Responding to Toxicity by Lubov Karpinchik, B.A. DDC
Responding to Toxic Organisational Culture:
Self-Awareness in the Context of Organisational Psychology & Social Care
Lubov Karpinchik, B.A., Dissertation Doctor’s Clinic
Yet Another Expose in Social Care: The Context
Many of us working in social care contexts in Ireland are trying to come to terms with a programme recently aired on our national television’s station RTE, called PrimeTime, which investigated the abusive treatment of residents at Mayo’s Áras Attracta Care Home. Filmed over a three-week period with hidden cameras, the documentary focused on three women — Ivy McGinty, Mary Garvan and Mary Maloney. The nature, levels and intensity of abuse are quite staggering with depictions of residents being slapped, kicked, pulled around, prodded, hit with keys, and otherwise roughly treated and handled. In one incident, a staff member actually sits on a Service User pinning her to her chair. The Gardaí and the HSE are now formally investigating the Home and it has caused national outrage.
Most likely, we – the caring professionals, will struggle and try to analyse how and why certain practices were allowed to be carried out and, more importantly, how not to repeat those mistakes.
Purpose of the Opinion Piece
The purpose of this opinion article is to increase awareness of the organisational processes and to become more conversant of the individual role(s) we play in creating positive or negative dynamics within the team, units, and organisation as a whole.
Unfortunately, organisational corruption and toxicity are not new phenomena. Many lessons have been learned throughout the years about how organisations who are generally perceived to be of high ethical stands in society, become corrupt. The answers lie in the individual/group dynamics that I will attempt to outline here.
It may appear that non-profit organisations are less exposed to the clear cases or corruption as they are guided by different principles to that typical of for profit organisations. Indeed, one can argue that corruption is more likely to occur in the ‘high-performance’, ‘target-evaluated’, sales and profitability driven organisations where we are quite literally inundated with examples of bad practice, illegality and poor governance. One only has to think of the recent global banking crises. However, increasing budget and personnel restrictions, combined with rising expectations within delivery of care, put additional pressures on staff who are now expected to consistently do more with less resources.
Similarly to the laws of physics, emotions and behaviours in the organisations are contagious. They disperse within groups creating negative or positive influences. Our behaviours and ethical stands are influenced by the way we are socialised. Although, socialisation is perceived to be a major concept in psychology it, by enlarge, refers to the way we construct the Self, our behaviour and how we see what is right or wrong in a wider society. It is also through socialisation we construct our understanding of what it means to be ‘caring’. What practices are ethical and appropriate? And what is unacceptable.
As important socialisation agents, organisations help to shape our views and behaviours. So, the reasonable question is how do people whose position was to care for vulnerable individuals, who were supported by similar professional ethics, responsibilities and duties became, (as we have seen on TV and press report), corrupt? The answer to that question may, hopefully, reduce the possibility of such disgraceful practices happening again.
Psychologists frequently note that our mind often registers the wrongdoings, but when practices are gone unnoticed or we are subjected to repeated action supported by other team members by saying “that’s how we do things here”, we tend to rationalise it. Eventually, we run the risk of become the agents of the wrongdoings. That is why it is vital to be intimately aware of the process or cognitive mechanism of individual rationalisation of corruption.
Bad practices are often justified on the ground of comparison with other agencies. For example, if some unsatisfactory level of care is being acknowledged by you but was not acted upon, an individual can rationalise it by contrasting it to other agencies who were found to carry out even lower standards of care.
Mental response and justification of wrongdoing: “You have no right to criticise us. Others are worse than we are”.
Appeal to Higher Loyalties
We often, erroneously, act out of misplaced loyalties to our team members, as well as those, who are in a superior position than ourselves. However, such mental justification may be the critical cause of your practices being illegal and corrupt. Not your superior.
Mental response and justification of wrongdoing: “We were working towards more important goal. We needed to get ready for upcoming inspection and things got ‘on the way’. I noticed it was not right but I would not report it because of my loyalty to my boss”.
