The Grey Areas of ACT
1.Bed bug preparation - nurses, social workers, occupational therapists, concurrent disorders clinician, peer support workers and 'other' (health care workers) all participate in helping clients when they have to prep their apartments for bed bug spraying. This may not always fit with a team member's version of what their role entails, but it is part of being an ACT team member and yes, it is what you do.
2.Putting our clothes (everything - including shoes and backpacks) in a large plastic container when we get home. One that has two-sided carpet tape around the top of the container so that we do not transport bed bugs in to our own homes. This can be a bit shocking to roommates or if our spouses have invited the neighbors over for coffee, but a necessary practice so we don't end up with bed bugs ourselves
3. Landlord mediation . Sometimes landlords call (frequently) upset at the behavior of an ACT client, and all staff - nurses, social workers, occupational therapists, concurrent disorders clinician, peer support workers and 'other' (health care workers) - work with landlords to slow down/reduce evictions and help clients maintain their housing. Learning to work with landlords and residential tenancy legislation can be new ground for some disciplines, but is an opportunity to expand one's scope of practice.
4.Working out at the gym. We work "with" clients, and as this is a collaborative method of delivering services to people, we will be on the treadmill beside the client while we talk with them.
5.Yes, we do drive clients in our own cars. This can be a stressful situation for some team members, and while we do not expect a team member to transport a client who has bedbugs 'dripping' off of them, there is some risk of obtaining one of the little critters in the course of your work. Regular vacuuming of the vehicle is a task each member on the team is encouraged to do - and, adhere to the plastic container by the front door – if you are diligent with both of these practices (vacuuming and clothes in the bin) you will likely never have to worry about bed bugs in the house.Unless your cat drags one home.
6.Going in to someone's apartment when we have not seen or heard from them for a time. On occasion, staff will be the first to discover a client who has died. It is important to debrief these situations right away - either with EFAP or someone on the team trained in Critical Incident Stress Debriefing
7.Client Location. All staff are involved in searching for clients if they are missing or homeless, and this may involve walking through parks, looking under trees, tarps, talking with people who are outside to see if they know, or have seen, the client who is missing. This can be somewhat pleasant in the spring and summer, but in the middle of winter it is not so pleasant. Again, this may not always seem to fall within the purview of one's discipline, but it is if you are working on ACT.
8.Depot injections. This one falls to the nurses, but frequently ACT clients are given their injections in odd places like alley ways; sometimes the lobby of a fancy, or not so fancy, hotel; standing by your car; sitting in your car (if it is really cold out or raining heavily); the office of another service provider in the area that you have a relationship with; in the park; by a tree; near the sea….
9.Mediating/intervening relationships with significant others. We work with the “whole” person, and that means whoever they consider “family”. Family has a wide definition and is whoever the client identifies as being important in their lives. We may not always agree with their choices of “family”, but we work with the “whole person”, and therefore, with those who are important to the client.
10. At times you may find yourself the official “locksmith” on the team.Client’s occasionally (or frequently) give away or lose their keys and require frequent lock changes. We don’t always have access to a locksmith, so it may become one of your “specialties”.
11. Grocery shopping. This is an important, basic life skill, and all staff - nurses, social workers, occupational therapists, concurrent disorders clinician, peer support workers and 'other' (health care workers) all participate in working with clients to learn how to budget and shop for food. It’s the old adage, you can give a person a fish to eat today, but show them where and how to fish and you can go for coffee. The boundaries can feel fuzzy, and at times they are, but it is the ‘grey’, or ‘blurry’ areas of being an ACT worker. We often talk about how we normalize really bizarre events that we are part of in people’s lives, and after awhile things that might shock others are not as surprising as they may have been when we first started the work.
12. House cleaning. Everyone on the team gets to participate in this activity since home hygiene is important for clients to avoid eviction and maintain a healthy living situation. We work “with” clients, and will find ourselves washing dishes while a client sweeps or vice versa, and helping clients sort laundry and put away clothes. You may wonder why you spent 4-6 years in University to wash dishes, but this is vitally important work we do with clients, because this is the important work that will eventually see clients graduate from ACT.
13. Taking a cat to be neutered. Yes, we work with the “whole person” and that includes their pets, and sometimes the pet needs a little operation, so we (the royal we) - nurses, social workers, occupational therapists, concurrent disorders clinician, peer support workers and 'other' (health care workers) - will participate in this necessary duty with clients.
14. Speaking of pets, guess who feeds clients’ pets when the client is in hospital or otherwise detained? You guessed it, the ACT team, and everyone gets to form a relationship with a variety of cats, dogs, turtles, iguanas, etc.
15. Holidays.Once in awhile you might find yourself spending Christmas day with clients and having a turkey with clients and colleagues.
16. Bike Mechanic.Helping a client learn how to fix a flat tire on their bicycle.
17. Pawn shop negotiations.Going to pawn shops to get information on a client’s belongings that they have pawned and then budget/plan with the client to obtain their belongings again and plan how much money they need to give the pawn shop to prevent their items from being sold.
18. Going to the movies.Part of ACT’s work may be taking a client to a movie and sitting with them. The reason for this is to acclimatize clients to being in social situations and modeling appropriate social behavior, even though it may feel like you are getting paid to watch a film. Since we are client centered it is the client’s choice and you may feel you have earned your pay especially if it is sitting through yet another Transformers movie.