INTRODUCTION
PLACEMENT OVERVIEW
The Leicester voluntary organisation that supports for people in crisis; women, girls involved in or at risk of prostitution and sexual exploitation. The Organisation started as a small development within Leicestershire Aids Support Services when it was acknowledged that women working on the street were more on danger of contracting HIV.
The project remained small with just two staff until 2000 when following the recruitment of a new manager, WHIP as the project was then known, was successful in obtaining funding allowing substantial development. One of the first developments was to change the projects name from WHIP (Women’s Health in Prostitution) to the charitable voluntary organisation, as it was felt that the new name reflected the holistic nature of the work that was needed.
Following successful funding applications to the Diana, Princess of Wales Memorial Fund and Comic Relief, the project could recruit three more support workers and an admin worker. We managed to secure additional funding from the local Drug and Alcohol Action Team which allowed us to move out of the of the Leicestershire Aids Support Services building and into new premises on London Road in the city.
In 2003 following consultation with an external management agency, the project split from LASS, the project split from LASS became independent and achieved charitable status. In the year 2007 the project was moved to another location where it has continued to succeed in developing service delivery according to the needs of women and young people that the organisation supports.
It aims to make positive and informed life choices. Most of the service users have mental health issues, drugs addiction, alcoholic and homeless. The Project is committed to working towards positive lifestyle changes and helping service users achieve their full potential. Its mission is to improve the quality of life of those who have been sexually exploited or those involved in prostitution through direct and indirect service delivery. The project has strict requirements for student’s commitment whilst on placement because they must complete their required hours.
The Project offers practice guidance and procedures such as confidentiality at the workplace. The essay work will maintain confidentiality as mandated by the Voluntary Organisation Confidentiality Policy; which stipulates that. Confidentiality of service users’ information must be maintained always, unless one or more exceptional circumstances apply. The Project has other policies such as Safeguarding; the policy states that all students have a duty to safeguard and protect vulnerable groups. Whilst students engage in conversations with the service users it is expected that they will pick up on any issues that could be deemed as safeguarding concerns. For example, concerns could be raised regarding some individuals who require care and support (Section. 42, The Care Act 2014).
The role of students is an important one; they have a legal obligation to maintain confidentiality and privacy always. For example, the women who access the services should be given privacy to discuss issues which relate to their welfare. The welfare of children at the Project takes priority and as stipulated by the Section 1 of the Children Act 1989. Therefore; students are legally obligated to prioritise child safeguarding.
Another example is when service users in “Drop-in” discuss or disclose any concerns that are deemed as risking a child’s welfare then these concerns must be reported the practice supervisor and to the Local Authority Children’s Duty and Advice Service as a matter of urgency.
It is vital that; students maintain professionalism at the Drop In. They must not discuss personal issues with service users. This could bring about a barrier to developing positive relationships with service users and have a detrimental impact on their self-esteem as problems such as needing an extension on an assignment is far removed from the service users’ issues of homelessness and domestic violence.
The charitable voluntary organisation has a legal duty to ensure the health and safety of the service users, visitors and staff. It is therefore essential that students make themselves aware of the relevant policies.
Ensuring the safety in the building is vital for staff, students and service users’. Please be aware that some of the service users are involved with individuals who can pose a physical risk to the safety of others. To reduce this risk, it is essential that the front coded door is closed properly. Clients are escorted in and out of the building. The project is a voluntary organisation; because its resources are limited and must be managed in the most effective way to ensure as many service users benefit as possible.
DESCRIPTION
The voluntary organisation Project caries out Street Outreach; it is conducted twice a week in the evenings. The Outreach team involves professional outreach workers, experienced volunteers and students on placement. The team drives around the prominent places that are well known for street prostitution; they communicate with the sex workers and provide them with information about well-known dangerous individuals who frequent the street services, the sex workers are also given guidance on how to be working safely on the streets. Condoms are distributed as and other sexual health supplies, clean injecting equipment and rape alarms. The outreach team hands out warm drinks and food monitor which females are working and deal with any immediate health or other emergencies. The main aim of the Outreach is to provide a haven for sex workers.
