Organization is a social unit of people that is structured and managed to meet a need or to pursue collective goals .All organizations have a management structure that determines relationships between the different activities and the members, and subdivides and assigned roles, responsibility and authority to carry out different task (Sorenson, 1999, p. 76).
Initially I will give a brief back ground about organisation of my placement, the Primary task, Authority and issues of diversity and inter-professional working. Interpersonal skills of a mental health professional are essential for an effective multidisciplinary team member, interpersonal skills, characteristics and attitudes are key to team working. Individuals on a team should be encouraged, through reflective practice and appropriate support, to examine their own characteristics and how they might adapt to a team environment. It is also important to recognize that while mental health professionals may have well-developed skills within their own area of expertise, it should not be assumed that they have all of the skills needed to collaborate effectively with others as part of a team.
There is the primary task (also referred to as functional task or work task), this corresponds with the mission of an organization. Most organizations face multiple tasks all vying to be expressed in the service of the primary task. This is the point where authority, becomes central, i.e. the person who decides what task has priority. It is the authority boundary in conjunction with the task boundary that helps the task become clear and for the work of the group to be taken on successfully. (Hayden and Molenkamp, 2002, p. 7). Absent clarity at the authority boundary, destructive chaos is likely to result and the survival of the group is in peril. While in some instances such a collapse is desirable for the new to arise and for the task to be met. Yet from the perspective of the group that dies, the loss continues to live well after the time boundary passes.
The primary task of my group in the organization, include case management, analysis of social welfare policies, and Care management’ was considered to be fundamental element of the community care reforms in the 1990 Act. In 2003 one in ten of local authority social workers were employed as care managers but it is difficult to know what this meant in terms of their roles and function. In theory the core tasks included: case finding and referral; assessment and selection; care planning and service packaging; monitoring and re-assessment; and case closure. (Knapp et al, 2005: 40).
Functions that team the play for society was our objectives as a team was to create a society in the next two decades in which no child lives in poverty and where all children have opportunities to realize their potential. Improving opportunities for disadvantaged children is at the heart of our strategy. (HM Treasury 1999, p. 39). As with older people, the consistent message that disabled people have given about the services they receive is that they do not adequately meet their needs. Research by Jenny Morris in the early 1990s found that statutory services were inflexible; were only available for the most basic personal care tasks; tended to `fit the client to the service’ rather than the service to the client; were provided in a way that reduced independence; and were only available to people in their own home so they could not be helped to go out, either to social activities or to work.
Authority boundaries and facilitating structures, the role of authority boundaries and structures is to provide a space or object for the anxiety and worry work to be displaced among social workers, so that the group can attend to the task realistically and appropriately. The term leader acts out as the organization’s ambivalence and splitting.
Interpreting this situation through Hirschhorn’s model suggests problematic consequences. The issue groups volunteers to take up the organizational tasks and attendant risks offered and accepted authority and, using Colin’s facilitating structures, did important work; they thus entered the virtuous cycle. This process, however, reduced the authority and increased the anxiety in the top team; they were likely to be heading for a vicious cycle of anxiety, leading to social defences, and therefore dysfunctional process and inhibiting structure. Thus, there were two competing processes: one facilitating change and the other undermining it.
All organizations have socially constructed defences against the anxiety which is aroused through carrying out the primary task of the organization ( Isabel Menzies 1970 p.496) These social defences may be evident in the organization structure, in its procedures, information systems, roles, in its culture, and in the gap between what the organizations says it is doing and what it is actually doing. Social defences are “created” unconsciously by members of the organization through their interactions in carrying out the primary task. Social defaces helps the top team rarely to operate in the “work group” mode; basic assumption behavior is more prevalent. The term leader, in his leadership, yet an analysis of the top team’s dynamics suggests a high degree of basic assumption dependence.
Additionally, lack human diversity within any given organization if the workplace is within, to coin (Hirschhorn’s, 1988 pp.39) term, then the learning organization must account for the variety of images that obtrude from the personal histories of each member.
