Introduction to Practice
Download student handouts: Introduction to Practice handouts [Word doc].
Suggested Learning Strategies
Strategies that Focus on Caring
1. Qualities and Characteristics of Care Providers Discussion
Invite students to form small groups and discuss what qualities and characteristics they would want in a care provider for themselves or a family member.
Ask them to describe the “perfect” care provider in terms of:
- Personality
- Work habits
- Knowledge level
- Relationship with other health care team members
- Relationship with family members
- Other characteristics that seem important
Which qualities and characteristics would be considered most important? What does this tell you about the qualities and characteristics of an effective care provider?
2. Caring for Clients Discussion
Invite students to consider some of the key aspects of caring. Questions that could be used to elicit discussion:
- If we truly care about and for our clients, what sort of environment will we want them to live in (e.g., client-centred model of care)?
- In what ways does a team approach contribute to better care for a client?
- How are legal and ethical standards related to a philosophy of individual worth?
- How is striving for increased personal competence related to being a caring health care provider?
- How does maintaining professional boundaries by the health care provider show caring for the client?
- How does a respectful work environment among colleagues contribute to positive outcomes in client care?
3. Unfolding Case Study: Caring for Peter Schultz
As a homework assignment, have students read their textbook and other relevant course or online materials describing the role of the HCA in various health care settings, including community day programs, home care, and complex care. Ask the students to identify the positive aspects and challenges associated with working in each setting.
- Whole Class Activity and Discussion
- In class, briefly review the health care settings. On a whiteboard, list the positive aspects and challenges that may be experienced by the HCA working in these settings. Ask the students to consider positive aspects and challenges that might be experienced by clients and their families in these same settings and list them on the whiteboard.
- Small Group Activity
- Divide the class into small groups, assigning each group to one of the following health care agencies and settings that is described in the handout. After the students have read the scenario, they should work together to identify the positive aspects and challenges described and be prepared to share their observations with the larger group. See STUDENT HANDOUT 1 below.
- Whole Class Activity Debrief
- Come together as a class and have each group report back on the positive aspects and challenges identified. Work together to identify additional positive aspects and challenges that may be experienced by clients and families being supported in these care settings. For each setting, discuss how the HCA could provide support to address the challenges identified.
Note: Students could be instructed to add the descriptions and notes from this session to their client portfolio for Peter Schultz.
STUDENT HANDOUT 1
Unfolding Case Study: Caring for Peter Schultz
Client and Family Experiences with Different Health Care Settings
DIRECTIONS: In this handout, Peter’s wife Eve shares their experiences with various types of health care settings and agencies. In your group, review your assigned type of health care setting. After reading, work together to identify the positive aspects and challenges described in the scenario and be prepared to share your observations with the larger group.
Adult Day Program
People from various agencies came to the house to interview Peter and me. They arranged for Peter to spend one day a week at an adult day program. Peter was cross about going and didn’t like it at first, but after a couple of weeks, I think he quite looked forward to it. Peter was often called on to sing a song or recite one of the many poems he knew by heart. One of his favourite activities was the bell choir. By the time complex care was needed, he was attending the program three times a week, which was a Godsend to me.
Home Support
Community services also introduced me to home support. This was such a wonderful help to me. An HCA came every morning and got Peter up, bathed and shaved him, dressed him, and prepared his breakfast. Unless you have had to do so, you can’t imagine how hard it is to help someone who resents being helped and thinks he doesn’t need to be bathed, shaved, toileted, or dressed, especially if you are the spouse. I can never thank these HCAs enough for all they did for me.
I did the vacuuming and found it very tiring. I thought about someone to do it for me and people coming in to bathe Peter. I got myself all upset, feeling the intrusion of strangers in my home and then was filled with guilt because they were all here to help, then sadness that there were some places I couldn’t take him.
Respite Care
Also available were respite times. If you were a caregiver, you were entitled to four weeks of respite a year. This meant your loved one could be cared for in a residence for a week while you had a rest. It didn’t help at first because I felt so guilty, but after a year or two, I really looked forward to some time by myself.
Complex Care
I just came home from the complex care home. I took Peter there on the 26th of April, 2004. I took his clothes, his slippers, the toiletries, a harmonica, the large print Bible our daughter had given him, this German Bible written in old- fashioned script, which he could still read without glasses. Drove into the yard and parked.
“Where are we?” he asked.
“I need a little rest, honey, so you are going to stay here for a while.”
He accepted that. I hauled the suitcase out of the trunk. He insisted on carrying the heavy thing. I punched in the code and the door opened. We went through it. The door closed. It was the beginning of our “involuntary separation.”
I am often amazed at the competence and kindly patience of the HCAs in the care home. Peter is at a table where five people need lots of help, but that never seems to bother the HCAs. They simply slide around from one to another on their wheeled chairs, keeping an eye on them all.
You might expect a dining room full of elderly people with cognitive and/or physical challenges to be a pretty gloomy place. Not so. Most of them look forward to meal times, and most of them usually enjoy the food. The servers are all so friendly and pleasant, calling the clients by their names and remarking about their clothes or hairstyles, congratulating on birthdays and anniversaries. All over the room there is uplifting chatter and merriment, the HCAs joining in as they stroll around watching out for anyone needing help or attention, gracefully solving any dilemma that crops up. The clients could hardly be better cared for, in my opinion. I am thankful that Peter is living here.
Metzger, Z. B. (2010). The Last Lap of the Long Run, Addendum to “On the Long Run”: An Account of our Travels with Dementia. This material is licensed under a CC BY-SA 4.0 licence.
Strategies that Focus on Critical Thinking, Problem-Solving, and Decision-Making
1. Classroom Debate Activity
Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined for a debate; one group will take a pros position toward the topic and the other group will take a cons position.
Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:
- Each group provides a brief introduction to their position on the topic.
- In alternating format, the two groups present the two or three reasons identified to support their position.
- Each group provides a brief closing statement.
After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.
Debate Topics for Introduction to Practice
- HCAs can provide better care to clients in complex care settings vs. community settings.
