Behaviour

Back to: Linking to Care, Point of Care Testing (POCT). Aotearoa Edition

In our earlier lessons we have discussed real world guidelines, obligations rules and standards that have an impact on how we can do we do, and our conduct and behaviour. For this lesson we are using the term behaviour to describe how we can potentially apply all we have learned so far into practical application for when we are facing wai ora, colleagues and the community. And representing Health Network Collective in the community.

Let’s revisit a few of the lessons we have covered so far, and put the theory into a scenario to help understanding of what the theory means.

Our respecting Medical in Confidence extends to combining our guidelines, obligations and what we have learned of Medical in Confidence.

Let’s look at an example;

• You’ve been navigating John, who is a long-term addict in community addictions and mental health care, through his HCV screening and treatment journey. Trish, Kaiawhina to John, has been facilitating this relationship and been very much involved with this journey. Over coffee and a catch-up chat at a café with Trish one afternoon, Trish starts to chat in very general terms about John and makes a statement that “Johns completely crazy eh…” 

Using Trish’s statement as a que to enter a conversation about John being crazy, and based on a non-clinical conversation que, would be very inappropriate. Especially in the public café setting. Medical people do tend to have a ‘warped’ or ‘dark’ sense of humour at times, this is best left to the appropriate time and place or not at all. That time and place is not in the presence of other people, in public, where comments or discussions may be heard. The risk is not only breaching Medical in Confidence, there is also a risk of damaging your own and your organisation professional image and reputation. This could result in mistrust, reputational risk and serious complaints.

You may choose to reply to Trish with a statement along the lines “I don’t feel that’s appropriate to discuss here” or simply ignore the statement and change the subject. We would encourage you to be cautious in challenging Trish on her behaviour, and would recommend you seek further advice from you supervisor or manager. Not being a senior positioned medically qualified professional or senior manager, avoid the possible confrontation.

However, let’s say that some of John’s behaviour and actions have caused you concerns. If we consider “first do no harm” from our Medical Ethics lesson and that ‘medical ethics is concerned with the obligations of the doctors and the hospital to the patient along with other health professionals and society’; looking at John through the lens of “does this behaviour suggest a threat or danger to John or others around him” might help rationalise what we could do. As we are not equipped professionally to deal with this scenario, seeking professional help and assistance is the only resolve. This will entail some level of exchange of information that could be labelled Medical in Confidence.

So back to the scenario;

• You’ve been navigating John, who is a long-term addict in community addictions and mental health care, through his HCV screening and treatment journey. Trish, Kaiawhina to John, has been facilitating this relationship and been very much involved with this journey. Over coffee and a catch-up chat at a café with Trish one afternoon, Trish starts to chat in very general terms about John and makes a statement that “Johns completely crazy eh…” This raises a ‘red flag’ for you, so you ask Trish if you can go somewhere private to continue the conversation. You have concerns over John’s behaviour and safety so this has become an appropriate conversation. Trish agrees with your concerns and is able to inform her organisation who deploy the appropriate resources and people to help John. This may be marae or community teams, ambulance, mental health intervention teams, or even police.
• And this is definitely not dinner table conversation when we go home… communities have a way of these conversations getting around…

First Aid

We will look at some forms of immediate reactions to first aid scenarios as we progress through the clinical lessons for POCT procedure. However, Health Network Collective is not conducting First Aid training or training that could be considered as suitable in lieu of approved First Aid training. It is expected that you will have a current certificate of completion of a first aid course from an approved training provider.

Psychological Fist Aid (PFA)

As with First Aid, Health Network Collective does not conduct Psychological First Aid training. We do however recommend the course where available as a great means of identifying and linking to care those in need. PFA has many parallels to our POCT practice.

Psychological first aid is a technique designed to reduce the occurrence of post-traumatic stress disorder. It was developed by the National Centre for Post Traumatic Stress Disorder, a section of the United States Department of Veterans Affairs, in 2006.

If we go back to the scenario of John, Trish and you. We can break this down into simple manageable steps by applying PFA principles.

• Prepare. Learn about the crisis event. Learn about the available services.
  • This is an exercise you have or will be conducting by meeting collaborating and coordinating with people and entities in your community. And you are becoming one of the available services by taking this course.
• Look. Check for safety.
  • We discuss personal safety in more depth in the following lesson. Never willingly place yourself or others in a position of danger. Gut instinct is our primitive warning system, listen to it.
• Listen. Approach people who may need support.
  • Listen… this is not about offering advice, or giving resolution or absolution. It is about listening so we can offer informed linking to care information. Encouraging the next step for who we are listening to in seeking further help.
• Link.
  • Some wai ora just want a contact to reach out to. Some may want you to navigate the pathway with them. It is recommended that you link and extract yourself and minimise or stop your involvement as timely as you can.

Health Network Collective Code of Conduct

You may or may not have noticed that Health Network Collective does not have a code of conduct. As a largely volunteer entity we are bound by the legislative acts, and common laws of the localities we are represented in. Health Network Collective, and as agreed to by you in question 1 of the initial quiz in this course, have agreed to abide by the guidelines and obligations discussed and referenced in the section one lessons of this this course. These collectively form conduct expectations that can be applied on a global scale, and that we have all agreed to.