Engaging With Vulnerable People Social Work Essay

This scenario is about Jessie a 20 year old Asian woman, who has been disowned b

What is equality? What does equal opportunity mean? Critically discuss with examples of where equality is used in society. (2000 words). The subject of equality is a complex phenomenon that has puzzled high profile people such as politicians, author’s, philosophers and ordinary man on the street alike. The debate has been on the agenda for centuries and continues without the elusive answer while an inequality masquerades around the world.

This essay will define equality and explain what equal opportunity means. The essay will focus on equality and equal opportunity policies on the local authority in the UK. The essay will also consider the issue of oppression and discrimination on the basis of race, gender and sex and any other form of discrimination that may come as a result of this discussion would be commented upon.

Equality is seen by Turner (1986) as both a value and principle that cannot be divorced from the evolution of citizenship. According to Malik (2003) equality is a concept that encourages the individual to confront, challenge and refuse to accept barriers that discriminate and deny them their life chances. Furthermore, he states that equality is valuing individuals of all diverse multicultural, gender, race, disability among others and by offering and providing equal chances in society irrespective of their variation within the population. Moreover, he explain that equality does not endorse inferiority or superiority within the society but uphold each individual’s human right not to be discriminated and denied his/her equality. In addition, he sees good practice as the cornerstone for promoting equal opportunities that can be achieved by anti-discrimination and anti-oppressive practices in the work place and wider society.

In a nut shell, Thompson (2000) confirms that equality does not advocate either uniformity or to treat everybody the same. In his view treating everybody the same reinforces inequalities, in that someone disadvantaged continues to be disadvantaged when treated in the same way as the person who has more life opportunity and access to resources. However, he point out that failure to recognise and acknowledge that people are different is colluding with discrimination and regard that as maintaining the status quo. Washington and Paylor (1998) reveal that the consequences of colluding with discrimination are social exclusion which has a multidimensional disadvantage. They mention that social exclusion dislocate people from the majority of the society social, citizenship, adequate living standard, employment and economic opportunities.

According to Thompson (2000) promoting equality is more complex and cannot be reduced to treating everybody the same because it runs deeper than avoiding personal prejudice or bigotry. Furthermore, he sees challenging discrimination and oppression through anti-discrimination and anti-oppressive practice as a strategy that can be used to promote equality, (Thompson 1998). In addition, he identifies empowerment as an important strategy with the potential to challenge racism and discrimination at personal, cultural and structural levels and reckons that empowerment is a unifying theme. Adams, (1996) assert that empowerment can be subject to contest although he accept that its core elements is to help individuals to gain control over their lives. Similarly, Darlymple and Burke, (1995) identifies empowerment as a process needed to remove obstacles to progress thereby enabling an individual to tackle their problems that lead to inequality and discrimination. Adam, (1996) defines discrimination, ‘as unfair or unequal treatment of individuals; prejudicial behaviour towards another person or powerless group such as women and ethnic minorities’. Discrimination comes in different forms such as race, age, gender, disability, religion, political opinion, belief and sex.

The UK Government has devised specific Legislations to promote equality at work places which helps the individual to lodge complaints when they experience unlawful discrimination. The Legislations that support equality are the Human Rights act 1998, Equal Pay Act 1970,Equality Act 2010, Sex Discrimination Act 1975, Race Relations Act 1976 (Amendment 2000) and Disability Discrimination Act 1995. These acts are watch dogs in their own rights at work places and their implementation form the bases of good practice, (Thompson 1998). Equality is prominently advocated in many quarters in society and public work places such as the local authority council. The UK Government intentions in addressing the issue of inequality are clear with the introduction of a merged unified body of Legislations geared to promote equality notable the Equality and Human Rights Commission (EHRC, 2007). Equal rights Legislation Framework helps to curb inequality and discrimination (Malik 2003 and Thompson 1998).

