This had two modules, and I was going to write them separately. However, as I haven't written in a while due to enjoying the sun, looking after my friend's son; recovering from looking after the little dude and flare ups; I'm not sure where the time has gone! Anyway this is a 2 for 1 or BOGOF (buy one, get one free) article.
Just to clarify before we begin, when I worked as an assessor for Personal Independent Payment (PIP), we were called Disability Analysts (DA). The role has just been renamed, re-branded to Disability Assessor (DA). Same role, just a different role!
Part One of these two modules purpose, outcome was to provide the understanding of the role of Disability Analysts within the PIP process and awareness of biopsychological (also known as physiology, psychology, behaviour, neuroscience and psychobiology); which is an interdisciplinary field that analyses how the brain influences our behaviour, thoughts and feelings approach to the DA role.
The first section was to understand the concept of disability. All Healthcare Professionals (HCP) should no matter what medical field have a good understanding of this. As we have to learn what the 'norm' is, what the 'abnormal' is and the between the two.
The next two parts were to understand the important aspects of the Equality Act; and increase awareness of cultural diversity. We learn about both these aspects in the first couple of weeks of our basic medical training; and if you have ever worked or work for the NHS (National Health Service), you have to do a mandatory update on both these aspects yearly.
The next element was to appreciate the biopsychological approach to disability analysis. In a nut shell, this emphasises the fact that disability is not only causes impairment or because of pathophysiological (describes the changes that occur during a disease process) reasons; but also due to some psychosocial and lifestyle factors (Gatchel, 2015). This approach measures impairment, health and working conditions; long term incapacity and ill health retirement. The model addresses disability in three ways. Firstly, medical which identifies the sequence from disease that causes the impairment to a disability that leads to incapacity. This works best when identifiable pathology (study and understanding of how illness and diseases work and their impairment on people) permits objective diagnosis and assessment; but is inappropriate for many common health problems, especially those that are subjective or when treatment is symptomatic and often ineffective. For example, Complex Regional Pain Syndrome (CRPS) and fibromyalgia, which don't respond well to conventional medications and treatments.
The social part of the model is widely accepted as the basis for social inclusion and anti-discrimination policies, but cannot be rationalised as the basis for an individual's entitlement to PIP. The final element of the biopsychosocial approach is biopsycholosocial, which attempts to take into account biology, psychology and social dimensions of health.
As a paramedic, you have to learn about anatomy, physiology and pathophysiology as a year on e student, in your first numerous weeks of all the major body systems. For example, cardiovascular system (the heart, arteries and veins) anatomy; what abnormalities there are commonly in the system and what causes these things; for example heart attacks, strokes, etc; as these are very common incidents for the ambulance service to deal with. We also learn to take in social information about our patients, for example mobility aids around the patient's home, social care support, asking the family if they are there, etc.
The next section of the part one module is definitions of disability and terminology. So the definitions of disability are a physical or mental condition that limits a person's movement, sense or activities. Basically defined as a person who has a physical or mental impairment that substantially limits one or more major life activities; a person who has history or a record of such impairment; or a person who is perceived by others as having such an impairment.
Terminology of disability includes not automatically referring to a 'disabled person' in all communications, as many people who need PIP and services, do not identify with this term; instead use 'people with health condition(s) or impairment'. Use positive not negative wording, for example 'suffers from' or 'confined to a wheelchair' instead think positive alternatives, for example 'uses mobility aids'. In this section, we were tort lots of different words to avoid and use instead. Some examples, avoid 'afflicted by, suffer from, victim of' instead we were tort to '{name of the condition or impairment]'; plus to avoid using any words such as 'cripple, invalid' to use 'disabled person'. Other examples, avoid 'spastic' and use 'person with cerebral palsy'; 'mental patient, insane, mad' all to avoid and use 'person with a mental health condition' instead; and so the lest goes on and on. It's more common sense than anything else, and about how you would prefer to be addressed. The final part was to address disabled people in the same way as you talk to everyone else and don't patronise them or attempt to finish their sentence; once a again think about how you would want to be treated in you were them!
The next part of module one was progressive conditions; which are diseases or health conditions that get worse overtime, resulting in a general decline in health function. Examples of progressive conditions include Multiple Sclerosis (MS), Alzheimer's, Muscular Dystrophy and types of vision and hearing loss to name but a few. It was about the main conditions that you would see at a PIP assessment, I personally found it very interesting.
