Chapter 18 – Iseult Paul (D1SOP18)

Responsibility

Social care workers are responding to a regulated sector therefore it is important that they take responsibility for managing their own workload. The next section explores this in more detail. The good news is that there are some very simple tools and strategies we can use to help us manage our workload.

The level of responsibility we have at any given time can vary and is often influenced by a number of factors. The poem ‘Social Care for Me’ gives a brief insight into this. Social care workers practise across diverse environments, with different service user groups, and their work is often conducted in difficult circumstances. The section on managing time explores ways of using time more efficiently and effectively, while introducing you to the concept of multiplying time. Social care students, especially those with no prior experience, may have expectations that they will have considerably fewer responsibilities than those they work alongside. This may be the case initially, but as students progress through college and practice placements the level of responsibility will increase. Read Jenny’s story in the case study about how her supervisor’s expectation of her ability to take responsibility for a set task differed from Jenny’s ability to perform it. Different settings, management styles, the culture of the setting and the type of work can influence the level of responsibility given to students during placements.

There is a very long list of skills required by social care workers. Lalor and Doyle (2005:160) suggest that these skills can be categorised under five headings: Communication, Assessment, Planning, Intervention and Self-awareness. As our skills develop, so too do our responsibilities, and this can lead to stress. The section on self-care highlights the importance of self-care in social care and of creating a good work-life balance. As a social care student, you have a responsibility to show up to college, do the assignments set by your tutors, achieve the standard of education required by CORU and prove that you meet the 80 proficiencies set out in the standards (see https://www.coru.ie/files-education/scwrb-standards-of-proficiency-for-social-care-workers.pdf).

Responsibility is synonymous with accountability and can be associated with capability. For example, would you be responsible for performing tasks that you are not capable of? It would be lovely to be able to say that social care practitioners are not expected to perform tasks they are not capable of, but it would be remiss of me not to note that we are often asked or expected to perform tasks we feel or think we are not capable of.

 

Sometimes in practice we learn by doing, and as a result we develop confidence in our knowledge and skills. Jenny learned by doing this activity with another member of staff, and the next time she was able to make the dinner independently. You may think the above scenario is unlikely to happen, but having to produce meals for individuals or groups of people, especially when it is your first time, can be scary – the last thing you want to do is poison everyone or appear incompetent. Learning how to cook is not on the curriculum for social care students but it is most definitely a skill required in some, if not all, social care settings. Tasks such as cooking or preparing a meal can provide opportunities to build relationships with staff or with service users, even if the cooking is not up to standard! As social care practitioners we have a responsibility to recognise and identify our own limits, and know when to seek advice from others (see Chapter 2 for more information).

 

Reflection and action planning can identify learning activities that help to build skills that lead to an increase in responsibilities (see Chapter 58, Domain 4-3). It is important to remember that you have a responsibility to show up and to conduct yourself in a professional manner in adherence to the social care code of conduct (see https://www.coru.ie/files-codes-of-conduct/scwrb-code-of-professional- conduct-and-ethics-for-social-care-workers.pdf).

It is your responsibility to have a realistic experience from each of your placements. Discuss with your college tutor or placement supervisor if you feel you are not gaining enough practice or support to meet your proficiencies and develop your practice.

Managing Your Workload

As previously noted, as your level of responsibility grows, your workload also grows.

Students are often worried about what they need to achieve to pass their course and placement, such as:

How will I make up my hours? How does theory translate into practice? Will I pass my exams, placement? What will I do for my intervention? What will I be doing? Will Ibe hanging round doing nothing? How am I going to manage my job and placement? Will I have to do personal care?

Tip: Don’t panic! You have experience of managing your own workload

Students already have experience of managing their own workload, for example attending lectures, submitting assignments on time, managing college, work and their personal/social life. Practice placements differ according to the type of service provision and the environments in which social care work is conducted. Most students starting placements will have a settling-in period, and this is good practice, but this may not happen across all settings. A third-year student will have more experience than a first-year student, so supervisors and tutors will have higher expectations of them. Learning goals and pre-placement visits will provide valuable knowledge as to what students can expect from their specific placements and gain some understanding about their workload. Do your research on the specific setting.

As you progress through college and each of your placements your workload will increase, but there are a number of tools you can use to help you manage your workload effectively and efficiently. The To-Do list is popular, and can be created very easily either the old-fashioned way, with pen and paper, or using technology, such as an app on your mobile phone or computer. It is important not to have too many items on your To-Do list, so make a list for each day or shift. The important thing to remember is to use a system that works for you.

Tip: Look up www.mindtools.com/pages/article/newHTE_05.htm for tips in preparing and using To-Do lists.