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It should be noted that the EHRC seek to outlaw and deal with all forms of discrimination and has the responsibility to promote human rights. McGauran (2001) and Solomos (1989) reveal a myriad of problems associated with putting the Equality Opportunity policies (EO) into practice by pointing out the obstacles and behaviours of some organisation. They reckon that despite the legislation and the organisation claims of adopting the EO policies some members of the organisation pay lip service and that managers subvert the procedures developed. Similarly, Liff and Dale (1999) and Dickens (2000) argue that adopting the EO policies does not indicate good intentions to change but can be seen as a mere declaration of the current practice.

Jewson et al (1990, 1992 and 1995) reveals a series of reason for organisation’s adoption of EO policies; as that for legal minimum requirements to guide management behaviour; as insurance policy; to demonstrate that the organisation is responsible employer; to be seen as pursuing the spirit of equality and to fulfill the law; to deflect pressure from pressure groups, community or media; for commercial advantage; to tap wider talent; in response to particular problems emanating internally or externally and to expand client or customer base. In addition, Dickens (1999 and 2000) argues that organisations does not promote equality of individuals but merely seek positive company image, better employee relations; as competitive position in labour market; to avoid penalties such as tribunal cost; bad publicity and investigations by EO Commission and Commission of Race Equality (CRE).

Hoque and Noon, (2004) point out that those EO policies may appeal to many unsuspecting yet to them it is not worth a paper they are written on. Their observation is further justified and substantiated by high profile cases of companies in the UK such as Ford UK, Microsoft, Coca-Cola and the local authority who failed to live up to the values of EO policies enshrined in their company policy. In like manner Young (1987), Liff and Dale (1994) show that many companies claim to have implemented the EO policies while the reality tells us that in practice inequality still persist within those organisations. Moreover, they see adopting EO policies as a way to deflect the pressure groups such as the CRE away from investigating them while they privately and publicly embraces unfair practices in all forms of discrimination and prejudices with inequality thriving to its greater heights. They also argue that EO policies have no substance or value to the victims of discrimination in the work place. In the eyes of Acker (2000) and Cockburn (1991) the extent of discrimination is perceived and understood differently by those who experience it and those who do not. They reveal that people living with disability, women, and other minority ethnic groups continue to be discriminated in work places. In like manner, Colgan et al (2003) blame the UK local authority for its myriad of failures to live up to the expectations of implementing the race equality plan despite being the pioneers of such policies in the 1980s. They also witnessed the tension and contradictions that existed with the introduction of New Public Management (NPM) agenda and those underpinning traditional personnel and EO policies and practice in public sectors. The impact of NPM on segregation within the local authorities in the UK has occurred as a result of managerial reliance on internal labour market which relies on word of mouth recommendations imbued with ethnocentric, open racism and gender and sex discrimination, (Carter 2000). Similarly, Rooney, (1987) cites an example of the local authority who recruited its staff by word of mouth when vacancies arose by telling predominately white managers to tell their friends. Adam, (1996) argues that such practice systematically marginalized and excluded potential black staff. In the same vein, Mirza (1991) cited in Thompson (2001) records the government failure to identify the roles of local authorities in ensuring their community care programme actively promoted equality or accounted for the impact of racial discrimination.

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Furthermore, the stereotypical perceptions of ethnic minority and women impact on the management structures which has left the responsibility of recruitment and promotion to line managers who leaves women far behind in the packing order despite the gender equality policies, (Cunningham, 2000).

The changing political and legislative climate introduced by the Conservative government in the 80’s was heavily criticized by Creegan et al. (2003). They postulate that it demonised and progressively undermined the power and resource of the local authority in the introduction of the EO policies. Furthermore, they reveal that the equal pay bargaining, downsizing and competitive tendering as the regimes that increased the difficult that affected the local authority promotion of equality. Cunningham (2000) mentions that the consequences of the above prove it hard for the trade unions to defend them.

Dickens, (1999), Jewson and Mason (1994) and Hoque and Noon (2001) expressed their concerns of the UK local authority failure to live up to its expectation of good practice despite a long established EO policy. On the one hand they, postulate that the local authority commitment to EO has not diminished and suggest that there has been an improvement in the recruitment of black and visible minority staff.