Prostitution has been extensively portrayed as the world’s oldest profession. The practice of prostitution in exchange for cash or other immediate benefits, has always been in existence in most cultures and Greek ancient times at times. Prostitution has been criticised by many religions and to date sex scandals that have taken precedence in several countries. Prostitution has moved across all social classes; from the poor ‘streetwalkers’ who are prejudiced identified by poor lifestyle choices and drug addictions and abusive pimps, to the middle and high-class brothels and escort services who are highly paid.
FEELINGS
Student on a placement are encouraged to reflect on how their feelings relate to Health and Social Care. Students may always appear very confident person to other peers but upon reflection their inner selves might be conflicted to that opinion. In this case study the reflection was based on the student’s actions and inner thoughts. Also, on the student’s personal attributes towards their work, colleagues and service users. Reflecting more on daily practice enhances their skills, knowledge and how they should apply theory into practice; so that they become better practitioners. At times events may unexpectedly and students may feel things are not going the way they imagined. That is no reason to panic because it is part of the ethical dilemmas the might face in the future. In Health and Social Care every day is different and dealing with situations in legal and ethical means produces good outcomes. Students are practitioners in waiting, therefore, their views and suggestions are taken seriously on placements.
When students are introduced to tasks for the first time, there are feelings of fear and anxiety. This might be their first encounter working with sex workers; dealing they’re your own feelings and the service user’s emotions might be conflicting. One should remain calm and be a good listener. Authors have described such friendly physical assessments as creating a potentially intrusive situation (Lewis 2006, Sturdy 2007) which might cause an individual to feel uncertain and inadequate.
Being conscious of being supervised by a more qualified practitioner increases pressure to perform positively and apprehension. Furthermore, the first experience students might try to hide their anxiety and fears from service uses and the qualified staff members. When questioned by a member of staff this might enhance the feeling of unsureness. The Social Care Institute for Excellence (Scie, 2013) states that Health and Social Care practice is about building rapport with service users and any negativity that could be detrimental to service user emotional wellbeing. Working under supervision could be emotionally draining. However, but it is ideal for best practice for improving job satisfaction and the deliverance of good social care. Maintaining good relationships with mentors make it easier to receive feedback; whether positive or negative.
EVALUATION
According to Gibbs, (1988); evaluates what was good or bad about the situation. As a The Equality Act 2010 legally protects individuals from discrimination in the workplace and in wider society. Health and Social Care practitioner it is important to update and refresh our knowledge of current legislation and evidence, for example, The Equality Act 2010 legally protects people from discrimination in the workplace and in wider society. Cultural competence is a useful tool because practitioners now work in diverse communication the writer experience is important because it has led to the recognition of the importance of effective communication such as body language and gestures help to the barriers in communication.
The good thing about this situation is that sex workers work in safe and protected environments. Sex work has constantly been legal in the United Kingdom, although there are various laws that make it a criminal offence. The Sexual Offences Act 2003 defines a prostitute as a person who ‘on at least one occasion and if compelled to do so, offers or provides sexual services to another person in return for payment or a promise of payment’.
The bad thing about the case study is that there are casualties in the sex industry. Prostitution is hardly viewed as a victimless crime; because it degrades and treats women as commodifies, portraying them as ordinary objects of male fetish and lust. Naturally, it is degrading for women and they are at risk of violence; both physical and sexual attacks. The criminals who commit such offences varies from pimps, abusive clients and violent participants waiting to catch a ‘free ride’. Women who have are involved in the sex industry often define it as “paid rape” and “voluntary slavery”.
Reflective practice has been recognised as one of the key models of learning, which practitioners can learn from their experiences. It is important to develop knowledge and skills towards becoming professional practitioners. (Jasper, 2003). Health and Social care students learn from their experiences on placement to help them understand and develop their practice, this means they must be consciously reflecting on the events and justifying the decision they make. The Gibbs’s reflective cycle (Gibbs, 1988) has been applied to the case study and it consists of six stages of the reflective process and asks cue questions to prompt the memory.