- HCAs should be able to provide formal care services to their own family members.
- An HCA has the right to refuse to provide care that makes them feel uncomfortable.
- Health care workers should be allowed to have their phones while at work.
- HCAs have the right to talk about their clinical experiences on social media.
2. Encouraging Reflective Practice
To develop HCA students’ ability to self-reflect and recognize and respond to their own self-development needs as care providers, consider introducing a model that can be used for reflective practice review, such as Gibbs’ Reflective Cycle.
- Description: What happened?
- Feelings: What did you think and feel about it?
- Evaluation: What were the positive and negative aspects?
- Analysis: What sense can you make of it?
- Conclusion: What else could you have done?
- Action Plan: What will you do next time?
Working together as a class, apply the Gibbs’ Reflective Cycle model to the scenarios outlined below.
Note: This activity refers to Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Oxford Centre for Staff Development. https://stephenp.net/wp-content/uploads/2015/12/learning-by-doing-graham-gibbs.pdf
Scenario 1
Today at your annual performance review, your supervisor tells you that they have received a report from another HCA that you were impatient with a client. The HCA stated that they tried to approach you about the situation, but you would not discuss it. You remember that you had been feeling anxious that day about a personal matter and had felt bad for sighing loudly and saying, “I don’t have all day,” when your client was taking a longer time than usual to pick her outfit.
Scenario 2
Today while you are assisting a client in the dining room, you overhear two of your co-workers recalling a story about another client and laughing loudly. Taken aback by the situation, you don’t approach your co-workers, but afterwards, it bothers you and you are unsure of how to move forward.
Scenario 3
As a recent HCA graduate, you are feeling excited about your new job at a complex care home. During the orientation session, you realize that the lift equipment being used is different from what you used during your clinical placement and despite the practice you receive during training, you still feel uncomfortable with using the equipment. You don’t want to leave a negative impression on your employer, so don’t speak up when the session leader asks if anyone has any questions or concerns.
Scenario 4
You are a new HCA and are struggling to keep up with your care activities. You often ask a more experienced HCA for help and guidance. Initially, they are very supportive and patient, however, as time goes on, they begin to feel resentful of your requests for assistance. The experienced HCA begins making snide remarks about your capabilities behind your back and excludes you from team discussions and activities. You notice the change in behaviour but don’t know how to address it. You are feeling isolated and demoralized, and this is making it even harder for you to perform your job.
Scenario 5
You are a new HCA who has recently been hired at a complex care home. Today you are assigned to work with an HCA who has been employed there for 18 years. When you suggest that the two of you come up with a brief plan for how to schedule your morning, the HCA insists that you follow their regular routine. Throughout the day, they make all of the decisions and disregard any suggestions that you make, saying, “This is the way we do things here.” At the end of the day, you learn you will be working with the HCA for the rest of the week.
3. Problem-Solving and Decision-Making Process
Have students, either alone or with peers, discuss an issue that presents itself to them. One that might be appropriate is the following:
As you move towards completion of the HCA program, you will have to decide which health care context you’d like to work in and whether you would like to continue your education.
The STUDENT HANDOUT 2 below will help students analyze this problem and come to a decision that best “fits” for them at this point in time.
STUDENT HANDOUT 2
Problem-Solving and Decision-Making Exercise
DIRECTIONS: Consider the following problem:
As you move towards completion of the HCA program, you will have to decide which health care context you’d like work in and whether you would like to continue your education.
Use a problem-solving, decision-making process to analyze this problem and come to a decision that best fits you at this point in time. Document each step in your process.
- Analyze the problem:
- What do you know about the choices available to you?
- What are the pros and cons of employment in various settings (community, complex, acute care)?
- What are the pros and cons of continuing your education at this time?
- Are there other options you might consider?
- Do you need more information? If so, how will you get it?
- What are your particular talents, abilities, and preferences?
- What roles and responsibilities do you have outside of work?
- How do these fit with the choices you are considering?
- What are your overall goals or desired outcomes? What is most important to you?
Use a table like the following to analyze the pros and cons (for you) of each choice.
| Options | Positive Consequences | Negative Consequences |
|---|---|---|
- Based on your analysis, what is the best choice(or choices) for now?
- Based on your choice, what are your next steps? How will you evaluate your choice?
- Self-reflection: Was this a new way for you to come to a decision? How did it feel to you? Were you happy with the outcome? What did you learn from the process?
Strategies that Focus on Professional Approaches to Practice
1. Professional Practice Exercises
- Invite students, as a whole class or in smaller groups, to discuss what is meant by “professional approach to practice.” Ask them to consider what sorts of behaviours reflect a “professional” approach. As the ideas are forthcoming, write them on a whiteboard or flip chart. Afterwards, encourage students to determine if there are any themes or major descriptors of professional approaches to practice. These may include:
- Respect for the client
- Respect for self as a health care practitioner
- Providing safe, competent care and assistance
- Being organized
- Functioning within defined parameters of one’s role
- Being dependable, reliable, and honest
- Working collaboratively with other members of the health care team
- Being ethical
- Being a reflective practitioner, recognizing and seeking ways to improve competence
- Introduce the Professional Behaviour Development Rubric from Section 5: Sample Course Assessment Tools and discuss how this type of tool could support students in their application of professionalism during the program.
- To further extend the activity, invite students to identify what they will need to know and be able to do, to function in a professional manner as an HCA in relation to the descriptors they have identified. Ask each small group to examine one of the major elements of professional practice and discuss the learning needs related to it. They may use a graph such as the one below.
| Major elements of a professional approach to practice | What I’ll need to know and be able to do in order to reflect professionalism in my practice |
|---|---|
| EXAMPLE
Working collaboratively with other members of the health care team |
Need to know and understand:
Need to be able to:
|
2. Exploring Workplace Policies
- Have students work in pairs to complete online research about the work-based policies of an employer, government website, or health authority in B.C. The policies can be related to:
- Electronic communication, including social media, the use of mobile devices, and texting
- Respectful workplace practices, including communicating respectfully, bullying (in person or online), gossiping, and harassment
- Privacy and confidentiality of personal information
Students should be prepared to report back to the larger group, describing the policy, why it is important, and how it relates to the professional practice of a Health Care Assistant. After each group presents, the students could identify commonalities between various workplace policies and then draft a respectful workplace policy (classroom agreement) for their classroom or lab setting.
