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Counselling, Caring and the Ambulance Service.

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Introduction

COUNSELLING Introduction In order to discus counselling and its meaning both generally, and in my workplace, it is necessary to come up with a definition. The dictionary describes it in terms of advice but this interpretation is a traditional one and carries an immediate implication of inequality for those involved. It is a narrow interpretation of the concept when compared to modern attitudes, which usually include a psychological aspect. Nevertheless, the traditional view still bears three of the fundamentals of counselling. These are: * That it involves at least two people, thus constitutes a relationship. * That there is agreement about the nature of the interaction, i.e. it is cooperative. * The aim is to help those involved. According to Stephen Murgatroyd (1990, P.5) counselling is not the sole prerogative of professional counsellors. It is a process that is widely used in within a community, which can take many forms. I have found this particularly true in my own profession. As a Paramedic within the NHS for ten years I have used techniques, which I now recognise as essentials of counselling practice, but have never considered myself a counsellor. Rather a professional who can learn much from the subject. In my workplace I find frequent examples of the more traditional model of counselling, as described by Murgatroyd (1990 P.7) ...read more.

Middle

way, we embark on a dialogue that seeks to put them at ease, allow them insight and hopefully afford them a feeling that they have some measure of control over the situation. Power thus becomes an important issue. In Davis & Fallowfield (P.15) the patient/practitioner relationship is discussed. They state that one of the most common problems encountered is the need for medical staff to take on the role of "expert" in order to reach conclusive goals. Very often this leads to neglect of the patient as a whole. Sanders (1994) identifies two qualities that he describes as "non-counselling". One of them, he describes as being "distant and expert". Sometimes, in a medical emergency, this is a necessary quality but creates feelings of guilt. I have often left relatives at the scene of a cardiac arrest at home whilst taking the role of "expert" and wondered at the emotional carnage that we have just encountered as we speed towards hospital with their loved one. Many times I know that we have not even begun to address their needs. It is certainly easier not to shoulder that sort of emotional involvement, as mentioned by Burnard (P.148), when he talks of the possibility of burnout. But sometimes assuming the role of expert can be used as an excuse to avoid emotional involvement. ...read more.

Conclusion

Although the obvious solution, this is not always possible and it is obvious that problems will continue to occur. Development The back of an ambulance is no respecter of class and ambulance work can be a great leveller. As a developing teacher of ambulance staff I am in the privileged position of teaching those who I believe are routinely placed in a position of power and privilege that can be used or abused. I believe a major part of my teaching role is to encourage the use of the humanistic approach, and to encourage students to reflect on their own attitudes and judgements in order to allow them to better use the skills described by Egan and the key aspects required as described by Carl Rogers in Kischenbaum & Henderson, (1989). The humanistic approach is already practised in my workplace and has been by the more experienced staff for years. Even though they did not attach labels to their skills they were using the humanistic approach espoused by Egan, Rogers and others. In the emergency care setting they have honed these skills to bring benefit to their patients as quickly as possible. It remains a joy to watch I see my future role as that of a champion for the humanistic approach, by my actions and my teaching methods. As more demands continue to be heaped on staff this may become more difficult. We are in danger of becoming more concerned with the product than the process. ...read more.

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