The work of (Kets de Vries and Miller 1985, pp.239) illustrates clearly the consequences of the neurotic qualities of managers permeating the working relations within an organization. Additionally, an element of diversity is a person’s age and life stage (pp.246) .On a different front writers such as (Gilligan 1982 pp.23) and (Schachtel , 1989 pp.214) have argued in their own ways that gender influences strongly the way in which men and women engage with their world.
The learning disabilities which Senge sees connected to structural manifestations of hierarchy and segmentation may be understood more deeply as evidence of patriarchal, phallocentric modes of engagement. Yet a reading of Senge shows no consideration of neurosis, age or gender, let alone libido, in the dynamics of the learning process. Furthermore, he does not consider how any one of these affects a person’s readiness to learn, which differs substantially between people at different times. He asserts that the learning organization is one which will end the war between home and work when managers realize that effective parenting is the model for leadership.
Knowlden (1998) suggested that experience impact on a social worker ability to be caring; as a student social worker I was often overwhelmed by the working environment. This could imply that it is not the amount of experience which is important, but the length of time it takes for a social work to acclimatize. Support mechanisms such as preceptorship and clinical supervision may, therefore, have a role in facilitating compassionate care. (Pearcey’s 2007 p.29) study offers some support for Wright’s views.
As a social work I observed that qualified social workers mainly cared for patients’ medical needs, with the core element delegated to junior practitioners. Many years ago a ‘task-centred’ approach to organizing care was proposed as a possible defence mechanism against the anxiety that a more interpersonal style of working creates (Menzies, 1970 p.258). This may offer some insight into the behaviour of social workers who seek refuge in form filling and other activities not directly related to care.
Social worker students from different health disciplines often have little idea of what each other’s roles entail. Inter-professional learning increase this knowledge, as well as giving students an understanding of the interpersonal skills needed for liaison and communication. Every professional has its own roles, skills and responsibilities making for efficient practices in curing, managing or treating particular ailments, but has this always created cohesive team working in day-to-day working life.
In my social worker practice fitting in the organization hierarchy was a problem, and I was not able to question, share knowledge and learn together without professional and defensive boundaries. Often, an institutional hierarchy may obstruct the flow of communication and prevent a person from contributing and feeling valued, which ultimately can negatively affect patient care (Reynolds, 2005 p.19). More longitudinal studies are needed that follow through and beyond my undergraduate studies, along with critical observation of the learning process.
Standardizing in the curricula of all health professionals can improve key skills and prepare students for their careers by driving up standards of professionalism and best practice. Sometimes, in the hierarchy of the hospital, it is hard to know what one place is as a student social worker student. When one is it the bottom of the totem pole. No one in this hospital is lower than me.
I think most of us have probably gotten that vibe at some point, even if it hasn’t been explicitly articulated. There’s the simple fact that, in some ways, we are occasionally more of a burden to the hospital than a benefit. It’s a constant between trying to be useful, trying to learn something and really make the most of rotation, and simply not getting in the way.
For example “one of social worker will help you,” the term leader said. Maybe he was joking? I couldn’t tell his intonation could have gone either way. Then, the leader handed me a folder. “Here, fan her with this,” she said. Again joking? Not sure. And naturally, being a social worker student, my mind immediately leapt to the assumption that they would think I wasn’t a team player if I didn’t agree to fan her. So really, what else could I do? When the staff physician walked in, I tried to be nonchalant about the fact that I was standing by the patient’s head and fanning her with a purple confidentiality. Being at the bottom of the hierarchy within a multidisciplinary asking question is also a careful balance.
A friend a year ahead of me gave me some pretty phenomenal advice: If it’s a question related to patient care or unique to a particular situation, or about management of your patient’s condition ask away. Of course, there’s a time and a place for everything.
From the view of the individual I have sketched, the important questions about groups are those devoted to the conditions that take away the factors in social environment that ordinarily keep his self-system in its normal integration. (Bion, 1961: 145-6)
Bion stated that the basic assumptions are states of mind the individuals in the group get into. The awareness of the group remains in its regressed form because the group is there and so restrains further disintegration which would be tantamount to psychotic states, an eventuality that the early structuring of the self also resists desperately. The problems of group dynamics thus become those of how the normal affirmations of the self system are removed. The situations of groups in this respect are of almost infinite variety. Thus when Bion said that certain illnesses might originate as diseases of the group, he thought specific illnesses might prove to be linked to specific states of the group.
