has been home unwell so she hasn’t been able to get much sleep during the day. Her husband has had to cancel his plans so that he can stay at home with their daughter and he is annoyed with her. Her own mother is also unwell and is in hospital having tests. The care home is short staffed so she is having to do more than the usual amount of work. She is called for the fifth time into the room of a new resident who is finding it hard to sleep. It is clear that the resident is physically all right but she is tearful and anxious. The care worker checks on her again and when the resident asks her to stay with her for a few moments, she says “No, I haven’t got time, I’m rushed off my feet, there’s nothing wrong with you, you aren’t the only person I have to look after.”
What are the physical pressures for both the carer and resident?
What are the emotional pressures for both the carer and resident?
How have they impacted on the way that the carer communicates?
What could she have done instead?
Knowing our limitations
Self-awareness means that we are able to recognise when we are not in a position to do our job as we would like to, or carry out our responsibilities as we are expected to. A typical personality trait of people working in health and social care is a desire to be helpful to others. We have to know when we are not able to help someone in the way that they need and be able to talk to them about alternatives, without feeling that we are letting them down. We also need to be able to tell our colleagues and managers when we feel unable to carry out a particular task or fill a particular role. Muddling through and making do can have damaging consequences for you, the service user and the organisation you are working in. Self-awareness and openness will help you to recognise when you have reached your limits and need to talk to someone else.
DEVELOPING AWARENESS OF HOW INTERNAL FACTORS IMPACT ON THE SELF
So far we have focused on how an awareness of our physical and emotional needs can help us to think more carefully about how we interact with others. Equally important and influential are more deeply rooted traits which come from our values and beliefs and how they affect our attitudes. Carl Rogers, the father of the person-centred approach to helping relationships, in writing about his own self-awareness said: “The most curious paradox is that when I accept myself just as I am, then I can change.” (Rogers, 1961, p. 17.) So, in the spirit of Rogers, this part of the chapter will encourage you to explore who you are and how you came to be you.
Values and beliefs
A value is something that is worth something or is important to us. Values can have financial or emotional worth and they can be important personally and/or professionally. They can be important to us as individuals or as part of a group. In health and social care we hopefully value ways of being, such as kindness and respect, and values like these guide us in our decision-making, our actions and the way that we interact with others. Values are often formed by certain beliefs that we hold.
Beliefs are assumptions that we make about ourselves, others and the world around us. Many beliefs are held by most cultures in the world: for example most people believe that it is wrong to take another human life or to steal, but all beliefs are dependent on environment and experience. So, there may be some cultures in which individualism and power are valued more than kindness, and these values are held dear by some individuals, families or groups of people within that culture. Whatever our values and beliefs are, they will inevitably affect the way that we communicate with others.
Cuthbert and Quallington (2008) cite Beauchamp and Childress (2001, p. 30) who highlight the values and virtues often associated with healthcare practitioners:
• compassion
• empathy
• sincerity
• discernment
• trustworthiness
• integrity
• conscientiousness
• benevolence and non-malevolence (doing good and not harming)
• truthfulness
• respectfulness.
If these virtues were skills, we could learn and perfect them and we would all be excellent practitioners, but the majority of them are dependent on our own personal beliefs and values; they are often deeply rooted within us and all we can do is become more aware of how they affect us. Sometimes our personal values clash with the professional values we need to uphold. We might all aspire to hold these values but at times they escape us and we feel irritation, anger, impatience or boredom. We might be so exhausted that all we value is sleep and food. There are times when we find it difficult to communicate because we find it hard to like or get on with someone, because their values and beliefs are at such odds to our own. In order to work ethically and to communicate effectively we need to be able to recognise when we find our values and beliefs challenged.
Our values and beliefs are not fixed, they are formed and change throughout our lives and are dependent on where we come from, who we grew up with, who influences us at different times and what happens to us. From the beginning of life we are influenced by family and culture and later we are also influenced by our education, both formal and informal, and by our friends and peer groups.
From the moment we become aware of the messages we are given, we start to form our values. Before we are even verbal we pick up on what is important to our parents. Vygotsky, a theorist who believed that children construct knowledge through social interaction, stated that “through others we become ourselves” (Vygotsky, 1966, p. 43). So, through observation and experience we pick up on our parents’ values and they become part of our makeup. For example, a child whose parents value cleanliness has her hands and face wiped many times a day. She is told not to pick things up and not to put them in her mouth, she is encouraged not to make a mess with her toys and not to get her clothes dirty. It is easy to see why cleanliness becomes a deeply rooted value and how that child, on becoming a community nurse in adulthood, might find it very challenging to visit a patient in their home which is messy, chaotic, dusty and dirty. She might find it hard to hide her shock or disapproval and communicate this clearly to the patient, who then feels judged and uncomfortable.
| REFLECTION 2.2 |
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How would you, as an interested observer, respond to the following situations?
The daughter of an elderly man in a care home phones once a month to check how her father is.
A father tells his 6-year old son that he has to practise the violin for at least three hours a day.
A child comes to school with a creased and dirty uniform most days.
A family have a picnic by the side of a river and leave their rubbish there when they leave.
If possible, discuss these situations with other people. How much do your responses differ? What do you notice about your own values and how similar or different they are to the values of others?
Values are not static, they are influenced by experiences throughout our lives and can change significantly as we grow up and form our own identities. Some are deeply entrenched and we defend them fiercely. As we grow up our values are influenced by our
