Quality of care

Odysseus

I'm just wondering about this topic at the moment, that is the question of unpaid leave which those of us working in the HSE [I think there are a few of here] will experience over the coming months and its impact on the service we provide.

Now I now we all come from various theoretical positions but one thing is constant, we supply a therapy service.

Now my work is done over a long period of time in a significant amount of cases, Like us all I work with some people who have been very damaged by life experiences; I work with a lot of death, bereavement, abuse and ongoing violence. One of my failings is around self-care; I have a tendency to get slightly anxious around my diary. By this I mean organising leave, so I find myself trying to do the impossible when I take a day or two off. That is is trying to fit everybody in.

It doesn’t always work this way, as I have monthly meetings and stuff like supervision to attend; however, when I start working with a client, I aim to have a set time on a set day and that is their time. For example, I have the same patient at 9.30 every Monday for the past six months. Now of course there have been missed sessions for various reasons, but I’m sure most of you get the point.

So whilst it is still early days around this issue, I don’t think anyone knows how it is going to work yet. My thoughts are it will be so many a month or quarter, so it will be another blank page in my diary, which means I will be saying to someone I won’t be here next Tuesday, how about [insert whatever date]. So some extra pressure on me, but I will just have to manage that; but it’s less time for clients.

I just wondering if anyone has any thoughts around the impact this will have on their clinical work? I acknowledge it is not the end of the world, but I think it will have implications for our work practice

Please do not post anything about the public sector and how reductions are needed. There are enough of these threads in other places. I would like to keep this focused on the question at hand; and that is do you think this forced leave will have much of an impact on the service you supply?


So anybody any thoughts?

Kooli

Any concerns I have about this solution in terms of quality of care are more to do with the caseload that my service deals with, rather than the individual clients.

If all of us are required to absent for 12 extra days, or however many they are proposing, then a service which is already creaking at the seams will be unable to cope with demand. I don't really know what we'd do about that.

As for individual clients - you mentioned self-care, which I think is such a HUGELY important part of our work, and has to be used as a preventative measure, not after-the-fact.

We already take 4 weeks off per year (or whatever your employer allows), and we have to trust that our clients can cope with that, or make other arrangements for them. We will have to see it the same way if there is more time off involved. A lot of private practice counsellors take at least 6 weeks off a year, and I'm sure they're all the better for it.

So my issue would be the effect it will have on the amount of clients we can see in any given year, rather than the effect it will have on my clients having to do without me for additional days throughout the year. It will definitely be a scheduling nightmare though, and I'm sure lots of the clients won't be happy with it.

JuliusCaesar

Well, I get 25 days annual leave + public holidays (about 9 a year) + study days (1 or 2) + attend meetings (as few as possible ) + attend supervison/provide supervision + teach + admin work....Although clinical hours (face to face time with clients) make up the bulk of my work activities, I do a lot of other stuff too. The extra days won't make a difference to me or my clients. They'll make a good bit of difference to me, as I'll get a chance to catch up with stuff that ends up squeezed into weekends and that I have difficulty doing when working full-time; so it improves my self-care!

However, as Kooli above says, add them up and yes it will make a difference to the services as a whole.

PS Odysseus, what do you do with your Monday clients when a Bank Holiday comes along?

Odysseus

Cheers for the responses, well it looks like I was a tad early off the mark on this. Apologies for the delay in getting back to to this I was out of the country for a while.

JuliusCaesar wrote: »

PS Odysseus, what do you do with your Monday clients when a Bank Holiday comes along?

In those cases I just had to cancel, I cover different clinics and in cases like above, I just have to leave it until the following week. If it was important that the person be seen I would offer them a space in another clinic in the same area.

As I said I aware that its a personal weakness of mine and it doesn't effect me too much. However, anxiety around arranging sessions is something that I do bring to supervision. I am generallly quite good at issues like that, by that I mean I carry very little of work around with me once I leave the building, but in cases where you don't know if the person will be alive for the next session or they are in an ongoing abusive relationship, its difficult to stop it popping back in to my mind occassionally, but thankfully that's where supervision comes in.