In contrast, Colgan, et al (2003) refutes the above claims and insist that the 1997-99 NPM exacerbated race discrimination rather than eliminating or at least amelioration within the organisation. Their observation was further supported by the complaints from the staff about racism in the local authority which the CRE intervened. Siebert (2009) noticed that the traditional prejudice that men perform and succeed more than their counter part in public life is a barrier identified in the Scottish local authority council. It is believed that gender mainstreaming emerged as a new quality strategy which advances gender equality. In addition, Wirth (2001) reveal that the reports from the international labour office suggest that half of the world workers are segregated. Anker (1998) mentions that gender based occupational segregation as responsible for women disadvantaged position in the labour market.

Following the intervention by the CRE the local authority acknowledged the findings and evidence that suggested that it discriminated against the black and visibly minority and women, (Council 1999). The CRE intervention prompted a call to reinstate good practice in the local authority which was unanimously backed by all political parties in 1998. They suggest that the focus should be to eliminate institutionalised racism in the local authority employment practice. Council, (1999) also state that women highlighted the existence of discrimination within the local authority organisations on the grounds of sex. The council reported that women felt that the organisation stumbling block was a culture of white men predominance. They postulate that the majority of senior positions were held by white men leaving women in the shadows. Furthermore, they see the culture as that which is influenced by white men who measured the effectiveness of their staff on the grounds of how long they have been here; how loyal you are (i.e. not a whistle blower); how cynical you are; and how much you drink.

The revelations by the council women staff discrimination on the grounds of gender and sex suggest that line managers has adverse problems to the local authority management that contribute to gender and sex discrimination, (Glea 2000). What emerges from the above notion is that the local authority has failed to sufficiently challenge and eradicate race, gender and sex discrimination and to promote real transformation. Again, the perceived experiences by black minority ethnic, visibly minority and women remain a dent in the local authority council image in the challenge and amelioration of institutionalised discrimination. Aspinall and Mitton (2007) argued that CRE (2002) guidance set out clearly that the local council has the duty to promote the race equality, measure the progress and assessing impacts of the minority groups’ applications. Similarly, O’Cinneide (2005) concedes that the race equality as a framework seeks to promote equality to participation, equal worth as different human beings, mutual respect and representation to alleviate the impact of economic inequalities.

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Jewson and Mason (1994) joined the chorus and eloquently expressed their disappointment about the companies who adopt EO policies and not put them into practice thereby becoming perpetuators of discrimination in work places. To substantiate their concern they reveal that local authorities that do not action EO policies undermine equality and equal opportunity for minority groups and women promotion to management.

The essay showed that the government has good intentions to promote equality and to ensure equal opportunity in the local authority with the introduction of various Acts and legislations geared to achieve the aforementioned objectives. However, despite such legislations in place such as CRE, EHRC and Gender equality amongst others at work places, the black and visibly minority and women are still heavily discriminated. It also emerged that equal opportunity for men and women of all walks of life is the objectives of employment guidelines and that EO policies measures are there to eradicate all forms of discrimination and to make equality cut across all employment pillars.

y her family and now lives alone. She has recently been admitted following a small overdose of ten Paracetamol tables. She is well known to the service as she has presented artificial cuts to her wrist. Some of the staffs have prevailing belief that she is a ‘bed blocker’ and she is aware of this. In relation to this scenario I will be discussing the concepts of vulnerable people with reference to the NMC code of professional Conduct. I will illustrate how the scenario represents professional values which could be used by the staff to empower their patients, respect them and also maintain their dignity. I will also exploring anti- discriminatory practice and suggest ways of how it could be promoted. To end my essay I will be reflecting on what I have learnt from completing this assignment.