Once you have created your To-Do list, you need to review all the tasks on it and decide how you are going to prioritise them. The Eisenhower Matrix (see https://www.mindtools.com/al1e0k5/eisenhowers-urgentimportant-principle) is a useful framework that can help you prioritise tasks according to their importance and urgency. The matrix has four quadrants.

• Tasks in the first quadrant are both urgent and important and therefore have the highest priority. Tasks or decisions in this quadrant require immediate action and you must do them first.
• If a task is important but not urgent, it goes in the second quadrant – these are the tasks you can plan for. This is the quadrant we should try to manage most of our work in. (Planning is a core competency required for social care and when interviewing for jobs it is one of the competencies interviewees are asked to give examples of.)
• Tasks that are not important but urgent are those in the third quadrant, and these are the tasks you can delegate. Practice educators often delegate tasks to students on placement to free up their time so that they can focus on other tasks.
• Finally, in the fourth quadrant are the tasks, considered not important and not urgent. These tasks have the lowest priority and you might eliminate them from the To-Do list for that day or altogether. If they need to remain on the list, move them to the next day’s To-Do list.

In his book The 7 Habits of Highly Effective People, Stephen Covey expands on Eisenhower’s idea of what action needs to be taken when making decisions.

The Eisenhower Matrix

Source: adapted from Covey 1989

This exercise can assist you in identifying how best to manage your workload by planning how to use your valuable time.

If you are spending most of your time in quadrant 1 on tasks that are important and urgent, you are failing to plan effectively. If you are spending too much time on tasks in quadrant 4, like checking your emails or messages every five minutes, you are probably wasting a lot of your time. Of course, checking and answering emails is part of our job, but it is less urgent and important than tasks such as ensuring someone is safe or has assistance with personal care. Tasks in quadrant 4 may never get done, or their level of importance may change – in which case, move them to a different quadrant. Set aside specific times for emails and phone calls where possible, and get rid of the tasks that will waste time, like surfing the net for hours on end. The most important thing to do is to review your To-Do list, check off tasks completed and add new ones.

Managing Time

Time management skills are one of our core competencies.

A conversation with a friend and her son led to some reflection and thinking about how we use our time. His mother had made a remark about time going slowly, which led to a discussion about how time actually moves. He said he didn’t understand why people said this kind of thing and made the point that ‘time does not go slow or fast, it moves at the same rate each time’. This led to a debate about how people might perceive time as going quickly or slowly. The following arguments were made:

1. When we do something we enjoy, like going on holidays, or out with friends, time flies.
2. When we do something we don’t enjoy, like housework, ironing, sitting in a hospital, time drags.

To test this theory we suggested that he went to put the kettle on, stand beside it and watch it boil, then come back and tell us if the time had dragged. He pointed out that this would be wasting time. He said, ‘I could be doing some press-ups while I wait for the kettle to boil and save time.’ His point was that it would take the kettle the same length of time to boil, whether or not he was watching it. So he would use this time in a more productive way – he was using his initiative to manage his time more effectively. Social care often requires us to be creative in how we use our time. Emptying the dishwasher while waiting for the kettle to boil is just one example; going for a walk or coffee with a service user and having a ‘conscious conversation’ is another. Gordana Biernat (2016) suggests six ground rules for conscious conversations (see https://www.powertalk.se/conscious- conversation/ for more information).

Good time management enables us to be more productive, and we often try to do more than one thing at a time, but does multitasking actually save time? In the above scenario you might think that my friend’s son was multi-tasking, but let’s take this a step further and consider the idea of him ‘multiplying’ his time.

In his 2015 TED Talk, Rory Vaden, a self-discipline strategist and bestselling author, explores the idea of multiplying time (see https://youtu.be/y2X7c9TUQJ8). He suggests that people need to forget about trying to manage time and instead think about self-management. In introducing his concept of multiplying time, he makes the point that the ‘key to multiplying your time is to procrastinate on purpose’. When I was serving my apprenticeship in my previous profession, my mentor (who also happened to be my dad) always told me, ‘Don’t put off until tomorrow what you can do today.’ The concept of intentionally putting things off, and thus multiplying time, is intriguing. Time moves at the same pace – an hour is an hour no matter what – so how can we multiply it? It requires a different way of thinking, and involves looking at the significance of tasks. In order to multiply time, you must give yourself the ‘emotional permission to spend time on things today that will give you more time tomorrow’ (Vaden 2015). Vaden offers a framework called the Focus Funnel (see Figure 1), which is quick and easy to use, and I believe can serve us well in social care. He suggests that as tasks pass through the funnel the first question to ask is ‘Can the task be eliminated?’. One way of eliminating tasks is to say no to them in the first place. As social care practitioners we can struggle to say no, but we have to be realistic about what we can and cannot do, and know that it is sometimes okay to say no. Managing our workload effectively and efficiently often involves saying no to additional tasks or responsibilities. As practitioners we need to be flexible, and saying no might not be a viable option, but when we say yes to one thing we are indirectly saying no to something else.

