a professional, and you are called upon to represent a group whose ethics disagree with your own, how do you resolve the conflict?
What's the ideal resolution? When this is compromised by real-world considerations (can't lose your job or change it easily due to contractural or financial considerations), how does this compromise being a real human being?
How do professional ideals interfere with being a real human being? How do human ideals interfere with being an ethical professional?
Is there necessarily a conflict? Meaning, even in the ideal realm, is there a conflict of interest between being a professional and being a human being?


The third area is pretty well related to the second area. Lauren DeStefano writes about being treated as a 'professional tool' and her human reaction.
I was a switchboard operator for a small lending company. I was the only person directing calls, 8-4:30, Monday through Friday. Every single person to call the office had to go through me, and, this being a loan office, a lot of people functioned under the delusion that I was personally responsible for their low credit scores or for their account representative being out of the office that day. I was called a lot of things I couldn’t repeat in polite company (and I pride myself on this blog being family friendly, besides). For the first month or so, I took it. I referred to each caller as “Sir” or “Ma’am” and in response to venomous remarks, I apologized, saving my curse words for after I’d hung up.
But eventually it took its toll. I don’t know about the rest of the world, but I was raised to be respectful when addressing another person. This isn’t a practice universally acknowledged however. One afternoon, a gentleman called and asked to speak to his account rep. The rep was out of the office that day, and another rep was filling in. I explained this, and he was angry because the rep filling in was a woman. He demanded that I get my fat lazy (redacted) off the chair and go find his rep’s home phone number. And while he was in the middle of a tirade, which I honestly can’t remember, I hung up. Maybe it was a knee jerk reaction, maybe it was anger, or shock, but that’s what I did. A minute later, the gentleman called back. I answered the phone. And, folks, it was like I’d never even hung up. He was still ranting. When he paused for a breath, I told him, “Sir, like it or not, I am the only person who can direct your calls, and I’m not going to put you through to anyone until you learn to speak with some respect.”
He hung up. Didn’t call back. And for all I know, he’s still learning. But I felt better, and that was what mattered. I felt like I had shown this gentleman that I wasn’t just a voice on the phone, but an actual, fully-realized human being. I feel like people forget this, and that’s why they act the way they do.

Can our vulnerability as human beings make us better at our professions?

I don’t think it occurred to this person that I’m as much a human being as they are, and I’m sure they’ll never see this, so I can only quietly hope that this person learns some tact. But nonetheless, I maintain that it’s important for people to show respect to others, regardless of profession. We are all people here.

Her question is very similar to that asked by the nursing paper:
Can our vulnerability as human beings make us better at our professions?

Does the fiction of professionalism allow us to forget that others are human beings, with emotions and burdens and all of that, too?

Is professionalism a fiction? Are all social roles a kind of fiction? Does that mean being our 'real selves' is not a fiction? When we're playing a version of ourselves, to the extent that we 'edit' for others, does that mean at some level we're always playing a fictional version of ourselves? [Sorry to land us in the existential deep end, here!]


Here are some undigested and somewhat contradictory thoughts that I'd like to explore if we have time:
I think there's a relationship between the creation of human beings as object-professionals and the basic division of our society into Man/Other.
I don't think it's a coincidence that when googling professional vs human being, that it turned out the people doing this kind of thinking are women.
Is this related to that the fact that we as women are treated as objects by patriarchal society means that we are more directly confronted by the issues of being a human being vs being professional (or a professional object?).
Meaning, thinking women are objecting being considered as objects, which naturally leads to exploring the condition of being turned into objects in areas like professionalism?
Men, who are more invested in patriarchy since they derive the largest benefit of it, are more conditioned to think of other human beings as objects, or thinking that it's appropriate for human beings to be objects, and so therefore don't object to themselves as having an object role when playing the role of a professional?


Here are two links which may add some fuel to the discussion:
Authenticity vs. being a hypocrite:
“If you’re flawed on the inside, how dare you project perfection on the outside?”
Is impulse control hypocrisy? If you cover your mouth before you cough, are you a hypocrite?But is impulse control hypocrisy? If you cover your mouth before you cough, are you a hypocrite? Do you have to say every random thought that pops into your head in order to be “real”?

The correct definition of a hypocrite is one who preaches one set of standards to others while personally adhering to another. But that’s not at all what we’re talking about here. Feeling like doing something selfish and rotten but forcing yourself to do something altruistic and noble isn’t called hypocrisy; it’s called being a healthy, normal, decent human being.

Essential Qualities of a Human being:
Sympathy
Empathy
Trust
Morality
Sense of Humility
Forgiveness