Old Chinese Proverb That I Believe Encompasses

¶ … old Chinese proverb that I believe encompasses my feelings for the nursing profession. With the healthcare industry in its current state of disruption, it has become very important to re-evaluate the relationship of patient care and patient satisfaction. "Sometimes patient satisfaction needs to be measured one patient at a time. This usually has nothing to do with the impersonality of the plan, the aloofness of the provider, or the quality of the specialists to whom one is referred. Rather, it involves the basic rationing philosophies of HMOs, particularly the for-profit variety." (Birenbaum, 107) We can't forget that the business objectives of HMO's aim to purchase services and materials at the lowest price possible and trying to lock in a price in advance. HMO's have therefore changed the philosophy of the healthcare industry. As nurses, we have to make the best of this atmosphere. This essay therefore serves as the final writing assignment for our course and represents a culmination of all of our previous class assignments.

The underlying focus of this work was to present my new found insights into what professionalism and the responsibilities of nursing are. I have learned a great many things and I now consider nursing professionalism to represent a certain display of confidence because we have acquired unique traits and a base of knowledge from a very specialized discipline of study and practice. Of course many other medical professionals have this attitude because I now understand that the field of medicine entails these specialized skills, a need for constant self-evaluation and self-improvement, constant service orientations, pride in the profession, a covenantal relationship with our patients, creativity, trustworthiness, accountability, ethical behavior, and of course leadership. This attidude is in addition to a basic need for altruism, respect, compassion, honesty, and integrity and an ability to manage conflict, accept both positve and negative feedback, an ability to be diplomatic through negotiation but not being so self possessed that we can not be cooperative in our day-to-day or emergency settings. Being a professional in this case also means teamwork.

During class, I had the privilege of reading "The Spirit Catches You and You Fall Down" and found that I really enjoyed it. The Fadiman story was a priceless study in cross cultural medicine. I believe the book served as a guide to reflect on things that we take for granted because we are professionals. It was a persuasive anthropological study of the Hmong people and one family of the group in particular. The group was portrayed as one with a strong established culture that combined concern in regard to healthcare with their pious spirituality. The problem was that by western standards, the Hmong line of medical reasoning was considered to be primitive.

Lia Lee and her family were taken from Merced, CA, a large Hmong community and were thrown into the modern western world. Unfortunately, Lia suffered from seizures from the age of three months. Her father associated the seizures as the result of his other children slamming doors which was an obvious religious medical association. In reality, the Lee's thought that the baby's soul had been scared away from her earthly body and therefore she became a malignant or split spirit. Lia needed professional help but the Lee's saw professionals as shamanistic doctors. Because Lia was epileptic, she was also predicted to late become a shaman. "Hmong consider qaug dab peg [epilepsy] to be an illness of some distinction" and "Hmong epileptics often become shamans." (Fadiman 21)

Therefore, the Lee family attempted to cure Lia through their own ways which included home sacrifices of pigs and chickens while at the same time the western medical community felt the only safe haven for Lia was removal from the parents. As a nurse, it would be difficult for me to take sides in this case without more facts because the parents were obviously compassionate and understanding and the western medical community had their vast amounts of experience.

Lia's health and future would require a deeper understanding of both the parent's cultural beliefs and medical insight. Ironically, the west's professionals saw the Hmong professionals as witch doctors. But, shamanism has many great stories of historical journeys into the depths of the soul to the hidden world through myths, dreams, or near-death experiences. Many of these experiences and trips were drug induced like those of the peyote insights of the Native American Indian medicine men or the trance induced experiences of the Ecuadorian Jivaro Indians. Western doctors should still take into consideration that Shamanism is in fact the oldest form of healing known to man and it goes back to the beginning of human kind. "Our human bodies have evolved over hundreds of thousands of years through their relationships to the physical environment." (Wangyal-Rinpoche, 1980)

From the perspective of professionalism, I have learned that as a nurse, it is best to continue to function in the day-to-day with an open mind and to also be prepared to look for a viable solution through detailed research. For example, I have discovered that the Hmong philosophy may not have been all that far fetched. Shamanism is actually the foundation of many modern medical cures including various technologies, sciences and medicines. Shamanism has also been unofficially credited with having discovered the fact that the ability of people who have suffered a state of amnesia, epilepsy or other 'soul splitting' similar to Lia's are actually one way that the body allows for time to heal from brain trauma induced by accidents or other physical abuses. "There is a doorway within our minds that usually remains hidden and secret until the time of death. The Huichoil word for it is neirika. Neirika is a cosmic portway or interface between so-called ordinary and non-ordinary realities. It is a pathway and at the same time a barrier between worlds." (Halifax, 1991)