21. People in particular roles
CHAPTER OBJECTIVES
Individuals may fulfil many roles during their lives, for example, carer, colleague, parent, single parent and student. These roles make particular demands upon the individual, which may have a variety of effects depending on their stage of life. One role most individuals fulfil at some stage in their life is the role of group member. Health professionals experience various groups in their role and thus the last scenario in this chapter is about the groups found in the health professions. This scenario is unique and thus there are unique steps to follow for the small group activity that occurs at the end of the chapter.
SMALL GROUP ACTIVITY: PARTICULAR ROLES
Carer
Colleague
Parent
Single parent
Student
• Define these particular roles.
• List some of the specific behaviours that might be typical of a person fulfilling these particular roles.
• List the negative emotions individuals fulfilling these roles might experience when relating to a health service.
• List possible explanations for the emotions someone fulfilling these roles might experience when relating to a health professional.
• List principles for effective communication to remember when communicating with a person fulfilling these particular roles. Give reasons for the need to remember these principles.
• Suggest strategies for communicating with a person who fulfils these particular roles. Decide why you might see such a person in your particular health profession.
• Check your answers against the information below, noting any additional thoughts or ideas.
A person who fulfils the role of carer for a person seeking assistance
(Key words: carer, legal and informal, long-term, caregiver, guardian)
Definition of a carer
A carer is someone who cares for a person with atypical health full-time or for more than a designated number of hours each day. (The designated number of hours varies according to legislation.)
Carers might be
• Spouses, daughters, sons, siblings, close friends of the same or opposite gender and sometimes neighbours
• A person who is paid to provide care, by either the government or the family of the person who requires care.
Behaviours related to being a carer
The behaviours of a carer will vary according to the age of the carer and the condition of the person requiring assistance. A carer might
• Act as an advocate for the person, always indicating their needs and desires
• Be constantly doing things for the person, regardless of the abilities of the person
• Exhibit non-verbal behaviours that appear opposite to their verbal messages.
Possible emotions a carer might experience
A carer might experience emotions related to
• Fear
• Anxiety
• Confusion
• Depression
• Grief
• Anger
• Inadequacy
• Desperation
• Loneliness
• Denial of the problem
• Hopelessness.
Possible reasons for these emotions
A carer might experience these emotions because of
• Spending all their time caring for the person
• Social isolation
• Responsibility and stress
• Limited knowledge about and skill in caring
• Loss of hope
• Confusion about the implication of recent needs that have resulted in seeking assistance from a health professional
• Fear of and anxiety about the future.
Principles for effective communication with a carer
When communicating with a carer it is important to
• Demonstrate empathy and sensitivity
• Make introductions
• Listen actively
• Give encouraging comfort
• Validate
• Answer any questions clearly and honestly
• Provide clear and well-organised information about the health service and any services or organisations that will provide assistance and support.
Strategies for communicating with a carer
• Do not avoid the issues – be prepared to respond to the obvious and stated needs of the carer.
• Be prepared to respond to the non-verbal behaviours of the carer – they may send a different message to their words.
• If necessary, refer the carer to other appropriate health professionals or organisations.
• If appropriate, confront the fears and feelings of the carer.
ROLE PLAYS
Role-play the following scenarios. Before acting the roles you may wish to decide what type of assistance Person 1 requires. If it is not possible to role-play these scenarios, consider and explore the possible responses and communication strategies that will achieve effective communication and family/person-centred practice.
Scenario one: The male and the health professional
Person 1: Your name is Steve. You are 39 years old and married to Marie, who was diagnosed with multiple sclerosis (MS) 7 years ago. You have recently reduced your hours of work to assist Marie with the maintenance of the house, her personal care and mobility, as well as your two children. Marie was falling at home while you were at work, so you reduced your hours to be with her when she most requires assistance. You accompany Marie to every appointment with the health professionals and you know them all quite well. You sit in the waiting area, feeling tired and distressed by Marie’s recent deterioration. You are not sure but you think you need to resign from work and live on your savings and a carer’s pension. You find it increasingly difficult to fulfil all the roles you have and you are not sure how you will manage when Marie finally dies. You stop, shocked at the thought – you would rather call it ‘passing on’. Your religious beliefs have been very important to how you manage your emotions and friends from church have been supportive, often cooking meals, doing housework and mowing the lawns for you. However, you are very tired and feel like you need a rest.
Person 2: You are the health professional responsible for the needs of Marie, a person with MS. Marie is being seen by a health professional with different expertise today and you have decided to use the time to talk with her husband, Steve.
Person 1: Your name is Genevieve and you are the main carer for your 6-year-old son, Damien, who has cerebral palsy (CP). Damien is a boy with a wonderful sense of humour who is confined to a wheelchair. Although you usually anticipate what he wants, he communicates using sounds, gestures and an augmentative communication system. You are also providing meals and some house maintenance for your ageing father who lives in the next street. You are tired and wondering how you can continue to care for both your son and your father. So much with Damien takes so long; you want to encourage him to feed himself and do some of his dressing himself, but it takes much longer when you give him time to do things for himself and you do not feel you have the time.
Person 2: You are a health professional who has not met Genevieve before, but have been working with Damien on school days. Genevieve has arrived early today and you go to meet her. You are committed to family/person-centred practice and want to find ways to encourage Damien to feed himself at least a few teaspoons of food every day instead of being fed everything.
GROUP DISCUSSION
As a large group discuss the observations, emotions and outcomes of the role plays. Suggest possible alternative strategies that may increase the effectiveness of the communication in a similar situation.