Students can also share their resources by posting workplace policies, links, or documents on a physical bulletin board in the classroom or to a virtual bulletin board through imageboards and forums.
The following resources may be helpful for this activity:
Note: Related information may also be found in workplace collective agreements available on union websites (See Resources for website information).
- Ethical Practice Considerations and Employer Policies Scenarios
Invite students to form small discussion groups and discuss situations in which an HCA is confronted with a workplace dilemma. Ask them to discuss the scenarios on STUDENT HANDOUT 3 below and put forward suggestions for how each situation should be handled based on what they have learned in the course. Encourage students to check out the websites of the health authorities (links are provided above) to consider whether there is a program, workplace policy, or collective agreement that they could refer to for guidance.
STUDENT HANDOUT 3
Ethical Practice Considerations and Employer Policies Scenarios
DIRECTIONS: Consider and discuss the following scenarios involving ethical dilemmas. Put forward suggestions based on what you have learned in the course. If relevant, go to your health authority website to refer to a policy that could be used for guidance.
Scenario 1
You are an HCA student and it is your first day of clinical. After the afternoon debrief, you receive a text message from a fellow student that says, “Can’t stand working with Zoya – slowest partner possible!” You notice that the text message is addressed to the entire clinical group, except for Zoya. What do you think of this text? How will you respond?
Scenario 2
You enjoy working with your colleague, Sandy, because they are friendly and outgoing with the health care team and clients of the care home where you work. You have noticed that Sandy spends a lot of time on their smartphone, checking texts and emails during their shift. One day when you are eating lunch with Sandy, they show you some pictures of them posing with one of the clients that they has taken with their phone. Sandy shares that they have posted these pictures to social media. What do you think about Sandy’s use of their phone at work? How will you respond to the current situation?
Scenario 3
You are an HCA working in acute care. One day, while you are assisting Ms. Adakai, her daughter takes a video of you and the client on her cell phone. She tells you that you have been very helpful to her mother and she would like to post the video on her recovery blog so that friends and family can see the progress she has been making. How will you respond to this situation?
Scenario 4
Mr. Chopra was a well-known businessman and considered a leader in your community. You got to know him and his family well as you served as one of his many care providers during his final illness. Shortly after his death, you are approached by one of your neighbours who is a newspaper reporter. She asks you for information about Mr. Chopra. You were fond of Mr. Chopra and would like him to be remembered for the fine gentleman he was. What will you do?
Scenario 5
Mrs. Rosen is a 93-year-old woman who is physically frail but able to walk. She has been exhibiting signs of moderate dementia. When you are at work at the complex care facility where Mrs. Rosen lives, Mrs. Rosen often follows you and tries to gain your attention. This makes it difficult for you to get your work completed, as Mrs. Rosen also follows you into the rooms of other clients. Another HCA suggests that you take Mrs. Rosen into to the lounge and tie her in a chair in front of the TV so she can’t bother you so much. What do you think of this suggestion and how would you respond to it? What are some other approaches that you could take?
Scenario 6
Mrs. Subin mobilizes with a wheelchair and requires assistance with transferring. While eating lunch, she tells you that she needs to go to the bathroom right away. You are very busy, but you quickly take Mrs. Subin to the bathroom and assist her onto the toilet. After washing your hands, you rush back to the dining room. You forget to go back to help Mrs. Subin off the toilet. She gets tired of waiting, tries to get herself back onto the wheelchair and falls. Fortunately, Mrs. Subin is not badly hurt, just a bit shaken by the incident. What happened in this situation that might be legally compromising? How might the situation have been avoided? What can be done now?
Scenario 7
Ms. Dhillon is a 57-year-old client of your home support agency. Her diagnosis is multiple sclerosis. She is a bariatric client and has poor muscle control. She requires two HCAs to provide care on the days she has a shower. Today, you and your co-worker Jessie are helping Ms. Dhillon with her shower. You notice that Jessie is quite rough in the way she handles Ms. Dhillon. She also sounds angry when she talks to Ms. Dhillon and raises her voice, even though Mrs. Dhillon has no hearing loss. While you and Jessie are helping Ms. Dhillon to transfer from the shower to her wheelchair using the ceiling lift, Ms. Dhillon reaches out and puts her hand on Jessie’s arm for stability. Jessie slaps Ms. Dhillon’s hand away, saying, “Don’t grab me.” What will you do at that moment? What will you do later?
Scenario 8
Mr. Zhao is a 77-year-old man who is a client on the acute medical ward where you work. His admitting diagnosis was pneumonia, and he is finishing a course of IV antibiotics. His history includes a cerebral vascular accident six years ago which resulted in swallowing difficulties and an inability to walk. He mobilizes using an electric wheelchair. He has a permanent J-tube to meet his dietary needs and can also have fluids by mouth if they are thickened to pudding consistency. Mr. Zhao has not been off the ward very much since he has been in hospital the past few days. At home, he usually travels about his local community in his electric wheelchair, shopping or attending various activities. He is feeling much better today and has left the ward “to get some air.” When you go to the cafeteria to get your lunch, you see him sitting at a table with two other hospital clients. He has a large bottle of soda pop. You know this is not safe for him to drink because of his swallowing problems. What will you do?
3. Interprofessional Teamwork
Share the case study below with the whole class and invite students and share their responses to the discussion questions below.
Zareen is an HCA who works on an inpatient orthopaedic unit and has worked on this unit as a casual for the past three months. She is participating in a morning huddle and hears about Mrs. Nguyen, a patient who was admitted two days ago with a fractured right hip that she sustained when she slipped on an icy patch outside her church.
