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Since the beginning of complex societies, the public has been interested in the broad idea of professionalism and what professional title entails. This understanding, however has served to provide an increasing interest in not just one side of the spectrum, that is professionals, but the relationship that exists between the professionals and their clients. Is it true that this relationship is expected to be objective and detached?
Many stereotypical assertion affix to the professionals, beginning with that professionals are seen as having the expertise in guiding the client and the client employs the professional to do specific tasks, weather be decisions, choices etc.. The difference comes a long between the professional and the client; (1) the professional is the one with expertise, (2) the professional is not directly concerned with the subject matter/ problem of the client i.e he is not directly experiencing the matter (3) professionals can easily obtain more clients but clients cannot obtain professional with that ease. The professional is seen as being in a superior position, that is a defining feature between professional and clients where the professional's defining features are the knowledge and skill. Clients might not know the course of the subject matter/problem and so they need a professional to guide them through it.
The client most often sees the professional as having a sole purpose as being the one which at the end of the day will help the client achieve the goal or purchase. The issue in this comes along with responsibility and authority. Professionals and clients can be seen as having a close relationship of mutual trust and cooperation but with a certain extent where the relationship is one-way. The professional doesn't disclose himself to the client and on the other hand although the client discloses a part of himself with the aim to achieve the goal the professional have much more concern on the client, than the client has on the professional. Confidence and trust are key factors in this whole relationship. Although the professional is the one which advice on the subject matter, the decision must be made freely by the client.
Storr's statement is seen as a fact in the film One flew over the Cuckoo's nest (1975) orientated in a mental institution. A new and rebellious patient is brought to a small mental institution where his antics endear the other patients to him and incur the wrath of the stern and repressive nurse who runs their ward. We see that there is a clear detachment and boundary between the patients and the professionals - not only this! The professionals are seen as authority and superior from the patients who must be obeyed at all costs. There was a quote which shook and I personally do not agree, where the professional sees McMurphy as a subject and infers that he is going to be studied and treated.
"We are going to study you, we'll make our determination as to what we are going to so and give you the necessary treatment"
The protagonist, McMurphy constantly antagonizes Nurse Ratched and upsets the routines, leading to constant power struggles between the inmate and the nurse. He runs a card table, captains the ward's basketball team, comments on Nurse Ratched's figure, incites the other patients on the ward to conduct a vote on watching the World Series on television, and organizes a supervised deep sea fishing trip.
Nurse Ratched showed no attachment regarding her patients. She controls the patients in the ward through a combination of rewards and subtle shame. Nurse Ratched can be described as the tyrannical head nurse of this mental institution, who exercises near-total power over those in her care, including her subordinates. She will not hesitate to restrict her patients' access to medication, amenities, and basic human necessities if it suits her needs. Her greatest success is with Billy Bibbitt, from whom she can get everything she wants to know under the threat of informing his mother. McMurphy's fun-loving, rebellious presence in Ratched's institution is a constant annoyance, as neither threats nor punishment nor shock therapy will stop him or the patients under his sway.
In the group therapy rather than listening to what the patients had to say she said everything herself leaving the patients to comment on each other's experience. This often resulted with judgmental statements showing lack of communication resulting in chaos. The patients in this mental institution didn't have a say in what they wanted. His reaction after failing to lift a heavy shower room control panel (which he had claimed to be able to) - "But at least I tried." - gives the men incentive to try to stand up for themselves, to do their best instead of allowing Nurse Ratched to take control of everything they do. Being objective Nurse Ratched lack of understanding caused the suicide for one of the patients, Billy. When she saw Billy dead all she could think about was going back to the routine. Nurse Ratched blames McMurphy for the loss of Billy's life. Enraged at what she has done to Billy, McMurphy attacks her and attempts to strangle her to death, he nearly chokes her to death in a fit of rage, Nurse Ratched has him lobotomized. However, the damage has already been done, and Nurse Ratched's rule is broken after McMurphy's attack leaves her nearly unable to speak, which renders her unable to intimidate her patients, subordinates and superiors.
