Support Worker Role

Support in a health and wellbeing setting consists of providing assistance to meet a person’s health and wellbeing needs. It should aim to maintain, improve, or restore a person’s independence and/or interdependence by using the person’s existing strengths and appropriate resources.

A support worker needs to develop and maintain relationships that focus on the intended outcome/s for the client.

It is crucial for support workers to maintain a non-judgmental and client-centred approach, respecting the client's values, beliefs, and preferences and working collaboratively with them to achieve their goals.

Reflection 

Consider the following image and imagine that this person is a friend or family member.

1. Did you find this image evoked some assumptions and value judgements?
2. What types of support would you hope this person would receive from their support workers?
3. Why do you think it is important for support workers to avoid imposing their values onto their clients?
4. What negative impacts do you think it could have on a client and the support worker's relationship if a support worker imposed their own values onto the client?

As you work through this module, consider how your own values may impact your ability to provide non-judgmental and appropriate care to potential clients.

The aim of the health sector as a whole is to provide equitable health care to all New Zealanders. The Let’s get real framework provides seven real skills to assist in achieving these aims.

Activity

Click on this link to display the Te Pou website and watch the video called An introduction to Let’s get real.

While the seven real skills of Let’s get real were initially developed for mental health, addiction and disability services, Let’s get real can be used by all healthcare services, regardless of context, organisation, role, or profession.

Let’s get real was developed by the Ministry of Health in 2008 and refreshed by Te Pou following sector consultation in 2018.

Te Pou

Te Pou is an organisation set up to improve the services provided in mental health, addiction, and disability services.

For more information about Te Pou, click the following link to access their website Te Pou | Evidence-based workforce development | Te Pou

Activity

Answer the following questions on Let's get real.

Here in New Zealand, support workers in the health system are responsible for providing essential care and support to clients under the direction and supervision of qualified health professionals. Support workers play a critical role in the delivery of health care services, particularly the community settings where they are often the primary point of contact for persons in need and their families.

According to the New Zealand Ministry of Health (2021), the key responsibilities of support workers in the health system include:

• Providing personal care and assistance with activities of daily living, such as bathing, dressing, toileting, and feeding.
• Administering medication and monitoring vital signs under the supervision of a registered nurse or other qualified health professional.
• Supporting patients and clients with mobility and exercise, including the use of mobility aids such as walkers and wheelchairs.
• Providing emotional support and companionship to patients and clients and promoting their social engagement and participation in activities.
• Maintaining accurate and timely records of patient care, including observations, interventions, and outcomes.

Activity - key skills and responsibilities

Click through the following cards to see the key skills and responsibilities of support workers and a short description of each.

Wellbeing outcomes

Overall, support workers can have a significant impact on the wellbeing outcomes of the individuals they support by providing relevant support and facilitating the social connections and requirements for meeting their clients' needs.

The specific role the worker plays can vary, depending on the setting in which they work. It may also vary based on the needs of the individuals they support. However, there are some common responsibilities across all fields:

• Emotional support: Support workers are often a source of emotional support for their clients, providing a listening ear and helping them to cope with difficult emotions.
• Practical support: Support workers may assist with daily living tasks such as cooking, cleaning, and personal care. By helping clients meet their basic needs, support workers can improve their overall wellbeing.
• Social support: Many individuals who require support may be socially isolated, so support workers can help to facilitate social interactions and connections with others.
• Advocacy: Support workers can act as advocates for their clients, helping to ensure that their needs and interests are taken into account in decisions that affect their lives.

Click on this link to display the He Ara Oranga wellbeing outcomes framework, which describes ideal wellbeing as defined by Te Hiringa Mahara | Mental Health and Wellbeing Commission.

Professionalism

Whatever your role in the health and wellbeing sector, you need to behave professionally at all times. You need to make sure that you adhere to any rules or codes that your employer uses, as well as follow New Zealand law.

What does professionalism mean?

There are many different views on what professionalism looks like. The Oxford Dictionary defines it as "The high standard that you expect from a person who is well trained in a particular job" (Oxford Advanced Learner's Dictionary, 2003).

Professionalism also encompasses an individual's adherence to a set of standards, codes of conduct or collection of qualities that characterise accepted practice within an industry.

Your own professionalism can be tough to measure. Often, your professionalism can only be judged by someone else. In the workplace, professionalism is measured against someone’s expectations or a standard that has been set by the company’s expectations, such as a code of conduct, rules or international principles. Using industry standards in a workplace environment takes a lot of this guesswork out of how you should behave.

It is important to consider that there may be differences in what is considered professional between different cultures. 

Activity

Consider the following questions, then share your ideas on the 3.2.3 Professionalism forum thread. 

