Guilt, Work and Switching Off

Over the weekend, I was reading Dorlee, from the ‘Social Work Career Development’’s guest post ‘The ABCs of Self-Care for Psychotherapists’ on ‘Private Practice From the  Inside Out’.

It is a useful and interesting list that can be extrapolated for many in the social work and social care sector – and probably many other sectors and areas where we work in stressful environments to be honest.
Libby's Guide to Total Relaxation

hewgriff @ flickr

It made me reflect on some of the ways in which our organisations work and are structured here in the UK and how unhealthy some of the ways we are forced to work are.

It is easy to blame poor management in the public sector (and that’s what I’m concentrating on, because honestly, that’s what I know) and in many cases it would be a fair place to apportion blame.

I have seen so many friends and colleagues ‘burn out’ by being almost criminally unsupported in the work place – ‘learning by doing’ through the false assumption that employers make that somehow social work graduates are immediately ‘ready for practice’ due to having one statutory placement.

Placements during the course are good arenas for training but they aren’t any more than a stepping stone to practice which is one of the reasons I am so strongly in favour of an assessed year of practice prior to registration as a social worker in the UK.

The real area for exploration though is the assumptions that are made at higher management levels about what work can and is safely carried out ‘on the front line’. I wonder sometimes what happens in the higher echelons of the Adult Services (and Childrens Services) directorates in the local authorities when they set some of the strangest and oddest targets and keep feeding the pressure on to the front line managers. It seems so very very distant.

So back to ‘self-care’ and ‘switching off’ from work.  It is something that, I think, for me anyway, takes practice.

I sometimes draw on my A level economics recollections of ‘Cost Benefit Analysis’ but instead of ‘costs’ and ‘benefits’ – I have the two ‘mental columns’ of ‘Things I can change’ and ‘Things I can’t change’ (without the financial implications!)

I can’t change whether Mrs M is going to have a fall this weekend. I felt that although she lacks capacity to make a decision as to her care and placement needs, it was in her best interests to stay at home in potentially risky environment as she had, prior to her dementia taking hold, indicated she never wanted to ‘go into a home’. She knows her way around her own home and while some ‘trip hazards’ may have been removed through an Occupational Therapy assessment and actions resulting from that, she remains a bit wobbly on her feet. Do I think about her when I go home on a Friday – sure, maybe a little – but I know I’ve done everything I could and I can’t stop her falling on a Friday evening or even on a Monday morning.

Am I worried about Mr Y who I assessed last week and made a decision not to admit to hospital under the Mental Health Act? Well, a little – after all, he wasn’t well and was disturbed – but I have to follow the criteria of the Act and I genuinely didn’t feel that he met them. Yet. I can’t ‘save the world’ or prevent all the accidents and incidents that might have adverse effects happening – so I try not to over-worry about them.

I am bound by the law of course and if someone doesn’t meet the criteria for compulsory admission to hospital under the Mental Health Act and they retain capacity – there’s nothing I can do. Quite rightly. Although sometimes, that instinct that drove me into this job – the ‘wanting to help’, the ‘wanting to make things ‘right’’ – it tries to pull me in another direction and those seeds of worry can be planted to blossom through the evenings and early mornings or over the weekend.

Sometimes I have to do this consciously and logically tell myself to evaluate situations.

Sometimes the worry comes because there are things that I haven’t done at work – telephone calls I haven’t made – reports I haven’t sent – visits I haven’t made.

Time is limited. As long as I can justify the time I do spend at work, I try to detach myself from these thoughts. I could always do more but the job is one of constant re-prioritising. Sometimes I forget to do things I’ve said I’d do or follow up on things I said I would. It happens. While it is my ‘fault’, I don’t necessarily see it as my ‘failing’. I know I can account for every single minute that I’m paid to be at work – even those minutes that I’m sitting chatting to colleagues about the weekends’ television or having a cup of coffee – because if we don’t have those minutes, we run the risk of further rushed, unreflected, unthoughtful pieces of work.

Colleagues have told me since my first social work job how important it is to look after ourselves in this profession.  The spur that often drives people into social care is a wish to make a difference and perhaps a desire for self-validation – the odd pat on the head of feeling that you made a positive difference to someone’s life. Unfortunately that same trait which is usually a force for good can be used and manipulated by managers to force people to work overlong hours, not take breaks throughout the day, push people to take work home because, you know, Mr K will suffer if you aren’t able to finish the paperwork this week. They know well how to pull on our ‘conscience’ because the same happened to them when they were mere practitioners.

It’s hard to say ‘no’ when you know the people involved. I’m drawn into some of the guilt because I promised to visit Mrs P last week. Well, I won’t say promise, because I don’t put things in those terms, but I said I would – then things happen and other things seem to take over and the telephone call about this or that suddenly has to take priority – and before I know it the week is over and I haven’t seen Mrs P or written up the report that I should have or telephoned a family member to confirm dates for respite.  It’s hard not to feel that I haven’t done my job.

But by weighing up what I did and how I prioritised, I can, at least switch off and learn to ease some of the personal responsibility by redrafting and reframing it as organisational guilt and responsibility.  That isn’t to say that I slack off or try and push the blame on others – to be clear, I never do that with a service user – and always take personal responsibility there as the last thing anyone ever wants to here if they are upset, disappointed or distressed is a social worker trying to fob them off on someone else – but mentally I try and differentiate between ‘things I can change’ and ‘things I can’t’.

For me, it works. But sometimes it’s something that has to be learnt each for themselves.

