Fulfilling Career in Social Work - Assignment Example

Critical Reflection Journal Week One Journal Entry 1 In partial fulfillment of the Masters of Social Work course, final year students are expected to complete a 500 hours clinical placement. Personally, I believe that a fulfilling career in social work generally entails empowering people and facilitating positive change not only in communities but also in the individual lives of the people that one encounters (Dominelli 2009). Therefore, I felt that undertaking my clinical placement in a cancer care hospital would provide a suitable opportunity for me to empower cancer patients and facilitate positive changes in their lives. Although I was looking forward to this experience, the first day was a bit nerve-racking. Soon as I got to the hospital, I saw several cancer patients sitting at the waiting room and some walking out from the chemotherapy room looking fatigued and in pain. Immediately, I began to feel apprehensive and inadequate. My feelings of inadequacy emerged mainly because this was the very first time I had come this up-close with cancer patients and I was starting to doubt whether I was well-equipped to meet their specific needs. Latham & Fahey (2006) observe that, students in clinical placements often experience a lack of self-confidence when faced with increased responsibility for patients’ health. However, a supportive clinical environment helps to develop and restore confidence levels of practicing students. During the orientation session, I shared with my supervisors about my apprehensions and misgivings in my skills in dealing with cancer patients. Luckily, they were very understanding and assured me that it was normal to feel the way I felt. They also pledged to guide and support me throughout my placement. After the session, I felt more energized and confident. From this experience, I learnt that clinical supervision in the workplace is very important in providing support and enhancing work performance (Powell & Brodsky 2004). Journal Entry 2 Following the orientation session with my supervisors on the first day, I believe that in the subsequent weeks I started to gradually adapt to the new workplace. I became acquitted with the procedures that patients go through when seeking treatment at the hospital. Moreover, in alignment with the Australian Association of Social Work (AASW) code of ethics , I also began building collegial and collaborative relationships with different personnel at the hospital. The AASW code of conduct provides that, “Social workers should cooperate and collaborate with other disciplines to promote and expand ideas, knowledge, skills and experience that improve professional expertise and service provision” (AASW,2010). By engaging and collaborating with other health personnel at the hospital, I was able to gain new insight on how to deal with specific cases of cancer patients. Some oncologists at the hospital were kind enough to share their personal experiences while treating patients. One Oncologist specifically advised on the importance of open communication with patients. He emphasized that while giving care it is important to be open to the feelings and opinions of patients while at the same time communicating openly with patients about the reality of their situation and what they need to do in order to improve their situation (Barsky, 2009). Through my interactions with other health personnel and the guidance they provided, I began to feel some sense of belonging as though I am part of a large multidisciplinary team. One of the most profound learning experiences that I had during the first week largely involved accompanying different nurses and oncologists in the work duties and observing how they attend and relate with patients. I believe during this process I was immersed in social learning. The social learning theory holds that learning is essentially a cognitive process that occurs best in a social setting through observation or direct reinforcement (Brandell, 2010). True to the assertions of this theory, I learnt by simply observing how the different nurses and oncologists attended and related to patients. Open communication was the most common attribute that all these health personnel showcased. Journal Entry 3 One of the notable cases I dealt with during this week involved an outpatient cancer patient known as Mr. Smith (pseudo name). Mr. Smith was originally from China and could only speak Cantonese. As a result of this language barrier, my supervisor and I had to find a professional interpreter in order to effectively communicate with him. Aside from the communication challenge, another major challenge that we encountered had to do with Mr. Smith’s attitude and perception towards cancer treatment. Mr. Smith adamantly refused to be subjected to any form of treatment mainly because he believed that cancer is a ‘death disease’. Thus there is no use of undergoing any treatment since one of his friends died from cancer. In reference to the psychodynamic theory which suggests that individual choices and behaviours can be influenced by an unconscious internalization of past traumatic events or experiences (Lishman, 2007) , I strongly believe that his perception and belief (narrative) on cancer treatment was largely shaped the death of his friend who battled for a long time with cancer. Using relevant information established through research, my supervisor and I tried to persuade Mr. Smith to accept treatment but to no avail. I must confess I felt overwhelmed and to some extent conflicted. This case generally put me in a dilemma. On one hand, the AASW code of ethics demands that social workers should respect the autonomy and self-determination of patients. On the other hand, this code requires that social workers should fulfill their duty of care and act in the best interests of others (AASW, 2010). I was not sure which principle to follow in this case. Even though, I felt it was in the best interest of the patient to be subjected to treatment, my supervisor explained that unwillingly subjecting the patient to treatment without his consent would be unethical (Hujier & Leeuwen, 2000). Consequently, we had to allow Mr. Smith to leave the hospital without receiving any treatment. This experience challenged my perspective as a social worker and made me realise that regardless of one’s convictions about what is best for the patient, in order to effect positive change, the willingness of the patient is paramount (Zastrow & Krist-Ashman, 2012). Week Two Journal Entry 4 During our regular briefing sessions with my supervisors, I was challenged to come up with a suitable intervention to help the previous patient, Mr. Smith. Although we had to allow Mr. Smith to leave the hospital without receiving any treatment, many oncologists at the hospital felt that it was critical that Mr. Smith receives urgent medical attention. Thus I was charged with the duty of coming up with a suitable interventions that is line with the principles embedded in the AASW code of ethics. Drawing on the ecosystem theory which holds that most human problems and needs are generated by their interaction with the environment, I knew that in order to