Vulnerability is dynamic. It is a general concept meaning ‘susceptibility’ and it is specific connotation in the terms of care is ‘at risk for health problems’. (Caring for the vulnerable) However, according to the Department of Health a vulnerable adult is defined as , “A person who may be in need of community care services by reason of mental or other disability, age or illness; and who is or maybe unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation. (DH 2000 restates 1997 definition) Whether or not a person is vulnerable in a certain cases will depend upon surrounding circumstances, environment and each case must be judged on its own merits. (http://www.surreycc.gov.uk)

These definitions have help to show why Jessie is vulnerable. As she is currently suffering from so form of mental condition which causes her to self harm and try to commit suicide. She has been exposed to forms of emotional hurt which in turn have made her very fragile and have caused her to act in such a self abusive way. She is allowing herself to search and probe the past for unresolved emotions, feelings or grief responses that lay at the root of current immobilized emotions, feelings or actions. (www.livestrong.com)

She is seen as a discredit to her family for refusing to marry her first cousin and runaway not knowing what the outcome will be, to a unknown place where she does not know anyone, may not even have a stable income for food and shelter.

Especially running away from a family that usually function as a unit like most Asian family do, making her even more vulnerable as this may have been the only time that she has been alone to deal with her problem without the help of her family making her feel selfless. These factors make her seem weak and emotional unstable which all make her fit in with the definition of vulnerability as she is unable to safeguard herself and maintain a normal life without the aid of health professionals and services.

Jessie needs helps and her overdosing was the only way she was going to get it she is well known to the ward as she has previously be admitted for artificial cuts nothing was done to help which could have made her more vulnerable. Going to hospital and being around health care professionals could have helped her to understand the bases of her care. She is more vulnerable if she is alone then surrounded by other people. Some people with mental health problems lack the capacity to make certain decisions for themselves, so is it right for the nurses who believe that she is a ‘bed blocker’ to sender away where she is unable to care for herself. This will just make her more vulnerable.

The Nursing and Midwifery Council, is the main regulatory body its purpose is to protect the public through professional standards which was set up by the parliament to ensure health professionals provide the highest standard of care. (www.nmc.co.uk).

As a nurse we must demonstrate professional values on the ward, for example ‘treating people as individuals and with respect’, Jessie is not treated as an individual as she is given the same menu as other on the ward but is not given the right to choose her own food, disempowering her and making her feel like she is not equal to others on the ward.

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As health professional ‘we are not to discriminate’, but Jessie cultural needs are not taken into to consideration such as her deity needs for example, is she a vegetarian or does she require halal meat.

The nurses on the ward seemed to view her as a burden and therefore did not treating her with respect. They think that nothing can be done for her the staff has given up on her before trying to help her recover.

Nurses are ‘to treat people kindly and with consideration’ and ‘also must speak openly and honestly with their patient’, but the nurse on this ward believe that she is a ‘bed blocker’ and talk behind her back which show how unprofessional they are as they have resulted to ‘gossip’. Health provides ‘must provide access to relevant health and social care information and support’, in the scenario the nurse are too busy trying to get rid of her and are not even attempting to her to help her, they could ‘make a referral if it is in the best interest of the patient’, but if Jessie is move into out patient care, is that in her best interest as she is very vulnerable as she has some form of mental disorder and she lives alone where she may end up committing suicide and succeeding. Finally nurses must ‘deliver care based on the best available evidence or practice’, for example have they try talking to her, maybe trying to refer her to talk to a psychologist. Her condition is not known maybe identifying her condition could help significantly in her care.

The value of respect and dignity are fundamental to care practice. As a health profession you should respect boundaries, the rules outlined in code of conduct. The main concern here is the values and attitudes associated with ‘respect for persons’ and their influence on your behavior and practice. (Values for Care Practice) In the scenario the nurses clearly have no respect for the patient as they talk about her behind her back and make her feel like she is less deserving then others on the ward. Maybe, if they talk to her about her needs and helping her to get discharged in a way that primarily helps her and also the nurses. Dignity in care means ‘the kind of care in any setting which supports and promotes, and does not undermine a person self respect regardless of any differences.’ (Values for Care Practice) The nurses should treat Jessie’s with dignity by not undermining her and support and promoting her care regardless of differences.