When a task cannot be eliminated the next question is, ‘Can it be automated?’. Automating takes time but this is where spending time today can save time in the future, thus, multiplying your time. Vaden refers to this as ‘ROTI, Return on Time Invested’. Setting up databases, templates for risk assessments or for support plans, or draft email responses are examples of how this is done in practice. If a task cannot be automated, can it be delegated? We often spend a lot of time on tasks that we could have delegated to others; the reason we don’t delegate might be because we think that the other person cannot do the task or that we will do it better or more quickly. In his book Successful Time Management, Patrick Forsyth discusses the importance of investing time in order to save time. Spending time teaching others to do a task will save you time in the future, so think of it as a ROTI; or, in order to save time you must ‘Speculate to Accumulate’ (Forsyth 2019). Examples of this in social care might include teaching service users to do tasks independently, or teaching students how to run a specific activity or create support plans.

After each task has gone through the funnel and you have decided that it cannot be eliminated, automated or delegated, it drops out of the funnel. The only question left to answer is whether you should do it now or whether it can wait until later. If you must do the task now, you give yourself permission to ‘concentrate and focus’ on the task, free from other distractions. If you decide the task can be done later – what Vaden calls procrastinating on purpose – you ‘hold’ the task at the top of the funnel. At a later stage the task goes back through the funnel and this time it might be eliminated, automated, delegated or concentrated on. However, if the same task continues to be put off until later and constantly remains in a ‘holding’ position, then you should really have eliminated it, so be brave and take it off your To-Do list (Vaden 2015).

Figure 1: The Focus Funnel

The staff, particularly Ted’s key worker, have multiplied time. They don’t have to spend time doing an activity they don’t need to or have to manage preventable behaviour incidents.

You might ask, ‘Why wasn’t Ted trained to do this task before?’ The importance/urgency matrix would say it was important but may have placed it at a lower level of urgency. Staff failed to plan ahead and the task only became urgent when Ted became angry. The Focus Funnel changes our thinking in terms of how significant a task is and this particular task had been put off for far too long. The task had not been eliminated from Ted’s To-Do list (so it was still on his key worker’s list of things to do); it was important to him. The problem was that staff were procrastinating because of the time required. A little bit of creativity, a partnership approach, and time spent concentrating on making a plan led to better outcomes, thereby multiplying time. Vaden (2015) speaks about how emotions such as guilt, worry, fear and anxiety influence or dictate how we spend most of our time.

This led to reflections about how social care workers spend their time. The very nature of the work can be emotional; for example, in the service I work in, we have experienced an unprecedented number of bereavements in a short space of time. Emotions impact on how we spend our time, especially during times of grief or stress, in both our personal and our professional lives. Priorities change in such circumstances and our number one priority is supporting our service users and colleagues. Do we go look at our To-Do List for that day and see if we can place this important aspect of our work onto it and assign it a priority level or number? The answer is no. We know in this instance, or in a crisis, what we need to do; and the reason why we know is because we feel it. We all know our service users are our top priority and supporting them becomes more important than our paperwork, phone calls, emails or housework.

The first time the unit I work in experienced a bereavement, it was unexpected. As a team, we were not only upset but unsure what we should do. We had many questions:

• How do we tell the men and women in our service their friend has passed away?
• How do we support them with their grief?
• Should we cancel our activities for the day?
• Who should we contact? Who do we need to inform?
• Can we go to the funeral? How can we get everyone there?
• Is anyone coming to support us?

We spent a lot of time trying to figure out what to do that morning and how best to do it. We couldn’t have planned for this particular event, but what we did do, as a team, was reflect on the experience and the likelihood of it happening again, and we created a ‘bereavement protocol’. Having this protocol in place means that we know what to do and how to do it, and we don’t waste time. We have multiplied our time.

Spending time with service users and building relationships is an important aspect of our job, and where students often think social care workers spend most of their time. Unfortunately, the reality is different, and a lot of time is taken up with admin tasks such as writing reports, answering or sending emails, making or receiving phone calls, creating risk assessments, doing the staff rosters, budgeting, attending meetings, doing housework and so on – the list is endless. In fact, a large portion of our time is spent working indirectly for or on behalf of service users.