Denial of Injury
This can be reflected in the reporting of ‘near misses’ in the ABC chart. Incidents that did not happen but could have happened if gone unnoticed, in time, can lead to a serious injury. Injury may be both of physical and psychological character and that is why it is important to record near misses. This relates to a variety of social care involvements. For example, did your service user miss or postpone events that were due to happen as agreed? Why did it happen? What lead to the event? Is this happening as a result of your/team practice or was it due to external factors? Analyse the situation.
Mental response and justification of wrongdoing: “No one was really harmed. It could have been worse”.
Denial of Victim
This refers to rationalising wrongdoing by blaming the violated party. It may be that certain practices are ‘blamed’ on the victim, their personality and behaviours or both. The health, safety and wellbeing of the Service User are of paramount concern to our profession regardless of the situation that the Service Users might be in. It is the responsibility of the social care worker to evaluate and provide safe and secure environments free of threat, danger and harm.
Mental response and justification of wrongdoing: “They deserve it. They chose to participate”.
Denial of Responsibility
Often, bad practices are blamed on others even though the actors may include the entire team. Responsibility is then placed on management or even the organisation as a whole. It is important to remember that most social care organisations are guided by policies on ethical conducts as well as mission statements and Duty of Care principles. Those are the guidelines for Social Care Workers’ professional conduct and should be followed and observed by individual practitioners as well as teams and organisation.
Mental response and justification of wrongdoing: “What can I do? My arm is being twisted. I only followed her/his instructions. It is none of my business what the other unit does”.
Metaphor of the Ledger
Some justification of wrongdoing can come from personal evaluation of ‘entitlements’ that may not be ethical or in accordance with the Duty of Care principles. Be vigilant around over time and extra work that you do. Make sure you follow the guidelines at all times. Do not ‘justify’ rule braking based on previously accomplished work.
Mental response and justification of wrongdoing: “It’s all right for me to leave this procedure for next shift. After all I work overtime”.
Recent events in Ireland and, indeed, abroad, have shown that when unethical acts are uncovered in organisations, there is, all too often, strong resistance to accepting the facts, no matter how strong the evidence. This is due to the fact that when our mind rationalised the wrongdoing through one or more mechanisms described above, the belief is formed that there has been no wrongdoing. Therefore, when such facts come out, it is important to accept rather than deny the facts and start to address it on individual and organisational levels.
If some practices do not feel right, they are probably not right. Report your concerns and act quickly. There are, probably, explanations to wrongdoings that may seem rational for the individual and even groups. However, your moral compass should determine if there is a ground for concern.
The importance of external evaluation of practices should not be underestimated. Actively seek evaluation of existing practices rather than resisting. Create mental readiness to be guided away from already existing practice by looking for new approaches, feedbacks and evaluations. Discussions with MDTs can be an effective tool to analyse existing patterns of behaviour and try out new approaches not only around Service Users but also around Team dynamics of the Social Care Worker.
Justice should be seen as a reflective tool to what is perceived fair and appropriate behaviour outside your work place as well as inside. Ask yourself if you would like to be treated the way the Service Users are treated. What would you change? And why? Do you carry through your ethical stands at work or do they differ at the work place and why? Are you justifying certain practices as the right ones but would not do so if you saw it elsewhere?
Respect each other and give opportunities for staff and Service Users to openly discuss positives and negative aspects of practices. Try to stay impartial and take notice if you tend to rationalise negative feedback.
Be Creative and open to changes. Involve ‘newcomers’ in the planning of care and delivery. Do not rely on already established patterns that have functional validity but lack in individualised, empowering dimension of care.
Look at the Mission statement of the Service. What values does it hold? Are they carried through in your practice?
One may well wonder whether the recent expose of degrading practices in a Care Home for adults with intellectual disabilities stands alone. Organisational Excellence lies in a multi-level approach. Any organisation comprises of individuals. Rationalisation can endure for a long period of time and can be collectively practiced in organisations and industries. Indeed, if in doubt, get an opinion from an independent professional.
The social care profession is often interpreted by the way a social care worker looks after the Service Users. However, a more effective service comes from care professionals and organisations who strive to reach awareness about possible issues and educate themselves in the widest possible range of potential barriers to engaging in best practice standards.
Copyright Lubov Karpinchik (2015) Dissertation Doctor’s Clinic @Thesis Clinic