understand and address Mr. Smith’s wrong misconception about cancer treatment, it was important to understand his environmental context. Since individuals exist within families and families exist within communities, this theory suggest that so as to find solutions to patient’s problems emphasis should be placed on their environment (Kirst-Ashman, 2007). Similarly, the strengths perspective asserts that every family group and community group has identifiable strengths. Thus by focusing on these strengths, social workers can help patients to overcome difficulties (Gray, 2011). In reference to these two theories, I decided to contact some of Mr. Smith’s close family and friends in order to get insight on the underlying issues that influence his decision and attitude towards treatment. Mr. Smith’s eldest son Andre was particularly very helpful. He explicitly mentioned that his father was afraid of the medical uncertainty and the side effects of chemotherapy. Mr. Smith’s attitude corresponds with the issues pointed out in medical literature that have explored cancer treatment refusal (Hujier & Leeuwen, 2000). Following this revelation, I employed the problem solving practice model to dispel the patient’s misconception about treatment and help him understand the importance of receiving treatment. Through, Andre we managed to convince Mr. Smith to receive treatment. Journal Entry 5 The next patient that I worked with during this week was Mrs. T. Although she was making good progress in her treatment, she was going through some emotional and psychological turmoil. As a result, she signed up for counseling in order to get support. In order to facilitate an effective counseling session, it was essential for me develop a strong therapeutic relationship with Mrs. T. Stein-Parbury (2009) notes that, a strong therapeutic relationship can be established by creating a rapport with the patient. In therapeutic relationships, a rapport should be established from a mutual understanding and a sense of trust with the patient so as to create a special connection that will enable the patient to communicate openly (Stein-Parbury, 2009). In order to realise this goal, I had to demonstrate sincerity, care, empathy and trustworthiness. I also had to employ some interpersonal skills in order to effectively get through to Mrs.T. Interpersonal skills generally entail the total capacity to effectively communicate with others through the use of verbal and non-verbal skills such as facial expressions, gestures and posture (Stein-Parbury, 2009). By creating a rapport with Mrs. T in the initial sessions, she gradually began to communicate openly. During one of the counseling session, she revealed that her emotional and psychological turmoil mainly stemmed from her dysfunctional family relationships. She felt that her daughter whom she lived with did not care or offer any emotional support as she went through her cancer treatment. Moreover, she felt that her daughter’s parenting skills were wanting. After conducting a psychosocial assessment, I made another appointment with Mrs. T. Due to the sensitivity of her case, I decided to consult with my supervisors on how to address the patient’s situation. I must admit, I was beginning to experience some sense of self-doubt. I was not sure whether the approaches I intended to use would help Mrs. T realise positive mental and physical health outcomes. After speaking to my supervisor, she urged me to challenge the patient to be more proactive about her situation rather than just listening to her. This advice helped me to address this case effectively. Journal Entry 6 The past few weeks of my clinical placement have helped me to recognise that confidence is an extremely important aspect of practice. Confidence plays a major role in enhancing one’s learning process and overall professional development (Barsky, 2009). Drawing on different experiences I had with different patients, I realised that despite of my lack of confidence, the knowledge and skill set that I required to deal with various patients was within my knowledge base and scope of practice. As a result, I felt it was important for me to believe in myself and exude more confidence while dealing with patients. In one particular incident, my supervisor allowed me to attend a session he was facilitating. The session involved a widowed elderly patient who was regularly being abused by his step son. Despite of the constant verbal and physical abuse, Mr. Green declined to report his step son to the police. This scenario elicited certain ethical issues set in the AASW code of ethics. This code of ethics demands that social workers should respect the autonomy and self-determination of patients while at the same time requiring them to fulfill their duty of care and act in the best interests of their patients (AASW, 2010). In the course of this session, I watched keenly as my supervisor confidently employed the problem solving approach and helped Mr. Green understand his problem and brainstorm on possible solutions. At the end of the session, they were able to find a middle ground that would promote the patient’s overall mental and physical well being. I also noticed that during this session, my supervisor employed a task-centered approach and helped the patient to break down his problem into small achievable tasks. At the end of the session, I could see that Mr. Green felt more hopeful and empowered to deal with the challenges in his life. Contrary to my initial belief that social work practice should focus on finding solutions for patients, I learnt that if patients are effectively guided and challenged they can find their own solutions (Brandell, 2010). References Australian Association of Social Workers (AASW) (2010). Code of Ethics. Retrieved August 20 2012 Barsky, A.E. (2009). Ethics and Values in Social Work: An Integrated Approach for a Comprehensive Curriculum. London: Oxford University Press. Brandell, J.R. (2010). Theory and Practice in Clinical Social Work. London: SAGE Dominelli, L. (2009). Introducing Social Work. Cambridge: Polity Press. Gray, M. (2011). “Back to Basics: A Critique of the Strengths Perspective in Social Work”. Journal of Contemporary Social Services 92(1), 5-11. Hujier, M. & Leeuwen, E. (2000). “Personal values and cancer treatment refusal”. Journal of Medical Ethics 26(5), 358-362. Kirst-Ashman, K. (2007). Human Behavior, Communities, Organizations and Groups in the Macro Social Environment. An Empowerment Approach. London: Cengage Learning. Latham, C., & Fahey, L. (2006). “Novice to expert advanced practice nurse role transition: guided self-reflection”. Journal of Nursing Education, 45(1),46-48. Lishman, J. (2007). Handbook for Practice Learning in Social Work and Social Care: Knowledge and Theory. London: Jessica Kingsley Publishers Powell, D. J & Brodsky, A. (2004). Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods. San Francisco: Jossey-Bass. Stein-Parbury, J. (2009). Patient and Person: Interpersonal skills for nurses. (4th ed.). Sydney: Churchill-Livingstone, Zastrow, C. & Krist-Ashman, K. (2012). Brooks/Cole Empowerment Series: Understanding Human Behavior and the Social Environment. New York: Cengage Learning. Read More