Role Boundaries in Care Work Role Boundaries

Role Boundaries in Care Work Role boundaries are a critical component in a health care setting. Much of this is a response to how the system is organized. The health care industry is composed of many different roles that specialize in different areas and expertise. Therefore, the individuals in the system must honor their role boundaries to ensure that the collective efforts of the individuals in the system can work together to provide high levels of patient care.

The care experienced by Anwar Malik in hospital was defined by the collective effort that each individual gave to Anwar. Each team member has a range of tasks that can be organized with various role boundaries. If any of the members violate their roles, then this can lead to the team's effort not being effective and could also compromise the level of care provided to the patient. Diabetic Anwar Malik was admitted to hospital with a swollen foot and the foot appeared, upon initial inspection, to be gangrenous.

Anwar was then transferred to a ward that was under the responsibility of registered ward nurse Grace Taylor. Grace proceeded to examine Anwar's foot and recorded the results of her inspection. The next team member that visited Anwar was the staff nurse, Jasvinder Kaur, who tested Anwar's blood sugar levels. Based on the results it was determined that Anwar should be administered his insulin and Anwar received an injection to maintain his diabetic healthcare routine. There were also many other team members who participated in Anwar's care during his visit.

The patient was also visited by a representative from the diabetes and endocrinology division as well as a surgeon and an anesthetist. Two other assistants administered the remainder of Anwar's care on his admittance to hospital. Millie Harrison provided Anwar a set of clean pajamas and checked to see if the patient had any other requests. Ella Platt performed bedside duties such as taking the patients temperature, offered drinks, fixed the bed, and made sure he was comfortable with his surroundings.

Ella Platt's role in the care system was to make Anwar feel as comfortable as possible about his stay in hospital as well as preparing him for his operation. From the brief example provided, it is easy to see that patient care is really a team effort. There are a number of different staff members who are all responsible for significantly different tasks. Furthermore, the system is based on the biomedical model.

This perspective to providing health care has developed under the influence of biological and medical science and uses systematic observations and experiments. Therefore, not only are the team members responsible for maintaining their professional boundaries while conducting their duties, they must also conduct their roles with technical precision so that the results of their tasks can easily be shared with the team. If a team member does not perform their duties within professional boundaries, then this can be a source of conflict within the group.

For example, if a nurse or an assistant spoke poorly of another staff member, then the patient could easily lose confidence in the entire team as well as the hospital in general. The same can be said with other potential sources of conflict. The Biomedical Model The biomedical model is defined as "a conceptual model of illness that excludes psychological and social factors and includes only biologic factors in an attempt to understand a person's medical illness or disorder" (Medi Lexicon, N.d.).

Despite the definition limiting the psychological and social factors that may be responsible for treating the disease, this does not specifically imply that the psychological and social factors are irrelevant in the treatment process. In fact, this is part of the reason why maintaining appropriate boundaries are so important because the staff will unlikely know many factors about the current psychological or social state of the patient. If these boundaries are violated, it can create a situation that can hinder the treatment of the illness or disorder.

The biomedical model of disease also has some limitations in regard to many of its assumptions. For example, it assumes that disease to be fully accounted for by deviations from the norm of measurable biological variable (somatic) and leaves no room within its framework for the social, psychological, and behavioral dimensions of illness which is reductionist in form and assumes the language of chemistry and physics will ultimately explain the biological phenomena that is being observed (Caplan, McCartney, & Sisti, 2004).

However, many theorists believe that this approach is too mechanistic and should include more of a systems approach which would include factors such as the general quality of life, clean environments, psychological and possibly spiritual stabilities in life (Hewa & Hetherington, 1995). Furthermore, the composition of care under the biomedical model is continuously evolving. For example, the nursing staff is becoming more and more responsible for duties that would formerly only be conducted by doctors. This may include performing many different bedside caring duties during patient visits.

This adds to the complexity of the professional duties that are performed by assistants and can add to the likelihood that they are often distracted during the jobs and thus can make professional boundaries even harder to maintain. There are estimated to be over a half a million health care assistance in the UK who now must all be professionally trained and qualified (unit 4).

Ella Platt, the health care assistant in the example provided, performed a number of these duties herself which can also include working with advanced information technology platforms and systems for patient records. Discussion When care work is carried out by a health care assistant it is generally under the supervision of a registered nurse. This can often create tension in the various positions that the patient is exposed to.

For example, a patient may feel more comfortable with a health care assistant than a registered nurse due to the fact that they may see them more regularly. Therefore the patient may ask questions of the assistant that they may not be qualified to answer regarding.