Positive aspects of the placement include the insight gained into working in the voluntary sector. Practitioners in this field work with empathy and a non-judgemental attitude towards service users. Attitudes towards the sex workers were positive, focus was on their wellbeing and safety.
There are always safety concerns for sex workers in the street and another point to consider, is the relationship between sex workers and the police force. Many sex workers feel that the police are there to persecute and not protect them due to prejudice and stereotype attached to sex workers. Therefore, prostitutes might be reluctant to report instances of violence and abuse to the police, due to lack of trust. In one report, it was recorded that 80% of sex workers had experienced violence and abuse while working in the streets, and they find it difficult to press charges on their abusers because of the existing negativity which is placed around sex workers. (Campbell, 2002). Their reluctance also stems from how the police relate to sex workers. Many prostitutes protest that they experience violence at the hands of the police are unable to prevent this because the police are the gate keepers of the state (Brooks-Gordon, 2008).
On completing placements, students gain confidence, achieve goals knowledge and skills in preparation for the workplace. An awareness of working with people from different backgrounds is gained during placement; and clear roles are set.
After completing placements students must identify and apply theories. They meet with their supervisors to discuss areas of concern or improvement. Treating the service users with empathy and unconditional constructive regard proved crucial time and time again and as trainee practitioners they must build a rapport with service user’s trust. It also allowed some of the service users to be open about their feelings and their lives. Due to their mental disabilities some service users wouldn’t reveal such information while others would have without being treated with empathy or unconditional positive regard. They didn’t know any different. An example of where these theories didn’t work was when a service user threatened violence against both to the author and the staff members in the centre. This situation arose on numerous occasions.
ANALYSIS
This course equips students with knowledge and skills to deliver care and support in various health and social care settings. The course also raises awareness of the current issues in Health and Social Care such as engaging with service users from different backgrounds and how austerity affects communities and community projects. The placement presents students with the skills of identifying ethical dilemmas which may arise in the workplace and policy considerations which they must uphold. Students are obligated to practice within my capabilities because they will be held accountable for any acts and omissions (Hunt, 2004).
The supervision formed an integral part of this placement. According to Noble and Irwin (2009) supervision is supported by a collective responsibility to adopting a learning-centred relationship that is a vital element of professional development. Although, the placement setting is an unfamiliar one, supervision was necessary to “bridge across the education-practice gap” (Tsui, 2005). The placement provided policy guidance and teaching around issues of sex working and maintaining professionalism always. The placement opportunities to further research on the case study, for instance, reading around the issues of sex workers.
The best practice guides students on placement to work towards integrating evidence-based methods into their practice. Being on a placement helps develop ‘centred and stable professional self’ Urdang (2010). Professional should be empathic and at the same time avoid being personally and emotionally invested in service users’ issues. However, professionals are also encouraged to build a professional understanding, maintain professional boundaries and maintain good relationships with service users (Urdang, 2010).
Additionally, students are having to work towards promoting values of best of the health and social care profession, by ensuring that they work in a holistic manner.as Kadushin (1990) highlights; ‘the myth of sameness can result in oppression’. In addition, Thompson (2009) agrees that “treating everybody the same’ simply has the effect of reinforcing existing inequalities’ (p.140). Sex workers are often marginalised or stigmatised by society, working with them often requires effective communication and trust. furthermore, the placement provided the opportunity consider health and social care ethical dilemmas such as balancing quality and safety with efficiency; austerity measures that were introduced by the government makes it difficult to achieve the balance (Thompson 2009).
CONCLUSION
Placements give students the opportunity to reflect on their personal and professional development during their time in education. When the students become qualified practitioners, they would continue to use reflections to improve practice and develop as practitioners. The placement has also provided deeper understanding of sex workers and more confidence of working with the same group of people in their future careers. More has been achieved on this placement as compared to the previous ones because of the unknown territory and the challenges of working after hours. The organisation was working as a team and the experience was an exciting and valuable learning curve.