11 thoughts on “Guilt, Work and Switching Off

  1. I agree with you with the poor management.
    And i take my hat off to social workers you have learnt to swtich off – not so much that they dont care but enough to still want to make a difference.

    • Thanks – I hope that I never stop caring but without taking on too much responsibility for things that it is not possible to do. One of the big problems I’ve seen is when social workers over-promise and can’t deliver.

  2. So true. Sometimes you need to have an extra half hour at lunch or you’ll literally go crazy!! 🙂

  3. Hi cb,

    Thanks so much for your very kind mention and reference to my guest post:)

    I love the way you have extended the topic…and I hold much admiration and empathy for you and your position.

    It is so very difficult to let go but try to look at it this way, by letting go to let yourself refuel, you will be ok/recharged to be able to return the next day and do your best.

    Try to look at the analogy of the parent in the airplane who must first put on the oxygen mask on her/himself before placing it on her/his child – it goes against intuition but it must be done – otherwise, the chances that both the child and parent die are the greatest.

  4. Hi, cb! Thanks so much for mentioning Dorlee’s guest post on my blog. (Would you mind, please correcting the name – It’s Private Practice from the Inside Out and the URL, if you want to include it is Thanks.)

    Dorlee’s post has certainly stirred up a lot of conversation around the internet. Your post here is evidence of the extreme stresses and heavy responsibilities that mental health professionals face.

    It reminds me of when I first went into agencies to work. I thought that my bosses were often horribly insensitive to the needs of their employers – namely MINE!

    Only after years in the field did I begin to realize that those in charge had / have a very different list of priorities than I did / do. Theirs was often to secure funding, meet state guidelines, and keep the doors open on a meager budget. Mine was to earn a decent living, take care of myself, and to help my clients.

    Once I realized what they were responsible for (and more importantly, what I was truly responsible for), I was better able to accept responsibility for my own self-care. It was a long and painful lesson for me – as it is for many mental health professionals. But, it is one that has served me well.

    cb, I’m happy to find your blog and will be dropping in again and following you on Twitter!

    • Thanks Tamara, I’ve corrected the links! Sorry about that.
      You are right about the different responsibilities. It is hard in this field to remember to look after yourself, I think, for what of trying to help everyone else.

  5. Hello

    Good post.

    I think this is where blogs score as a personal resource and source of solace. It can actually be difficult to have discussions like this with colleagues because not all teams are trusting and there’s a lot of mutual anxiety in teams under pressure. Various managers I’ve had would tell you that you wouldn’t have to be so guilty CB if you only used ‘time management’.

    By considering the use of this term in the context of various conversations I’ve had over the years, I’ve decided I’m in fact familiar with the concept of ‘time management’ having three mutually distinct meanings.

    The first is the essentially sensible set of suggestions and ideas about the deloyment of your time and energy as finite resources in which people can, based on their aptitudes, work styles and natural rhythyms, try to do their best as long as no-one is too dogmatic about the approaches that should be taken and is realistic about challenges and emergencies.

    The second meaning generally applies in supervision contexts and is a way for a manager to talk about an employee’s work performance in vague but menacing terms that help close the discussion down (ie. shut the employee up) should they start talking about unrealistic workloads, unfilled posts, insufficient cover arrangements, runaway cases, duff IT and stroppy admin support. The manager can thus retain the initiative because it is always possible to work harder and because in any list of tasks that have been tackled in an order of priority it is always possible to argue with hindsight that the wrong priorities have been used. The phrase ‘work smarter, not harder’ may also be deployed to limit discussion because having heard it, most employees will either a. not trust themselves to speak again in case they explode and throttle the superviser (this is admittedly a high risk strategy), b. lose all hope about the possibility of any further sensible discussion in supervision (the best outcome for the superviser).

    The third definition relates to the persistent optimistic belief of senior managers that by ‘using time management’ staff can bend the normal rules of time and space: accomplishing a weeks’ work in a day, being in two places at once, eliminating travel time between visits, simultaneously occupying the same physical space at the same times of day in ‘hotdesking arrangements’ etc. This may extend into the view that since our staff can alter the nature of reality in the pursuit of performance indicators, it is reasonable to assume that their stubborn and frankly sullen refusal to do so indicates what a bloody shower they really all are.

    These are easy mistakes to make for senior staff as Doctor Who is back on the telly, and if you haven’t spent a lot of time near the shopfloor recently and still can’t open attachments on your e-mails or send a fax by yourself, the control room of the Tardis might look a bit like some of the equipment you’ve seen in the area offices lately when you’re attending disciplinaries and retirement parties.

    (Yes, I personally find that black humour can also help).

    • Thanks,Guilsfield! I have indeed had to ‘time management’ thrown at me many many times over my career. Let’s look at ‘blocking days out to do paperwork’ which is fine, in theory but rarely works in practice. I do genuinely have good managers but we are all so stretched at the moment that there’s a bit of self-preservation around.

      Definitely agree about black humour!

  6. Don’t you find though, that it’s only natural for you to worry outside of your day job when you’re in social care? I’m a social worker who does a little voluntary work too. But this week I found myself concerned with a couple that I had dealt with regarding our local council. I can’t go into detail but they couldn’t obtain funding from the council for services even though they are struggling financially so I found myself scouring the net for viable charities etc that could offer them help and support. Think it’s only natural that if you’re a caring person anyway you’re going to have it spill over into your daily life. You wouldn’t be in social care really if you didn’t let it affect you at some point.

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