More than 50 years ago, Treischman, Whittaker and Brendtro wrote a book entitled The Other Twenty-Three Hours…Working with Emotionally Disturbed Children in a Therapeutic Mileau.
Their book is still regarded as a classic today because it described the importance of direct care workers In other words, the trained therapist might see a child for an hour a day, but it was the direct care worker who influenced the child more powerfully during the other 23 hours of the day.
They are called by many different names: child care workers, youth workers, mental health aides, nurse aides, psychiatric technicians, behavior technicians, to name a few. They are the people who care for our residents, clients, consumers, or however we refer to them, on a 24/7 basis. They work at all hours of the day and night and they are almost always at work when others are enjoying the holidays with their families. Their job involves widely varying types of activities. At times they are counselor, at other times a disciplinarian. They can be cook, housekeeper, errand runner, administrator, driver, advocate, the list goes on and on. Writing a job description for these folks is very difficult.
It’s often dangerous work and often unpleasant. They can be caught between two adolescents who at the time, are acting like they would like to separate head from body of the other. They must act fast to prevent someone from hurting themselves or others. They clean up after someone who is sick. They bathe the bedridden and feed the handicapped. They organize activities and games. They escort to the ball game or fair and are always torn between their interest in the event and their responsibility as chaperon and substitute parent.
Worst of all is that they get little respect in many organizations. They have the most responsibility but the least authority. Their pay and benefits are usually at the bottom of the scale. It is difficult for them to afford their own place to live; they often live with parents or other family and friends. They work hard, long hours. If a colleague is sick or unable to report for work, they get to work a “double” so that the required levels of supervision can be maintained. The nature of the job makes it hard for them to maintain proper perspective on their work. Consequently they burn out because they feel ineffective and without power and influence. Often in an organization they are given very little attention except when they make a mistake. Turnover frequently exceeds 50% per year.
The irony of it all, is that direct care workers are the most influential in terms of whether or not the organization accomplishes its mission. The best efforts of administrators, psychiatrists, psychologists and social workers can be reinforced or undermined in five minutes of interaction between the client and the direct care worker.
So what is my purpose in writing about the sometimes miserable lives of direct care workers? First of all, it does not hurt for us to periodically remind ourselves of the difficult position into which our staff direct care workers are placed. Secondly, if we think with just a little bit of creativity we will be able to make small but significant changes in their work experience. Here are just a few things that could be done to increase a sense of job satisfaction for direct care workers.
1. Collaborate. Make sure that everyone, not just the professional staff, are heard when the time comes to evaluate a client’s progress and set new goals. All staff, top to bottom, need to collaborate with each other.
2. Communicate. Share information. Often, pertinent information about a client’s situation is withheld from direct care workers. Yes, underline the importance of treating sensitive information confidentially but don’t treat direct care workers like second class citizens.. Make sure that direct care workers know the organization’s goals and priorities and be clear with them about their role in helping the organization be successful.
3. Empower. Direct care workers are often faced with difficult decisions. Empower them to act. Give them tools and resources but also invest your authority in them and back them up, even when they don’t make the same decision you might have made.
4. Be Respectful. Introduce your direct care workers to special guests and donors. Evaluate all your decisions in terms of its impact on all staff, top to bottom.
5. Invest in their success by providing many training opportunities. Give them other resources that make their job easier. When they submit a work order about a clogged toilet or a van air conditioner that does not work, make sure you get problems handled quickly. You will be surprised how much easier their work is when equipment they need is easily accessible and actually works the way it is supposed to.
6. Model the behavior you want from them. Let them see you practicing the behavior you ask of them. Show them that you too are trying to learn; trying to do a better job today than you did yesterday.
Non-profit human service organizations need direct care workers that are successful. Their success ensures the success of the entire organization. They provide the foundation upon which all other program features are built.