ACTION PLAN
Over the time the organisation has been working with women in prostitution and has recognised many common childhood experiences including poor attachment, childhood sexual abuse, significant neglect and deprivation and physical and emotional abuse. The Project offers service users the access to psychodynamic counselling. There has been evidence, significant and sustained improvement in how the women and young people the author work with relate to others and identify and understand their own patterns of behaviour. This is due to the emphasis in psychodynamic therapy of reconsidering childhood relationships and encounters and the revisiting of these during therapy.
As a future Health and Social Care practitioner, the Gibbs (1988) cycle of reflection puts things into perspective by helping to make sense of situations and placing theory into practice. The placement experience has taught the writer assertiveness where they feel service user needs are not being met and putting service user safety and wellbeing first. The writer also achieve this by doing some wider reading and learning from a qualified member of staff.
However, due to the government policy of austerity many services have been cut down and professionals must work with limited resources and a high demand of services. It is now difficult for the charitable organisation Project to continue with long term psychodynamic therapy for the client group. Also, stigma and shame that is placed on sex workers; has become a barrier to sex workers accessing services. They also view themselves as victims because of the self-stigma they believe that even professionals might be pre-judgemental towards them. This notion is supported by the need for psychodynamic therapy which is now limited because of funding issues.
It is evident that the government is setting out strategies and policy documents that protect sex workers and how they could work effectively. Home Office 2000 published the ‘Setting the Boundaries’ an in-depth and detailed enquiry of the law which regulates sex offences. The report resulted in the objective transformation of the Sexual Offences Act 2003. The following year another strategy report was presented, and it was entitled ‘Paying the Price’, this was a ‘discussion paper on prostitution’. This report sought to set out a realistic and rational framework to challenge the issues of sex work in the UK. The report aimed to address the issues of social exclusion and to reduce anti-social behaviour and violence against women, and a detailed debate on sex workers was is essential. “Organised criminality, including trafficking and substantial drug misuse, and sexually and drug transmitted infection, are all part of the problem’. Systematic abuse, violence and exploitation are prevalent. “The strategy included prevention, tackling demand, developing routes out, ensuring justice and dealing with street prostitution”.
REFLECTIVE PRACTICE
The Gibb’s Model of Reflection (1988) promotes a unique approach to reflection, where the reflection is a continuous and not a direct process. The reflective model has been proven to move through the stages refection one after the other. The process moves but moves between the stages and, often returns to the theoretical starting point several times before settling on a holistic consideration of an event or situation that includes most methods that influence the case study. Maintaining a reflective diary of vital issues and thought process encourages the construction of understanding of the work which is being done, and to justify the actions taken (White, 2001). Overwhelming support from the organisation was also important in the reflective process. Yip (2006) emphasises that the Gibbs (1988) reflective model and it is the most useful when starting out the reflective process, and quickly adapted and developed a model of reflection that was most suitable for this essay.
CONCLUSION
In conclusion, the reflective essay, has discussed and analysed the placement practice area with reference to a case study of sex workers. The essay introduced the Gibbs (1988) reflective model chosen to interpret the events of the case study. The author discussed how to engage with different models of reflection, skilled power dynamics, and explored different understanding of mental distress.
The reflection promotes the engagement of theory into practice. The reflective model has been employed to explore situations and the possibilities of how situations could be handled differently, sometimes it is important to place less emphasis on theory and engage with service users. Critical reflections should be an ongoing process for health and social care practitioners in their areas of practice because it encourages best practice and good outcomes. It is extremely challenging and to some extent it would be difficult to work in settings such as the charitable voluntary organisation; without being reflective practitioners.
The essay has illustrated critical knowledge that notifies practice, with an analysis of how the knowledge was acquired. The work has linked theory to practice. The essay has maintained confidentiality, as outlined by the organisation Confidentiality Policy; which states that confidentiality of information about service users, their families, and work colleagues and, in some cases, agencies should be kept confidential. The placement has provided a practical and theoretical learning experience, with insight into the professional world of Health and Social Care. The realisation of being an effective practitioner and working with sex workers has created an awareness of working with people from various backgrounds. The placement also develops student’s knowledge and skills for working in adult health and social care and has led to the identification of areas of improvement. The organisation in Leicester works with a wide range of service users; adults and young people in distress.
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