1. What behaviours or activities could be considered professional, and what behaviours or activities could be considered unprofessional for a support worker?
2. Can you think of any examples of how different cultural groups could view professionalism differently?

Personal attributes

Personal attributes are characteristics that make you the person you are. Personal attributes can be:

• positive: compassionate or flexible
• negative: impatient or aggressive 
• neutral: reserved or ambitious

Some jobs will suit people with certain personal attributes more than others. For example, an event organiser might need to be outgoing, creative and organised. 

Personal attributes tend to be part of your personality rather than a technical skill that you can learn. However, it is possible to improve some traits. For example, if you are not a confident person, you can work on improving your confidence. 

Activity

Read through this list of different personal attributes. Visit the 3.2.3 Personal attributes forum thread and list the 5 attributes that you think are the most important for your role as a support worker, and give a short explanation of your reasoning.

Are there any important attributes that you would like to improve in yourself?

Working as a support worker means carrying out your duties within your boundaries. This means that you only provide support that you have been trained to give and are responsible for. Working within your boundaries may also be called your scope of practice.

Professional boundaries are those rules and limits that prevent the lines between support worker and client from becoming blurred. They are set by legal, ethical, and organisational frameworks to maintain a safe working environment for both parties.

Working closely with tangata may cause uncertainty about how far to go when carrying out your job responsibilities. Professional boundaries help us to make sense of this and can be described as the boundary between what is acceptable and unacceptable for a professional both at work and outside work.

Professional boundaries are important in support work because you work closely with your clients and will hopefully develop a friendly relationship. However, you do need to maintain a level of professional distance between you and your client. Well-defined boundaries reduce anxiety as the roles and boundaries of the relationship are clear, allowing for a therapeutic environment based on mutual respect.

Some examples of professional boundaries may include:

• not discussing a client’s private health information with others
• keeping work contact numbers separate from your personal contact numbers
• not performing additional favours for clients outside of the scope of your role

Zone of helpfulness

The 'zone of helpfulness' describes the range of care activities that should be carried out by a professional support worker. As a support worker, you need to avoid slipping out of the zone of helpfulness. An under-involved support worker could be disinterested or even neglectful, whereas being over-involved with the client or their whānau can put both the client and the support worker at risk.

Source: NCNZ Guidelines: Professional Boundaries (flippingbook.com)

Multiple boundaries within teams

Everyone in your team should know where their role in the workplace ends and someone else’s begins. For example, your role is to support the person as described in your job description and their personal plan. Your supervisor also supports the person and has been trained to carry out different tasks. Therefore, they will have different boundaries from you, the support worker.

Nursing Code of Ethics

The Nursing Code of Ethics is a good guideline for support workers in the health and wellbeing sector. This code of ethics is based on:

1. Relationships and interactions which are based on mutual respect, including respect for culture, religion, gender, sexual orientation, ethnicity and other life-directing individual and group values. An example of this is providing and working within the concept of cultural safety.
2. Respect for the individual, whānau, group, iwi, hapū and community encompasses partnership and collaboration; these are all encouraged to engage in the process of nursing and their effort, knowledge and expertise are acknowledged.
3. Relationships and interactions seek to achieve an equitable outcome for the individual, whanau, group, iwi, hapū and community. The purpose of nursing is to uphold and improve the health of all of these.

Activity

Click on the link to display the Nursing Council of New Zealand’s Guidelines: Professional Boundaries document. Read pages 5-12 and reflect on the zone of helpfulness and the activities of support workers that constitute appropriate and inappropriate professional practice in the following situations:

• When you have a pre-existing relationship with the client.
• Working with Māori clients and whānau.
• Caring for close friends or family/whānau/hapu/iwi.
• Working in small rural or remote communities.

Read pages 24-27 and reflect on the issues around accepting gifts or loans or helping with financial transactions.

Activity

Overstepping boundaries

The relationship between support worker and client is one that can be difficult to navigate at times. Realistically, boundaries may be crossed or blurred at times. This could be due to many things: stress, bad luck, bad timing or even manipulation by a client.

It is your responsibility to avoid overstepping or crossing the boundary, and if it does happen, ensure it is not repeated and leads to a violation of the professional relationship.

Examples of crossing professional boundaries may include:

• Sharing personal or intimate information.
• Flirting or indiscriminate touching.
• Keeping secrets with or for the service user you support.
• Acting as if you are the only one who can care for or understand the tangata you are supporting, positioning yourself as the ‘super support worker’.

Conflicts of interest

A conflict of interest occurs when there is the potential to undermine the worker's impartiality due to a conflict between the worker's self-interest and their professional responsibilities or the best interests of the client.