This is why Empowerment is an important aspect of a patients care, as it can be ‘determined by how much capacity a person has in making choices and the transform those choice in desired certain and outcome.’ (Class notes) The NMC is committed to empowering individual so that they can play a greater role in their own care.

The nurse could empower her by simply ask her how she felt once in a while and asking if she felt ready to go home or would like to self- discharge if they had made the appropriate referral which will assist in her care further. They could for ask when she was being admitted if she had a special dietary requirements as she may want food the is cultural specific. This would have help here to feel more respected at she is getting helped and treated with dignity by not being rudely treated and talk about behind her back. While Jessie is receiving care they could help to give her the choice to make decision of her own care if she is capable.

There are many different forms of discrimination, but much of discrimination focuses particularly on vulnerable groups like for example, older people, those with mental health problems or those of different race. (Values for care practice)

‘Discrimination literal means identifying differences, it not always negative for example discriminating against good food and harmful poison is clearly a good thing.’ (Anti-discriminatory practice) But when the term is use in a legal, moral or political sense it generally relates to unfair discrimination. It refers to a process where a difference has been identified and is used a bases of unfair treatment and this person could suffer a disadvantage. ‘ (Anti-discriminatory practice) For example, in a hospital where a nurses holds a some form of prejudice against a Jessie so they treat her unfairly by not giving them a option to choice their own food, which will have a bad implication on their health as she may refuse to eat all together.

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Prejudice is unconsciously held and can thrive in environment such as care setting and might not be recognized by those who belong to a group. For example, in Jessie case some of the nurses have residing views that she is a ‘bed blocker’. Not all nurses in general so if a new nurse joins the ward she may adopt this view unknowingly and it will become a part of everyday practice.

That why good practice is anti- discriminatory practice (ADP), it an approach to practice which seeks to reduce, undermine or eliminate discrimination, specifically in the terms of challenging sexism, racism, ageism and disablism. ADP is an attempt to eradicate discrimination from our own practice and challenge them in the practice of other and institutional structure in which we operate. (Anti-discriminatory practice)

Treating patient fairly is one of the care duties of a care practitioner. Unfair treatment increases vulnerability and cause disadvantage. This is why ADP is a positive way of ensuring that people are treated as individuals, in a fair and equal way. For example, in Jessie’s case nurses should ensure that she has equal access to resources maybe asking her if she wants to read a book or watch TV or even take part in group activities, so that she engage more with other people on the ward.

Principles have emerged from literature regarding how discrimination can be tackled in practice for example, by framing differences so that sharing different views and accepting different choice are positive, this can help patients and staff enhances their knowledge and experience.

Nurses have to work with many patients some of whom they may not like, but it is possible to find a redeeming feature or some attribute that you can admire, therefore nurses should focus on the positive not the negative. In the case of Jessie they should hold against her reason why she has been admitted previously, they should acknowledge that factor she needs help and give it to her by talking to her, listening to her and taking into consideration her care needs.

All discrimination should be challenged, question and refused to take part in. Power is often exercised by those who engage in discrimination, so if we can help to empower those who are seen as venerable to help empower those who are seen as vulnerable, can help to break the cycle against discrimination ( Twelvetree, Values for care practice)

As a nurses your should follow the Nursing and Midwifery Code of Conduct

“2.2 You are personally accountable for ensuring that you promote and protect the interests and dignity of patients and clients, irrespective of gender, age, race, ability, sexuality, economic status, lifestyle, culture and religious or political beliefs.” (NMC 2004: 5) As a nurse you should not condone discriminatory behavior that reinforces stereotypes and prejudice. So, if one nurse on the ward hears the other nurses call Jessie a ‘bed blocker’ it should question it so that it not reinforce.

Reflection -define and say what I have learnt!!

(145 words left)

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