Mrs. Nguyen lives alone in a two-level townhome with a cat. She has one son who lives in town and he reports that his mom has lost a lot of weight since her husband passed away six months ago. The team leader reports that Mrs. Nguyen is one day post-op from a right hemiarthroplasty (partial hip replacement); she does not have hip precautions and is weight-bearing as tolerated (WBAT). Mrs. Nguyen would like to be discharged home with supports in a week.
Discussion Questions:
- Identify four members of the health care team who may be involved with Mrs. Nguyen’s care.
- What unique contributions might Zareen expect from the members of the interprofessional health care team that would support the goal of being discharged home?
- What might Zareen’s role be in Mrs. Nguyen’s care?
- How might Zareen demonstrate interprofessional communication with the team?
Note: This case study is used with permission from Island Health. (2012). Transitional Learning Continuum, Health Care Assistant in Acute Care Curriculum.
4. Understanding Workers’ Rights and Responsibilities Activity
This activity is designed to support students in better understanding HCA rights and responsibilities, the role of the supervisor and supervision, and the importance of workplace orientation and training. While some content may overlap with content in other courses, given the overall importance of occupational health and safety, it is included in this HCA Introduction to Practice course.
It is suggested that instructors:
- Invite students, as a whole class or in smaller groups, to identify the specific rights and responsibilities of workers. Elicit rights and responsibilities on the whiteboard or on a flip chart. See those listed in below as a guide or provide the STUDENT HANDOUT 4 below.
- After the brainstorming session, work with students to consider workplace safety and how rights and responsibilities can be considered specifically within the role of the HCA, using the questions and answers on the INSTRUCTOR DISCUSSION GUIDE 1, if helpful.
STUDENT HANDOUT 4
Workers’ Rights and Responsibilities
Workers have the right to:
- Information, instruction, and training about safe work procedures and how to recognize hazards on the job
- Supervision to make sure they work without undue risk
- Equipment and safety gear required to do the job safely (workers are responsible for providing their own clothing to protect themselves against the natural elements, general purpose work gloves, safety footwear, and safety headgear)
- Refuse to perform care activities and work in conditions they think are unsafe, without being fired or disciplined for refusing
- Participate in workplace health and safety committees and activities
As a worker, you are responsible for working without undue risk to yourself or others.
To keep safe on the job:
- Don’t assume you can do something you’ve never done before. Ask your supervisor to show you how to do it safely before you begin work. Ask your employer for safety training
- Use all safety gear and protective clothing when and where required
- Always follow safe work procedures and encourage your co-workers to do the same
- Immediately correct unsafe conditions or report them right away to your supervisor
- Know how to handle any hazardous materials or chemicals you use on the job
- If you have any doubts about your safety, talk to your supervisor
- Tell your supervisor of any physical or mental health conditions that may make you unable to work safely
Source Document: WorkSafeBC (2013). Student WorkSafe Infosheet: Workplace Rights and Responsibilities. https://www.worksafebc.com/en/resources/health-safety/information-sheets/student-worksafe-infosheet-workplace-rights-and-responsibilities?lang=en
INSTRUCTOR DISCUSSION GUIDE 1
Rights and Responsibilities
- Right to a safe workplace
- Consider: What makes a workplace safe?
- Employers, owners, supervisors, workers who act in ways which keep themselves and others free of injury and disease
- Work is planned, anticipating and taking steps to minimize hazards
- Direct care workers are supervised so that issues can be addressed as they arise
- Everyone is encouraged to report both negative (“I saw something that wasn’t right”) and positive (“I think I found a possible way of helping a client demonstrating response behaviours”) situations that they experience
- Information about known hazards (including patient/resident/client) is given to the right people
- Workers get the equipment needed to do their jobs properly
- There are adequate numbers of workers with appropriate skills to provide required care
- Provisions are made to respond when things go wrong to restore a safe situation
- Lessons are learned from incidents and mistakes
- Work is viewed to be “proper” vs. “improper” not “safe” vs. “unsafe”
- Consider: What makes a workplace safe?
- Knowledge of the hazards they face
- Consider: What types of hazards do HCAs face in their daily work?
- Overexertion/musculoskeletal injuries (MSI) from mobilizing people and equipment
- Falls resulting from slipping and tripping
- Violence (could result from aggression, responsive, reactive, or challenging behaviours). Greater risk with people with cognitive impairment, some active mental health disorders (psychosis, delusions), alcohol/drug impairment or withdrawal
- “Life” hazards, such as walking into objects or getting hit by doors
- Infectious diseases, such as norovirus, hepatitis, HIV
- Other possible hazards (e.g., Hazardous chemicals, radiation, cytotoxic drugs)
- Consider: How might hazards look different between facility and community settings?
- There may be more unknowns and fewer interventions in a home setting.
- Most homes were never built as places to provide care.
- There may be fewer people to talk to if you aren’t sure about a situation.
- Hazards related to care in the community that you aren’t as likely to be exposed to in a facility include driving, animals, hoarding, and exterior stairs.
- Hazards may also impact the people being cared for, such as unsafe handling, behavioural challenges, fall hazards, etc. The hazard may have greater impact on the resident (after a fall, a worker may be bruised, but a resident may have a broken bone (or worse).
- Consider: What types of hazards do HCAs face in their daily work?
- Safe equipment
- Consider: What types of equipment keep HCAs safe?
- Lifting equipment
- Shoes
- Safety-engineered needles and sharps containers
- Soap and hand sanitizer
- Consider: What types of equipment keep HCAs safe?
- Training (including orientation)
- Consider: What types of safety-related education or training might HCAs receive at work?
- Orientation
- Safe resident handling (equipment specific training)
- Violence prevention, including expected action in the event of an incident
- Infectious disease prevention
- Bullying and harassment
- Safe driving
- Consider: What is typically included in an orientation?
