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.

Golden Hello

The Local Government Association stated yesterday that the public castigation of social workers in the UK through a variety of media outlets has had an impact on the recruitment of staff. This isn’t any great surprise after all, I’ve had to justify my choice of profession to random people I meet in a social context more than ever over the past few months.

I won’t be embarrassed by it although it seems that’s pretty much the way the government is happy for it to go judging by their pandering to the tabloids.

image *Micky at Flickr

So it was interesting to note that the government also announced a plan to offer graduates places on a ‘National Management Trainee Scheme’ along with payments of £20 000 to trainees who enrol on the programme run by the ‘National Skills Academy’ (oh, that makes it really clear).

That, along with the lately announced CareFirst scheme to put 50,000 long term unemployed people into the social care workforce through training – which sounds at least potentially positive.

It’s a bit confusing though- for me anyway. Phil Hope, the Care Services Minister says he wants to

lure experienced graduates, managers and leaders from the private sector into the social care sector

and he thinks a £20 000 package from the ‘National Skills Academy’ will do this?

Is he looking at new graduates or at ‘luring people from the private sector’ because while I can see £20 000 being very tempting to new graduates, I’m not sure it would be so much to those who are already successful (because we don’t want the unsuccessful ones, right?) private sector leaders.

I had a nose around the National Skills Academy site. I didn’t know what it was and had never heard of it. Honestly though, the language and government-speak just made me run scared from it. It did however, mention a little about this graduate scheme saying it will establish

A new trainee scheme with equal status to local government, central government and health schemes. Intended to identify future leaders in any setting and give entrants a rounded experience of different types of employment. Entrants could be new to social care or existing staff, with an emphasis on increasing the diversity of people in leadership roles.

Maybe I’m over simplistic and over idealistic but I can’t help thinking the £20 000 would be better spent training up front line social workers and providing substantial and useful on-the-job training for newly qualified social workers (that the universities seem unable to offer as a matter of course)  rather than pumping the money into the management system which already suffers from too much detachment from the front line services.  Good management is necessary but I am of the mind that a manager should always be prepared to do for themselves what they ask others to do. That might be a little simplistic but it’s generally served me well for although I’ve never managed people directly, having worked for many years providing direct care has informed what I ask care homes and care agencies to do enormously.

I know I shouldn’t be so cynical – after all – maybe it is a genius idea that is the government’s way of solving all the problems.. the government created.

I just can’t help it though. Years of being micro-managed and de-skilled through frankly ineffectual management and being told at regular intervals how important re-organisations are again, and again and again at the expense of the actual relationship-building work and support and advocacy work which makes a real impact on the lives of those who we work with can become a teeny bit disheartening.

I’m not ready to give up yet though. My aim is to change from the inside but more and more I can see myself drifting into the voluntary sector eventually.