A person who fulfils the role of a colleague
(Key words: team, multidisciplinary team, interdisciplinary)
Definition of a colleague in the health professions
A colleague in the health professions is
• Any other professional whether inside or outside the health service who works with the health professional to assist vulnerable people
• Any other worker who supports the health professional to assist vulnerable people.
Attitudes and/or behaviours expected of a health professional
A health professional should be
• Professional
• Ethical
• Reliable
• Respectful
• Punctual
• Caring
• Interested in people
• Committed to caring
• Sacrificial
• Willing to assist
• Self-aware
• Thoughtful
• Diligent
• Supportive of colleagues
• Reflective
• Reflexive
• Accepting of differences
• Observant.
Attitudes and/or behaviours not expected of a health professional
A health professional should not be
• Self-serving
• Self-focused
• Non-reflective
• Personally ambitious
• Lazy
• Judgemental
• Sexist
• Sexually predatory
• Resistant
• Uncooperative
• Slovenly
• Non-reflexive
• Racist.
Possible emotions a colleague might experience
A colleague might experience emotions related to
• Frustration
• Grief and loss
• Disappointment
• Feeling misunderstood
• Betrayal
• Isolation
• Feeling unvalued
• Feeling inadequate.
Possible reasons for these emotions
A colleague might experience these emotions because of
• Personal experiences that occur outside the work context in family or social relationships
• Their own attitudes and behaviour at particular times
• The attitudes and behaviour of other colleagues
• Unmet expectations
• Accidents either at work or in their personal life
• A person dying either at work or in their personal life
• Attempts to fulfil the unclear expectations of others
• Limited resources and pressure of work.
Principles for effective communication with a colleague
When communicating with a colleague it is important to
• Use holistic communication
• Listen actively
• Validate
• Clarify
• Understand
• Confront
• Show sensitive honesty
• Give encouraging comfort
• Be assertive.
Strategies for communicating with a colleague
• Demonstrate colleague-centred communication.
• Balance acceptance of the colleague with confrontation that empowers them to change inappropriate attitudes and behaviours.
• Do not assume understanding of the behaviour of a colleague.
• Demonstrate unconditional positive regard despite the differences.
• Use ‘I’ messages to communicate both your negative and positive emotions to a colleague.
ROLE PLAYS
Role-play the following scenarios. Before acting the roles you may wish to decide what type of assistance Person 1 requires. If it is not possible to role-play these scenarios, consider and explore the possible responses and communication strategies that will achieve effective communication and family/person-centred practice.
Scenario one: The male and the health professional colleague
Person 1: Your name is Ian and you are a single parent with three school-aged children. You are often called to emergencies with the children and find it difficult to balance life with work. You love your work as a health professional and have excellent relationships with your colleagues and the people you assist. You work efficiently and always have positive results.
Person 2: You are new to this health service and you are Ian’s immediate supervisor. You have noticed that he often arrives late and leaves early without explanation. He works efficiently when he is at work and everyone thinks very highly of him. He appears to have excellent relationships with everyone, as well as positive outcomes. You have a supervision meeting with Ian scheduled for today.
• What are your aims for this session and why?
• Role-play the session when you have established those aims.
Person 1: Your name is Paula and you have a very busy day of work scheduled in your health service. A colleague notices your schedule and offers to assist you. You are quite surprised because this colleague often appears to avoid work. Together you agree that they will do some easy administration tasks due today that your supervisor has allocated to you. You clarify when they must be done, how to do them and where to place them upon completion. Throughout the day you notice your colleague chatting and reading a novel and you hope they have done those tasks. You have no time to do them yourself. At the end of an exhausting day, you are with this colleague and your supervisor asks for the tasks the colleague had agreed to complete. You look at the colleague, who looks away, and say you have not had time to complete them. The supervisor is not happy that you have not completed these specific tasks and says they hold you responsible. The colleague listens and says nothing. You are angry because you had no time to complete them today. You are now in the room with the colleague, you feel angry and you……. (decide what to do).
Person 2: You are the colleague who offers to assist then chooses to chat and read instead, thinking that you will get to those tasks later. As the day disappears you think I can do them tomorrow. You watch the supervisor talk to Paula but you cannot see the problem – you said you would do them and you will try to remember to do them tomorrow. You find it difficult to understand why Paula is angry.
GROUP DISCUSSION
As a large group discuss the observations, emotions and outcomes of the role plays. Suggest possible alternative strategies that may increase the effectiveness of the communication in a similar situation.
Health professionals have a responsibility to care for themselves, their colleagues and those seeking assistance. Reflection is beneficial in achieving this care in a manner that considers the needs of all communicators within the health professions.
A person who fulfils the role of parent to a child requiring assistance
(Key words: parents, foster-parents, role models, family, legal guardian, uncertain)
Definition of a parent
A parent is someone who
• Has been part of creating the ‘child’
• Is legally responsible for the ‘child’
• The ‘child’ views as their parent or parent figure – their protector, provider and model.
A ‘child’ is someone who has a parent and may be of varying ages.
Behaviours related to being a parent
The behaviours related to being a parent will depend on the age of the child. Such behaviours are often related to the feelings the parent is experiencing.
For a young child a parent might be
• Protective and even angry on behalf of the child
• Anxious to understand everything related to the child
• Controlling of the child
• Able to coax the child into engaging and being involved in the process
• Able to reassure the child and provide safety for the child.
For an adolescent ‘child’ a parent might be some of the above and/or
• Protective and overbearing
• Accusatory, depending on the cause of the need for a health professional.
For an adult ‘child’ the behaviour of the parent might depend on the quality of the relationship with the ‘child’ and the nature of the reason the ‘child’ is seeking assistance from a health professional.
Parents most susceptible to experiencing difficulties when attending a health service
The parents susceptible to experiencing difficulties when attending a health service may be those who