- The name and contact information for the new worker’s supervisor
- The employer’s and worker’s rights and responsibilities including the reporting of unsafe conditions and the right to refuse to perform unsafe work
- Workplace health and safety rules
- Hazards to which the new worker may be exposed, including risks from robbery, assault or confrontation
- Working alone or in isolation
- Violence in the workplace
- Personal protective equipment
- Location of first aid facilities and means of summoning first aid and reporting illnesses and injuries
- Emergency procedures
- Instruction and demonstration of the new worker’s care activities or work process
- The employer’s health and safety program
- Workplace Hazardous Materials Information System (WHMIS)
- Contact information for the occupational health and safety committee
- Consider: What types of safety-related education or training might HCAs receive at work?
- Supervision
- Consider: Who are supervisors?
- Anyone who instructs, directs, and controls workers in the performance of their duties
- Not always obvious from their job title – it isn’t a co-worker
- Consider: What are supervisors’ responsibilities?
- Ensure the health and safety of all workers under their direct supervision
- Be knowledgeable about the regulations applicable to the work being supervised
- Ensure that the workers under his or her direct supervision are made aware of all known or reasonably foreseeable health or safety hazards in the area where they work
- Consider: What traits would you like to see in an effective supervisor?
- Takes a personal interest in my well-being
- Gathers information before acting
- Has good listening skills and empathy
- Has a presence during the workday, without micromanaging
- Provides feedback in private, in measures appropriate to the size of the issue
- Creates an atmosphere in which people are willing to admit to mistakes
- Consider: Who are supervisors?
WORKERS’ RESPONSIBILITIES
- Consider: What are the responsibilities of the worker?
- To protect their own health and safety as well as others affected by the worker’s acts or omissions
- Consider: Who are these “others”
- Co-workers
- Clients
- Families and members of the public
- Consider: As an HCA, how can you protect your own health and safety?
- Follow instructions
- Use lifting equipment
- Back away from escalating situations
- Take a flexible approach to care
- Keep your vaccinations current
- Wash your hands, follow infection control protocols
- Stay within your role and parameters of practice
- Ask for clarification or help when you aren’t sure about the right thing to do
- Report little issues to your supervisor, before they become big ones
- Refuse work that you believe to be unsafe
- Do not work while impaired (sources of impairment can include fatigue, drugs or alcohol, medical conditions, distractions from your life outside work)
5. Maintaining a Respectful Workplace Scenarios
In groups of three or four, ask students to explore how to respond to challenging behaviours from classmates or co-workers and consider how different choices in verbal and non-verbal expression can change the meaning of a statement and influence the outcome of a conversation. For each scenario, students will consider the following questions:
- Is this behaviour respectful? Why or why not?
- How might you feel in this situation?
- How would you respond to this situation?
Students can incorporate knowledge from the Interpersonal Communications course to guide their responses. This means considering verbal elements such as word choice, and non-verbal elements such as tone, gestures, and facial expressions. The goal is to create a response that is most likely to result in a positive response from the other person and maintain a productive working relationship. Students will use conflict resolution skills to manage conflict effectively, incorporating the following program learning outcomes:
- 5.11 Identify problems, concerns, and conflicts within the health care team and discuss these with appropriate team members in a timely manner.
- 5.12 Approach problems or conflict in a non-threatening way.
- 5.13 Respond non-defensively to feedback, even when provided in a critical or confrontational manner.
- 6.18 Use effective approaches to conflict management.
Using non-verbal behaviours or innuendo (e.g., eye-rolling, making faces, deep sighing)
Scenario 1
You are a new HCA student and still have lots of questions. Every time you ask your student partner for help, they roll their eyes. They eventually will answer your question, but you feel uncomfortable with the response and are uncertain how to respond.
Scenario 2
As you are assisting a client with their morning care, you notice the HCA waiting for you sighing loudly. You are concerned that they may be frustrated with you but are not certain.
Spreading rumours, gossiping, or sharing information you were asked to keep private
Scenario 3
During a shift a fellow HCA says “Reyna has been calling in sick to a lot of shifts lately, but I saw photos they posted on social media of them out partying. Seems like they’re just faking it to get out of work.”
Scenario 4
A peer tells you that a fellow classmate failed their last skills assessment and might have to leave the program. You initially say, “Oh really?”, but then realize that this is a breach of trust and confidentiality as you did not hear it directly from the classmate who failed.
Sarcastic remarks, name-calling, verbal affronts, demeaning comments, putdowns
Scenario 5
Your client asks to use the bathroom. When you ask the HCA for help with the transfer, they respond sarcastically saying “Again? They just went!”
Scenario 6
You are a student practising in the lab and your student partner keeps criticizing you, saying that you are too slow and are wasting supplies. You feel embarrassed and upset.
Using silent treatment or withholding important information
Scenario 7
You are working on an unfamiliar unit, and during the morning report, you ask if there is anything you need to know about your clients. No one says anything. Later, you discover that your client is late to an appointment because you didn’t have them ready in time. When you ask the HCA about it, they respond that “you should know where to find that information.”
Scenario 8
You had a conflict with a friend from class. You texted them yesterday to try and resolve the situation, but they have not yet responded to your text.
Failing to support others and work productively as a team
Scenario 9
It’s a particularly busy shift, and you are having a hard time keeping up with your care activities. You feel overwhelmed and notice that your HCA partner has finished all their care activities. You expect them to offer to help you, but when you look over, you see that they’ve just sat down at the nursing station and are reading a magazine. You are feeling isolated and frustrated.
Scenario 10
You are working on a group presentation with two other students. One of the students in your group has not completed their portion of the assignment. The presentation is due at the end of the week, and you are worried that their portion will not be completed in time.
Distracting, telling jokes, and disrupting others during classes and meetings
Scenario 11
During lab practice, your student partner tends to create distractions while you work. This includes discussing things not related to the lab and showing you pictures and social media posts on their phone. You are finding it difficult to focus on practicing the care activities.
Scenario 12
During a staff meeting, one of the HCAs consistently interrupts and talks over their colleagues, disregarding their input and monopolizing the conversation. Their disruptive behaviour prevents other HCAs from sharing their perspectives. You are frustrated because you had some ideas to share but were not able to do so.
Adapted from Griffin, M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing. 45(12), 535–542.
