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ch 7 definitions

Course Code
PSYC 365
David Cox

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Ch 7: The Heath Care Provider
Second year -Transformation begins to take place
-Become more assertive an confident
-Ask questions that show they are now focusing on what needs to be known for patient’s sake rather than for
-Feel financial strain of medical school because don’t feel they can continue to rely on families for financial
-Social relationships take on unique quality differentiation for those inside and outside of medical school
-Enjoy elevated status among the outside but loneliness is common because many people on outside don’t’
understand medical school and are generally unsympathetic to student’s complainants
Third year -Interact directly with patients in hospital setting new set of insecurities, don’t know enough to take on
duties of a physician
-Gap between real life and textbook feeling uncertain and inadequate (but patients usually accepting)
-Issues need to accept they will make mistakes, strike balance between clinical competence and unrealistic
expectations of perfection, contagion (because expose to contagious disease), encounter with critically ill
patients, deal with death
-Susceptibility accidents that may compromise a student’s health (needle, cuts)
-Critically ill taught to cope by immersing self in work using humour, coming to realize death is not
always equivalent to failure,
Compassion fatigue -Lack of energy among health care professionals, particularly nurses, who are constantly working in an
environment in which suffering is common
Residency -Time during medical training that bridges attainment of a medical degree and establishment of practice
-MDs learn specialities; last 2-5 years
-Help cope with demands of on-call nights advised to prioritize sickest patients and responds to beepers
fast and always try to prevent rather than treat
-Canada: on-call every fourth night(no shift longer than 24 hours with 10 hours rest between shift) – 80 hours
per week
Burnout -Condition that’s similar to compassion fatigue and includes symptoms of physical exhaustion,
depersonalization of patients, feelings of discouragement and low accomplishment; perceived
ineffectiveness, cynicism, dissatisfaction with relations with co-workers
-In nurses, physicians, other health professions
-Experience lack of correspondence between what they think they should be doing and what they actually are
-Prevent focus on one’s own well-being throughout one’s career by spending more time with friends and
family, focus on spiritual and personal needs, find meaning in work, setting limits at work, maintain positive
Uncertainty -Significant source of stress for physicians resulting from fact that consequences of medical decisions are
Prognosis -Predication of how a medical condition will change in the future
Primary care physicians -Those physicians in general and family practice
Feminization of medicine -Trend toward increased proportions of female physicians in profession
Micro-inequalities -Fewer opportunities for career advancement, social isolation, lack of recognition for good work
Caring -Role that most lay people think is the primary task of nurses
curing -Role that most lay people think is the primary task of physicians
Nurse practitioner -Nurse who often works in rural, remote settings, frequently performing functions that would be performed
by a physician if available (physician often in short supply)
-Caring and curing overlap
Effort-reward imbalance -Long hours, multitasking, patient loads are not duly recognized
-Personal factor in stress that can include finding work meaningful, having sense of autonomy, feeling
competent, having positive impact
-Nurse with this are more likely to stay in profession and feel satisfied with their work
-Reduce stress
Behavioural interventions -Rehabilitation;
-Most patient need some form of external reinforcement and need to find ways to self-reinforce
-Objective criteria for success allow for reinforcement to be directly contingent on desired behaviour and
allow patient and physiotherapist to shape program by gradually in rasing observable standards
-Downside = psychological goals might get ignored by practitioner adoption this focus of setting goals that
are physical in nature (objectively measurable)
External reinforcement -Encouragement and praise from physiotherapist, friends, family, other practitioners needed by rehabilitation
patients for their successes
Self-reinforcement -praising oneself or rewarding oneself for accomplishments
Cognitive interventions -rehabilitation; focus on thinking
-crucial in 3 areas:
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