Practical Dilemmas and challenges – stories to illustrate

1.       How do I balance safety with the dignity of risk-taking?

My customer wishes to go ice skating with friends, but is normally a little unstable on their feet – talk to clinicians about the risk, and if there is any health issues e.g. epilepsy that may have an impact, talk to the customer. Explain the risks, provide options and choices to consider and the pros and cons of each. Include guardians as appropriate.  Work with WHS to compile a risk assessment, and how you can deal with any issues, reducing or removing the higher, ones.  This will enable you to facilitate choice and control, whilst balancing duty of care and minimize risk.

2.       How do I minimize restrictive practice with human rights?

Essentially, you must work alongside positive behavior clinicians in this area, try to determine why a particular behavior is happening, (e.g., self-harm) – what is the function of your customer’s behavior, and what occurs prior, during and after this event.

What could be the trigger and how can we intercept early to minimize the occurrence or regularity of this behavior?  This will require frequent and regular discussion and debriefing. Interacting with your customer with sensitivity prior to a behavior and you will learn to see the signs of escalation in the approved fashion (refer to the customers Positive behavior Support plan which is tailored to them as a person).

This plan should enable you to be person-centered, whilst minimizing any safety risk to them, or others, continuing to uphold their human rights. Dealing with incidents using empathy, dignity, respect and of course, privacy is important.  Always debrief with other support workers or your leader after a behavior to determine what has occurred.

Try to determine why and what we can learn for the future, ensuring you report and feedback to your PBS team to track, monitor and measure whether approved plans are working, or require refinement.  It is also important for your ongoing health and wellbeing as incidents can be challenging to manage and require a degree of resilience and team support. 

3.       If I suspect someone is abusing my customer, how do I navigate this?

It is critical that you report this internally, or to the commission immediately as it must be investigated thoroughly by an independent person/body, and actions are put in place to ensure the customers emotional and physical safety is always prioritized.

When faced with challenges over time my best advice would be:

·         Enable individuals to change their behavior to improve their own health and wellbeing with help from PBS team members

·         Address situations where there is risk of danger, harm, or abuse

·         Support and empower customers where practical to manage their own health and social wellbeing

In summary, it is your responsibility to develop effective relationships with your customers, help them maximize their abilities and passions, uphold their human rights, dignity, and privacy. Enable them to exercise choice and control wherever practical and safe to do so ultimately helping them grow and develop – this is the essence of true practice excellence!

 Guest Blogger: Ursy Murray