6. The Role and Mandate of the B.C. Care Aide & Community Health Worker Registry: Search and Find Activity
This activity is designed to support students to understand the role and mandate of the B.C. Care Aide & Community Health Worker Registry. It can be designed as a follow up to the LearningHub’s Health Care Assistant Practice in B.C. online Module 4, Lesson 5 – Public Protection Mandate of B.C. Care Aide & Community Health Worker or used on its own.
- In class, invite students to work in pairs or small groups to visit the B.C. Care Aide & Community Health Worker Registry website to answer the questions outlined in the STUDENT HANDOUT 5 below.
- After students have completed the activity, come together as a class, and ask students to report back on what they have learned. An INSTRUCTOR DISCUSSION GUIDE 2 with links to the relevant web pages is provided below.
STUDENT HANDOUT 5
The Role and Mandate of the B.C. Care Aide & Community Health Worker Registry: Search and Find Activity
DIRECTIONS: Visit the B.C. Care Aide & Community Health Worker Registry Website.
Working in small groups, search the website to answer the questions below. Be prepared to report back to the whole class.
Questions:
- The B.C. Care Aide & Community Health Worker Registry (Registry)
- What is the Registry?
- How does it work?
- What is the role and mandate of the Registry?
- HCA Registration
- What is the purpose of registration?
- Who is required to be registered?
- Who can apply for registration?
- What are the application requirements for graduates of an HCA Program in B.C.?
- What is the account verification process?
- HCA Education
- What is the role of the Registry in HCA education?
- Where can individuals complete a recognized B.C. HCA program?
- Where can HCAs find resources related to their role?
- What are some continuing education opportunities for HCAs?
- Alleged Abuse Reporting
- What is the employer’s role in the Registry?
- What is the definition of abuse, as set out in the Community Care and Assisted Living Act, Residential Care Regulation?
- What is the process for reporting alleged abuse?
- What are the key points in alleged abuse reporting?
The relevant web pages with information to answer each question are provided below.
- The B.C. Care Aide & Community Health Worker Registry (Registry)
- What is the Registry? See About the Registry.
- How does it work? See About the Registry.
- What is the role and mandate of the Registry: Role and Mandate.
- HCA Registration
- What is the purpose of Registration? Why apply? See Applicants.
- Who is required to be registered? See About the Registry.
- Who can apply for registration: See Applicants.
- What are the application requirements for graduates of an HCA Program in B.C.? See Graduate of an HCA Program in BC.
- What is the account verification process and why is it important? See Frequently Asked Questions – Registrants.
- HCA Education
- What is the role of the Registry in HCA education? See Educators.
- Where can individuals complete a recognized B.C. HCA program? See Recognized B.C. Health Care Assistant Programs.
- Where can HCAs find resources related to their role? See Resources.
- What are some continuing education opportunities for HCAs? See Continuing Education.
- Alleged Abuse Reporting
- What is the employer’s role in the Registry? See Employers.
- What is the definition of abuse, as set out in the Community Care and Assisted Living Act, Residential Care Regulation? See Reporting Alleged Abuse.
- What is the process for reporting alleged abuse? See Reporting Alleged Abuse.
- What are the key points in alleged abuse reporting?
- Alleged abuse is reported in the workplace.
- Within 7 calendar days, the employer submits an Alleged Abuse Report to the Registry.
- Upon receipt of an alleged abuse report, the registered HCA is suspended from the Registry and the employer and union (or HCA if non-unionized) are informed of the suspension from the Registry.
- If an employer investigation results in HCA being able to return to work, the employer submits an updated report to the Registry and the HCA is reinstated to the Registry.
- If an employer investigation results in an HCA being terminated, the union or the HCA (in the case of a non-unionized HCA) may request an investigation by a third-party investigator appointed by the Registry.
- Within 10 days of receiving an investigation request, a third-party investigator is assigned.
- Depending on the outcome of the third-party investigation, the HCA could be returned to the Registry without conditions, returned to the Registry after meeting conditions, or removed permanently from the Registry.
Detailed information about removal from the Registry is available here: Removal from the Registry.
Suggested Course Assessments
The course learning outcomes may be assessed by the following tasks:
- One or more quizzes or examinations that pertain to knowledge of the British Columbia health care system, workplace settings, roles and responsibilities of health care team members, respectful workplace, legal and ethical aspects of caregiver practice, and human rights (Learning Outcomes 1, 2, and 3).
- An assignment in which students analyze one or more scenarios taken from practice situations. Students discuss the role of the HCA, rights and responsibilities, legal and ethical implications, and appropriate caring (person-centred) approaches (Learning Outcomes 1 and 3).
- A written assignment in which students describe the qualities and characteristics of an “ideal” care provider, with emphasis on how an “ideal” HCA works both independently and collaboratively. Each student will compare themselves to this ideal and use this comparison to delineate self-development needs (Learning Outcomes 1, 3, and 4).
- A written assignment in which students develop a personal mission statement related to their work as HCAs and career goals, both short and long term. The students should then search online to look up the mission and value statements of various employers. Using this information and their knowledge of the challenges and rewards of various workplace settings (community, complex, acute care), the students will describe where they would like to work and why and how this fits with their own beliefs, values, goals, and interests (Learning Outcome 5). Refer to HCA Workplace Settings Assignment in Section 5: Sample Course Assessment Tools.
- The LearningHub modules included in the Online Learning Resource section can also be included as graded activities, as certificates are provided for completion. These modules include the HCA Practice in B.C. module (required by the B.C. Care Aide & Community Health Worker Registry) and two modules on the topic of respectful workplaces.