The professional/client relationship is defined by boundary. These types of boundaries are safe connection between the professional and the client and are supposedly based on what the client needs not wants. This boundary can be violated when the professional needs exceeds the needs of the client and uses the client as an expense for his own good. Professional boundary can be also explained because of power imbalance - that is the professional as having more power than the client. This power exist by virtue as the client has faith that the professional will behave ethically "do good" and cause no harm. The professional is expected to be the one responsible in maintain the boundary independent of who is pushing it
The film Adam Patch is based on a true story which tells the journey of Hunter Dohrtey towards an "unconventional" approach to medicine. His philosophy is based on treating patients through humour and compassion. The film opens up by Adam Patch admitting himself to a psychiatric hospital. When Patch had a session with the doctor, the doctor just heard what he said without making eye contact and listening to him. This contrasts with Patch as he tried to understand the patients and their world-view. He saw them as a tool where he could learn something from them because they are in fact people that can give something to society. When Adam Patch enters Med school the doctor/teacher :
"we are going to make doctor out of you"
The teacher doesn't practice what he preaches and he sees the professionals as having power over the patients wince they are vulnerable. He also credits this profession as being prestigious.
To help and encourage Patch there was C.Fisher. To continue with the issue of boundaries Fisher gave help to a disturbed patient, Lawrence "Larry" by visiting him at home. Larry turned out to be far more disturbed than anybody had expected, and he murdered her, turning the shotgun on himself soon after. Storr's statement in this film, is correct in a certain extent. If Fisher maintained the relationship with Larry objective and detached as much as possible she would not have been killed. Apart from that I think that you should not trust a patient especially the intention is unknown. If a professional becomes attached to a client there might be consequences in the sense that the professional will not see the relationship objectively. The boundaries may result being safe to both the client and the professional. Having knowledge of both sides of the coin not only helps to safeguard your client right but also give the professional a key risk management tool.
In this film it comes clear how the head wants to create a clear-cut boundary between them (doctors) and the patients and he refuses Patch Adams ideas of the boundary and agreeing with Storr's statement. He says to Patch Adams:
"Because what you want is for us to get down there on the same level as our patients.. to destroy objectivity all too uphold some idealistic buddy system that will allow you to work through your own feelings of inadequacy."
The professionals most often forget that the client is in the need. In this film there is the example where the women lost her husband and all the hospital cared about was following medical procedures and getting her to sign forms before she can see her dying child.
In this film there is a contrast between what two professionals want. Adam Patch wants that "doctors and patients will work side-by-side as peers" while C.Fisher responds that she wants the white coat, she wants people to call her doctor more than anything else.
The intent of the professional's action or words might be different from the impact felt or experienced by the client. In Patch Adam's the doctor sought to explain the disease to thirst year students. Three points came out from this scene which struck me. First, he didn't address the patient with her name as if she was just a number and interesting disease. Secondly, he used difficult medical terms as possible treatment to her disease which involved the word "amputation" and this scared the patient, showing a lack of insensitivity from the doctor. Third, the doctor seemed immune in sensing the pain and fear in the patient's eyes. This contrast which patch Adams which sees the patient as a disease and he believes that with his sense of humor people will increase their health.
At the end of the film, after being dismissed two times from the Med school and running a clinic, practicing medicine without a license he is put upfront the medical front. Patch is able to convince the board in a final speech that he did his best to help the people that came to him, stating that treating a disease of the body is a win-or-lose situation, but treating a person's spirit guarantees a win regardless of the outcome. Dr. James Stonehill, a renowned urologist, agreed with Adams' contention and this understanding between the two men became a focal point of the film. Later in the movie, Adams encourages medical students to cultivate relationships with nurses and learn their interviewing skills early, and argues that death should be treated with dignity and even humor. In the end the jury accepts Patch's medical methods and decides to allow him to graduate. He receives a standing ovation from the packed hearing room.
The professional in my opinion, must work objectively within the boundary because of three things which come in mind: (1) emotional attachments towards the client (2) to treat all clients equally (3) to safeguard the professional own safety. But in contrast to this, I think that sometime for the client's best interest you have to step out of the boundary, maybe you have to disclose personal experience which is similar to the client, so that he might feel better - obviously this has to be done cautiously since the professional on the one hand must not use the client to displace his feelings on. After all a professional is a human being like everyone else and knowledge and skills doesn't make him a superior entity in which life experience didn't get to him. The professional is in a powerful position in the sense that the professional can make or destroy people/clients/patient/service-user.