How Do My Beliefs Affect My Job

Providing patient care is the most complicated for me when I know the patient is non-compliant, or when the illness is self inflicted due to negligence. It is hard to do my job and do it well, when I know that the patient is either unappreciative or suspicious about what I'm doing anyway. As I've been in health care for longer and longer I've gotten more proficient at not letting this bother me. 

I do my job to the best of my ability regardless of who I'm taking care of. That is not always easy - and in some instances it's downright frustrating.

Some examples are:

I often x-ray diabetic patient's feet post amputation. Often these patients are over weight and have knows for an extended length of time that they need to get their glucose levels in check. It's hard for me show a lot of compassion for these patients. I absolutely have compassion for them, but it doesn't come as easily - knowing that their health problems are often a byproduct of Type 2 diabetes, smoking, and poor eating habits. I am aware that often there are extensive socioeconomic factors, genetics, education, language barriers, etc. It can be difficult still, due to my preconceived notions and biases.

Early in my career I found non-English speaking patients to be burdensome. Especially during mammograms. Often they would come and not want to remove their clothing. Sometimes they brought an interpreter, sometimes the interpreter was male, sometimes they were so modest that it made it impossible for me to get a good image. With mammography being as heavily regulated as it is, this posed a problem for me. If I was to be audited on some of those images - which were admittedly sub par (at best), I could have gotten written up. As a result of that fear, I avoided non-English or limited English speaking patients. It was a difficult exam to do. If they ended up being a "call back" the phone calls were difficult to navigate. The letters we sent out are in English so that was not helpful either. I viewed these patients as creating more work for me. And having that type of view is not doing what is best for the patient. That's not giving good patient care. As I've grown and changed and educated myself, I no longer view the non-English speaking patients as a burden. I find that our health care institutions need to be better prepared and provide us with the tools to give these patients a good quality exam, like our English speaking patients get. 

I am passionate about LGBTQ rights and inclusion. I've become the champion in our department for all things "trans". Working in mammography - this is a very sensitive category for women. Often, prior to gender reassignment surgery our patients will have a double mastectomy. Many surgeons require these patients to have a mammogram first. My beliefs in inclusion and sensitivity have helped so many of these patients. I understand that their breasts are not part of who they are. Many women associate their breasts with their femininity and womanhood. Trans patients think of their breasts as the opposite. They are embarrassed by them. They bind them down. They pretend they're not there. So when they come to me, and have to expose them and let me examine them, compress them, touch them. It can be extremely traumatic for them. I'm always honing my skills in this arena. I'm always adapting and making sure they feel comfortable. Letting them know that we don't always  celebrate breasts. I know that this is traumatic and scary. I always congratulate them and wish them well during their re-assignment. 

On the flip side of that: when a transwoman comes to our department wanting a mammogram - it is something we celebrate together! They have breasts! Which is definitely something they revel in! They enjoy having them and attribute them to their femininity. Here, I am able to switch gears and celebrate all things female for that woman. It is something they've always wanted and being included in the mammogram club is apparently a very big milestone for many of them "feeling" like a true woman.

There are certain degrees of beliefs, prejudices and biases that should be withheld when providing patient care in order to give each patient the same treatment. However, some of our beliefs can absolutely contribute to expanding our base of superb quality patient care and inclusion.