Resources for Introduction to Practice
Online Resources
Adult Guardianship Act. RSBC 1996, c. 6. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96006_01
Alberta Health Services. (n.d). Respectful workplaces: Resource guide. https://www.ualberta.ca/anesthesiology-pain-medicine/media-library/eliassons-wellness-docs/hr-respectful-workplaces-resource-guide-copy.pdf
B.C. Care Aide & Community Health Worker Registry. (2024). https://www.cachwr.bc.ca/
B.C. Care Providers Association. (2022). http://bccare.ca/
B.C. Centre for Disease Control. (2020). Ethics. http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/ethics
B.C. Government and Service Employees’ Union. http://www.bcgeu.ca/
Bright Knowledge from Brightside. (2017). What is reflective practice? https://brightknowledge.org/medicine-and-healthcare/what-is-reflective-practice
British Columbia College of Nurses and Midwives. (2021). Licenced practice nurses-practice standards-working with health care assistants. https://www.bccnm.ca/LPN/ PracticeStandards/Pages/WorkingwithHealthCareAssistants.aspx
Canadian Human Rights Commission. https://www.chrc-ccdp.gc.ca/en
Canadian Interprofessional Health Collaborative. (2010). A national interprofessional competency framework. https://drive.google.com/file/d/1Des_mznc7Rr8stsEhHxl8XMjgiYWzRIn/view
Canadian Network for the Prevention of Elder Abuse. http://www.cnpea.ca/en/
Canadian Nurses Association. (2018). Interprofessional collaboration. https://www.cna-aiic.ca/en/nursing/nursing-tools-and-resources/interprofessional-collaboration
Community Care and Assisted Living Act, SBC 2002 c. 75. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/00_02075_01
Community Care and Assisted Living Act. Residential Care Regulation. [B.C. Reg. 96/2009.] https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009
Continuing Studies University of Victoria. (2021). Skills to support independent living. https://continuingstudies.uvic.ca/health-wellness-and-safety/programs/strategies-and-actions-for-independent-living-sail/
First Nations Health Authority. http://www.fnha.ca/
Fraser Health Authority. http://www.fraserhealth.ca
Government of British Columbia, (n.d.). About B.C.’s health care system. https://www2.gov.bc.ca/ gov/content/health/about-bc-s-health-care-system
Government of British Columbia. (n.d.). Accessing health care. https://www2.gov.bc.ca/gov/ content/health/accessing-health-care
Government of British Columbia. (n.d.). Assisted living in B.C. https://www2.gov.bc.ca/gov/ content/health/assisted-living-in-bc
Government of British Columbia. (2023). B.C. health care assistants core competency profile. https://www.health.gov.bc.ca/library/publications/year/2023/hca-core-competency-profile-april-2023.pdf
Government of British Columbia. (2022). Building a respectful workplace: Checklist for employees. https://www2.gov.bc.ca/assets/gov/careers/all-employees/working-with-others/building_a_respectful_workplace_checklist_for_employees.pdf
Government of British Columbia. (2024) Define discrimination, bullying and harassment. https://www2.gov.bc.ca/gov/content/careers-myhr/all-employees/working-with-others/address-a-respectful-workplace-issue/define-discrimination-bullying-harassment
Government of British Columbia. (2021). Health authorities. https://www2.gov.bc.ca/gov/ content/health/about-bc-s-health-care-system/partners/health-authorities
Government of British Columbia. (2019). Home and community care. https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care
Government of British Columbia. (n.d.). Human rights in British Columbia. What you need to know. [Fact sheet]. https://www2.gov.bc.ca/assets/gov/law-crime-and-justice/human-rights/ human-rights-protection/what-you-need-to-know.pdf
Government of British Columbia. (2022) Human Resources Policy 11 – Discrimination, Bullying and Harassment in the Workplace. https://www2.gov.bc.ca/assets/gov/careers/managers-supervisors/managing-employee-labour-relations/hr-policy-pdf-documents/11_discrimination_harassment_workplace_policy.pdf
Government of British Columbia. (2024). Long-term care services. https://www2.gov.bc.ca/gov/ content/health/accessing-health-care/home-community-care/care-options-and-cost/ long-term-care-services
Government of British Columbia. (2024). Professional regulation. https://www2.gov.bc.ca/gov/ content/health/practitioner-professional-resources/professional-regulation
Government of British Columbia. (2016). Protecting personal information. https://www2.gov.bc.ca/gov/content/employment-business/business/managing-a- business/protect-personal-information
Government of British Columbia. (2023). Protection from elder abuse and neglect. https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health-safety/ protection-from-elder-abuse-and-neglect
Government of British Columbia. (2022). Resident’s rights. https://www2.gov.bc.ca/gov/content/health/assisted-living-in-bc/operating-an-assisted-living-residence/operator-responsibilities/residents-rights
Government of British Columbia. (2022). Medical Services Plan of B.C. https://www2.gov.bc.ca/ gov/content/health/health-drug-coverage/msp
Government of British Columbia. (2024). Ministry of Health. https://www2.gov.bc.ca/gov/content/governments/organizational-structure/ministries-organizations/ministries/health
Government of Canada. (2019). Canada’s health care system. https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html
Government of Canada. (2012). It’s not right: What you can do when abuse or neglect is happening to an older adult in your life. https://www.canada.ca/content/dam/phac-aspc/documents/ services/publications/health-risks-safety/what-you-can-do-elder-abuse/pub1-eng.pdf
Health Employers Association of B.C. (n.d.). Collective agreements. https://www.heabc.bc.ca/ Page20.aspx#.YLEo5KhKjIV
Health Employers Association of B.C. (n.d.). Labour relations. https://www.heabc.bc.ca/Page11.aspx
Hospital Employees’ Union. http://www.heu.org/
- Facilities collective agreement. https://heu.org/collective-agreements/facilities
- Community health collective agreement. https://heu.org/collective-agreements/community-health
- Independent collective agreement. https://www.heu.org/collective-agreements/independent
- Community Social Services. https://www.heu.org/collective-agreements/community-social-services
Interior Health. http://www.interiorhealth.ca
InterRAI. http://www.interrai.org
Island Health. https://www.islandhealth.ca/
Master Class. (2022). How to recognize the five stages of group development. https://www.masterclass.com/articles/how-to-recognize-the-5-stages-of-group-development