Self-Care

The poem above gives some idea of what social care practice is like in a specific setting (intellectual disability). It highlights the various jobs that a social care worker does, from cleaning and making tea to spending time with people figuring out what supports they need or how they would like to live their life. The poem also demonstrates the flexibility required of the practitioner, and highlights some of the emotional aspects involved in the work we do. While each social care setting is different, the truth is that all practitioners have numerous responsibilities, an ever-increasing workload and many demands on their time. Creating To-Do lists, prioritising tasks, and effectively managing ourselves and our time are all strategies we can use to develop our practice, manage our workload and be more efficient. Regardless of the setting, social care work is demanding and emotional and it requires practitioners to be not only flexible but also able to cope with all the various demands on them.

Pressures from personal lives and work lives can become overwhelming and, unless dealt with appropriately, lead to stress.

Professor Tom Cox notes that stress can occur when ‘an individual perceives an imbalance between the demands placed on them on the one hand and their ability to cope on the other’ (HSA n.d.: 6). Social care practitioners do not have a physical box filled with tools to perform their work; they are the tool box. So we need to look after ourselves and develop self-care strategies. Self-care should be considered a core competency of the social care practitioner, and as a student it’s important that you start developing and practising this skill. You may already have some self-care strategies, for example going for walks, playing sport, taking time for yourself, doing activities that promote self-care such as yoga or mindfulness. If you do not have a self-care strategy it is advisable to develop one. Believe me when I say you are going to need it, and it will be one of the strongest tools in your toolbox. Self-care strategies do not have to be expensive or elaborate; in fact, some are cheap and easy.

The trick is to have a number of self-care activities that will help you create balance in your life and prevent or, in some cases, manage stress.

Remember, if you do not look after yourself, you will be in no position to look after anyone else. Give yourself permission to make yourself a priority, put it on your To-Do list and allocate the time you need to focus on your self-care activities.

References

Biernat, G. (2016) Six Ground Rules for a Conscious Conversation. Available at https://www.powertalk.se/ conscious-conversation/

Bouffard, W. (2013) Puttin’ Cologne on the Rickshaw: A Guide to Dysfunctional Management and the Evil Workplace Environments. Available at http://puttincologneontherickshaw.com/authors-blog/if-you-fail- to-plan-you-plan-to-fail/

Business Training College (2020) ‘What is a Time Diary?’ Available at https://www.businesstrainingcollege.com/business/what-is-a-time-diary.htm

Covey, S. (1989) The 7 Habits of Highly Effective People. USA: FreePress. Forsyth, P. (2019) Successful Time Management. UK: Kogan Page.

HSA (Health and Safety Authority) (n.d.) Work-Related Stress: A Guide for Employers. Dublin. Available at: https://www.hsa.ie/eng/Publications_and_Forms/Publications/Occupational_Health/Work_ Related_Stress_A_Guide_for_Employers.pdf

Lalor, K. and Doyle, J. (2005) ‘The Social Care Practice Placement: A College Perspective’ in P. Share and N. McElwee (eds), Applied Social Care: An Introduction for Irish Students. Dublin: Gill & Macmillan.

Mind Tools Content Team (website) ‘Eisenhower’s Urgent/Important Principle: Using Time Effectively, Not Just Efficiently’. <https://www.mindtools.com/pages/article/newHTE_91.htm>.

Mind Tools Content Team (website) ‘To-Do Lists: The Key to Efficiency’. <https://www.mindtools.com/ pages/article/newHTE_05.htm>

Rampton, J. (2018) Manipulate Time with These Powerful 20 Time Management Tips. Available at: https://www.forbes.com/sites/johnrampton/2018/05/01/manipulate-time-with-these-powerful-20- time-management-tips/#f158a4357ab4

Social Care Workers Registration Board (2017) Standards of proficiency for social care work. Dublin: CORU Health and Social Care Regulator. Available at <https://coru.ie/files-education/scwrb-standards- of-proficiency-for-socialcare-workers.pdf>

Social Care Workers Registration Board (2019) Social Care Workers Registration Board code of professional conduct and ethics. Dublin: CORU Health and Social Care Regulator. Available at https://coru.ie/files-codes-of-conduct/scwrb-code-of-professional-conduct-and-ethics-for- social-care-workers.pdf.

Tygielski, S. (2019) Why You Need a Self-Care Plan. Available at: https://www.mindful.org/why-you-need- a-self-care-plan/

Vaden, R. (2015) ‘How to Multiply Your Time’ (TEDTalk). Available on YouTube <https://www.youtube. com/watch?v=y2X7c9TUQJ8>

Useful Resources

HSELanD: the HSE’s online learning and development portal – www.hseland.ie

Palouse Mindfulness: Mindfulness-Based Stress Reduction (MBSR) – https://palousemindfulness.com/