Here the most prominent stem from the task. Although there may have been some nominal description such as “to study group processes,” none of the members has any clear notion of what that task involves this affected my group as I was working with. There is therefore immediately a considerable loss for the self of its ego anchorage in reality. Important also is the realization that the task, in whatever form it emerges, will involve members in some exposure of their private and even hidden self. This factor I believe to be important in the group dynamics group, although much more so in the therapeutic one. Since the origin of the secret self was its unacceptability, there is a great deal of anxious suspicion among members is that which he expresses some of his feelings about the situation.
In conclusion, from my experience, I have learnt that it is important for both the student and the organization placement staff to be aware of who is going where before the placement starts. A good social worker student will contact the organization team in advance of the placement in order to check what time to turn up, and whether there is any uniform policy or other protocols they should be aware of. Likewise a good ward team and mentor will encourage the student to come on a preliminary visit just to be given the above information and to say hello. It can help enormously to reduce anxiety on a first day if the student already knows one or two faces.
On a pre-placement visit the student can be introduced to their mentor and have a quick chat and any placement reading can be handed out together with the placement information pack, outlining learning opportunities and ward information, shift pattern, dress code etc. Off duty rotas can be planned together and a pre-placement visit can also be the forum for any negotiation over study days and child care needs etc., so that the anxiety over these can be managed prior to the placement. A good welcoming pre-placement visit can begin the process of socialization into the team and its culture and can give the student an early sense of belonging.
Bion, W.R., (1961) Experiences in groups and other papers. London: Tavistock Publications [Reprinted London: Routledge, 1989; London: Brunner-Routledge, 2001.]
Corbin, J. (2008) Is caring a lost art in nursing? International Journal of Nursing Studies; 45, 163-165.
Gilligan, C. (1982), In a Different Voice, Harvard University Press, Cambridge, MA, .
Hayden, C. & Molenkamp, R. J. (2002). “Tavistock primer II.” Jupiter, FL: The A. K.
Rice Institute for the Study of Social Systems.
Hirschhorn, L. (1988), The Workplace Within: Psychodynamics of Organizational Life, MIT Press, Cambridge, MA, .
HM Treasury (1999) Opportunity for All London. The Stationary
Kets de Vries, M., Miller, D. (1985), The Neurotic Organization, Jossey Bass, London, .
Knowlden, V. (1998) The Communication of Caring in Nursing. Indianapolis: Center Nursing Press.
Menzies, I.E.P. (1970) The Functioning of Social Systems as a Defence Against Anxiety: Report on a Study of the Nursing Service of aGeneral Hospital. London: Tavistock Institute of Marital Studies.
Pearcey, P. (2007) Tasks and routines in 21st century nursing: student nurses’ perceptions. British Journal of Nursing; 16: 5, 296-300.
Reynolds F (2005) Communication and Clinical Effectiveness in Rehabilitation. Edinburgh: Elsevier Butterworth-Heinemann
Schachtel, Z. (1989), “Men, women, and work”, in Changing Group Relations. The Proceedings of the Ninth Scientific Meeting of the A.K. Rice Institute (Eds),New York, NY, .
Senge, P.M., Roberts, C., Ross, R.B., Smith, B.J., Kleiner, A. (1994), The Fifth Discipline Fieldbook: Strategies and Tools for Building a Learning Organization, Nicholas Brealey Publishing, London, .
Senge, P.M. (1990), “The leader’s new work: building learning organizations”, Sloan Management Review, Fall Reprint 3211,
Sorenson, G. (1999). Taking the robes off: when leaders step down. In B. Kellerman and L. Matusak(Eds.), Cutting Edge: Leadership 2000. College Park, MD: Academy of Leadership Press, 1999.
Tweddell, L. (2007) Compassion on the curriculum. Nursing Times; 103: 38, 18-19.