National Healthcareer Association. (n.d.). Healthcare job interview questions (and how to answer them). https://info.nhanow.com/blog/healthcare-job-interview-questions-and-how-to- answer-them
Nidus. (2024). Your Choice. Your Plan. Your Life. https://nidus.ca/
Northern Health. http://www.northernhealth.ca
Office of the Seniors Advocate British Columbia. http://www.seniorsadvocatebc.ca/
Provincial Health Services Authority. http://www.phsa.ca/
Providence Healthcare. https://www.providencehealthcare.org/en
Public Guardian and Trustee of British Columbia. (2014). Protecting adults from abuse, neglect, and self-neglect: Supporting self-determination for adults in British Columbia. https://www.trustee.bc.ca/Documents/adult-guardianship/Protecting%20Adults%20from%20Abuse,%20Neglect%20and%20Self%20Neglect.pdf
SafeCare BC (2020). Civility matters: An online toolkit for long-term care staff. https://www.safecarebc.ca/civilitymatters/
Truth and Reconciliation Commission of Canada. ( n.d.). https://www.rcaanc-cirnac.gc.ca/eng/1450124405592/1529106060525
WorkSafeBC. (2020). Back talk for workers. https://www.worksafebc.com/en/resources/health-safety/interactive-tools/back-talk-for-workers
WorkSafeBC. (n.d.). Bullying and harassment. https://www.worksafebc.com/en/health-safety/hazards-exposures/bullying-harassment
WorkSafeBC. (2023). Communicating risk information to prevent violence-related injuries to workers. https://www.worksafebc.com/en/resources/health-safety/information-sheets/communicating-risk-information-prevent-violence-injuries-workers?lang=en
WorkSafeBC. (2023). Industry claims analysis: Time-loss claims in B.C. https://public.tableau.com/app/profile/worksafebc/viz/IndustryclaimsanalysisTime- lossclaimsinB_C_/Didyouknow
WorkSafeBC. (2020). Occupational health and safety regulation. https://www.worksafebc.com/en/law-policy/occupational-health-safety/occupational-health-safety-regulation
WorkSafeBC. (2018). Point-of-care risk assessments in long-term care [Videos].https://www.worksafebc.com/en/resources/health-safety/videos/point-of-care-risk-assessments-in-long-term-care/full-video
WorkSafeBC. (2013). Student WorkSafe Infosheet: Workplace rights and responsibilities. https://www.worksafebc.com/en/resources/health-safety/information-sheets/student-worksafe-infosheet-workplace-rights-and-responsibilities
WorkSafeBC. (2013). Toward a respectful workplace: A handbook on addressing and preventing workplace bullying and harassment. http://www.worksafebc.com/en/resources/health-safety/books-guides/a-handbook-on-preventing-and-addressing-workplace-bullying-and-harassment?lang=en
WorkSafeBC. (2016). Worker orientation checklist for health care. https://www.worksafebc.com/en/resources/health-safety/checklist/worker-orientation-checklist-health-care
Young, J. M. & Everett, B. (2018). When patients choose to live at risk: What is an ethical approach to intervention? BCMJ, 60(6), 314–318. https://bcmj.org/articles/when-patients-choose-live-risk-what-ethical-approach-intervention
Online Videos
Alberta Health Services. (2016, July 26). Patient and family centered care: Moments that make all the difference [Video]. YouTube. https://www.youtube.com/watch?v=Tej5g6w34BA&feature=youtu.be
City News 1130. (2020, December 8). Elder abuse calls increase [Video]. YouTube. https://www.youtube.com/watch?v=iYOCT8N9lwg
CLPNA. (2020). Respectful Workplaces; Building Healthy Working Relationships [Video]. YouTube. https://www.youtube.com/watch?v=ca94a0UnOyc
Indeed. (2020, January 3). Top interview tips: Common questions, body language and more [Video]. YouTube. https://youtu.be/HG68Ymazo18
McGill Caps. (n.d.). Writing a cover letter. https://www.mcgill.ca/careers4engineers/files/careers4engineers/guide_coverletter.pdf
University of British Columbia. (2012, September 17). Resumes 101: Accomplishment statements [Video]. YouTube. https://www.youtube.com/watch?v=bOSKynkOgQE&t=2s
Online Learning Tools
The following materials are ready for use in the classroom. A brief description and estimated time to complete each activity is included for each.
British Columbia College of Nurses and Midwives, (n.d.). Social media scenarios: Complaints to the college.
- Three case studies describing inappropriate sharing of client information on social media (10–15 minutes for review and discussion).
B.C. Health Regulators. (n.d). Achieving Competence in Collaborative Practice: Mini Module Series.
- Modules cover content on Interprofessional Communication, Intercultural Communication, Patient/Client/Family/Community Care, Role Clarification, Team Functioning, Conflict Management and Collaborative Leadership. Case Studies and a final assessment are included. (60-90 minutes)
LearningHub, Provincial Health Services Authority
LearningHub is a secure, province-wide course registry and learning management system hosted by the Provincial Health Services Authority. LearningHub provides a wide range of online and in-class courses on various topics. These e-learning courses can be used as activities or assessments for the HCA program courses. Students can access the LearningHub using their post-secondary email account. After completing all mandatory learning activities for a course, students can obtain a course completion certificate to show that they fulfilled all the course requirements. Instructions for registering and completing courses are available on the LearningHub site.
- Respectful Workplace (30 minutes)
- Health Care Assistant Practice in British Columbia (5 hours)
- SPECO (Student Practice Education Core Orientation) (8 hours)
Social Care Institute for Excellence. (2014). Dignity in care.
- Video and messages for practice to illustrate various scenarios with themes encompassing dignity in care.
WorkSafeBC. (n.d.). My handbook.
- Students can use My handbook to search for and store parts of OHS Regulation (e.g., violence in the workplace, ergonomic (MSI) requirements, etc.). The handbook is only stored for the duration of the web session, but can be downloaded or printed for future reference.
WorkSafeBC. (2011, July). Supervision in health care: Know your responsibilities.
- A series of four videos and a discussion guide describing how supervision in health care settings contributes to safety.
WorkSafeBC. (2013). Two-person care needs a planned approach.
- A video and discussion guide describing how planning can increase safety when a two-person approach is used for care (15–20 minutes for review and discussion).