The final section of part one of these modules was defining diversity and cultural competence plus types of culture. Diversity is defined as the state of being diverse, variety and the practice or quality of including or involving people from a range of different social and ethnic backgrounds; and of different genders, sexual orientation, etc. Whereas, cultural competence is the ability of a person to effectively interact, work and develop meaningful relationships with people of various cultural backgrounds; including beliefs, customs and behaviours. This also incorporates different types of cultures. All these paramedics are trained on in the first couple of weeks of their basic training; practice with every shift; and yearly have to do Equality and Diversity training which is mandatory.
That's the end of Key Guidance Required for Disability Analysts Part One; so onto the Part Two module. The purpose of part two was also to understand the role of a DA within the PIP process and knowledge of emotional intelligence, behaviour and risks. As well as, health and safety within the role,
The first part of module two was to understand health and safety policies and to ensure safe working practices at all times. This was mainly to cover backsides; for example, trips and slips, lone working, etc. As a paramedic, I worked on the rapid response cars, so I fully understood all of this and we are tort early in our training about dynamite risk assessing an incident and as it evolves, continuously changing our risk assessment. We are very efficient and effective at changing our risk assessment rapidly to the incident. I remember getting sent on a night shift to a chest pain call; en route whilst driving going through all the cardiac and respiratory protocols, a normal thing for me to do. I arrived on scene to numerous police cars and a couple of fire trucks; what I hadn't been told by control was it was an RTC (road traffic collision) chest pain; completely different set of protocols and hazards; working practice for the scene immediately changed.
The next section was to know how to manage situations to avoid aggressive behaviour. If any healthcare professional knows how to do this the best in the NHS are paramedics and ambulance staff; as well as A&E staff. All NHS staff are trained in Conflict Resolution Training and depending on the trust you work for self defence training techniques as well. Luckily )or not) I have only had to use them twice in my paramedic career, once when some guy smacked me in the face, he thought about doing it again until I told him he had already got himself arrested and that I would hit him back in self defence and I used to play full contact rugby. No surprises, he backed off me! The other was a lady who had sepsis and no mental capacity and it was used to release myself from her grip. Unfortunately, it resulted in two major shoulder operations.
The next part which follows on from the last one, and was to be aware of unacceptable claimant behaviour policy and how to follow guidance, if unacceptable claimant behaviour is encountered. Did exactly what it said on the tin and was another tick in the box element to cover backsides again!
The next element of module two was to understand the principles of Emotional Intelligence (EI) and their use in daily professional practice. EI is defined as the ability to manage both your own emotions and understand the emotions of people around you. There are five key elements to EI: self awareness, self regulation, motivation, empathy and social skills. In healthcare, it is recognising emotions in your patients/claimants and attempting to understand how they are influencing behaviours. In addition, EI is essential for effective communication. It is ensuring that patients/claimants understand the information you are conveying to them. This is quite subjective as it depends on the individual healthcare professional to decide on how the claimant is reacting, engaging and if they are 'normal' for them. This is not factual and is open to different interpretations by healthcare professionals based on their specialist medical field.
The next one was another tick in the box so claimants don't make the company look bad and make a complaint! It was all about being able to manage a situation effectively to avoid complaints. This again goes back to our conflict resolution training of being able to talk yourself out of a difficult situation. The following part was linked to this as it evolved being aware of the complaints procedure if any are received... another tick in the box!
The next few elements were all tick in the box exercises and to cover the company! The elements included health and safety; lone and out of hours working; risk assessment; accidents and incidents; and finally complaints again. Lots and lots of backside covering!
The final section of both modules was the six main types of assertion. An assertion is defined as an assumption that something is true; so it is subjective and depends on the healthcare professionals medical speciality. Assertion is most often used as a more accurate term for fact. Premise is another type of assertion; which is used in logical arguments to support a conclusion.
Probabilities is another assertion; which need not be true or false but can indicate probabilities and degree of truth. Logical arguments are based on assertions, where by you suggest that one thing is not true and that this means something else is true; in the simplest this can take the form of 'conclusion because assertion'. Next and final one, is First Principles which is foundational assertion, that you had as true, these serve as guidelines that have broad implications for an activity. The final assertion involves expressing beliefs, feelings and preferences in a way which is direct, honest, appropriate and shows a high degree of respect for yourself and others.
As you can see lots and lots of backside covering in these modules. Most are very subjective not based on facts but the healthcare professionals speciality; and also not much any healthcare professionals who's worked for the NHS doesn't already know and understand from their basis training!
The next module, in the next article will be covering Joint Anatomy Basics and Musculoskeletal Overview.
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