Hi, you! I need your help! To accept this mission, please continue reading.
In “Assessing d.learning: Capturing the journey of becoming a design thinker” (Goldman, Carroll, Kabayadondo, Cavagnaro, Royalty, Roth, Kwek, and Kim, 2012) Goldman et al. unpack the transformative journey of changing mindsets through a qualitative lens. Honestly, loved this article. It has some of my favourite elements – Vgotsky, Dweck, and qualitative theories. So I don’t need your assistance in appreciating this article, but your mission, if you choose to keep reading, is to help me apply their understanding in a current work situation that I am not sure how to progress. Maybe through this as a collaborative process, the solution will rise up like smoke.
The Background
Smoke is the key word here. I was offered a new job (Christmas eve starting at 2300) at a residence that has six elderly residents with a long-standing diagnosis of schizophrenia. Each resident has approximately forty years under the mental health act. This means that they: have a severe diagnosis, are not able to find their own shelter, are a threat to themselves/ others, and have not voluntarily accepted continual assistance care (under control of the state legally). Most of their adult life of each individual has been spent in a psychiatric facility. Due to their age, they are no longer considered a violent threat and can live in a community under 24-hour care. This includes medication, food, and knowing of their whereabouts at all time. Four of the six residents are cigarette smokers. One of the non-smokers smoked for 30 years but has quit about five years ago. Two of the residents that smoke are extremely delusional in that they believe that staff are trying to control them – poisoning coffee, the government is controlling their mind, they are in charge of the world during this third world war, etc. The workers in this residence consist of four daytime workers and two night-time workers. I work four nights on and then two nights off. Therefore, I am the most often work at nights.
On my last shift, I was told that two of the staff (the other night worker of two nights, and the primary day person) would like to change the smoking habits of the clients so that there is no smoking between midnight and 0600. Their reasoning is so that they “don’t have to deal with them”, and that maybe they will “stay in their rooms longer”. As you can clearly see, this is not an empathetic approach. In fact, they do not speak with the clients very often, and some clients are afraid of the workers. I, on the other hand, really enjoy engaging with the clients and listening to their perspective although I only have a small window working 2300 – 0700. Building rapport is essential in assisting others, and also allows workers to understand the clients’ motives. One of the clients smokes during the night for two major reasons – smoking a cigarette creates smoke army men that are used to fight in Armageddon that he is in charge of as the commander, and the soldiers are Corinthians (they disappear when the first ray of light hits them) and as such his army building needs to take place during darkness in order to save humanity. Therefore, in his mind smoking during the night is essential to his delusions. I agree that a changed mind be helpful for his health, but a move too quickly can be extremely jarring to a life-long delusion.
Mindshifts
So, the goal is to create a mindshift with the clients, and with the work culture. Goldman et al, identified four key mind-shifts: human-centred; experimental; collaborative; and metacognitive. If the smoking time restriction initiative had more time to develop, I would be developing a design that is collaborative with clients to see how the transition process could be developed with their buy-in. As the initiative has already commenced, the process will have to be a dynamic transition of moving parts. It will need to be a living experiment.
Clients
Human-centred – talking with the clients during the change to understand why they would like to smoke between the times of 0000 – 0600.
Experimental – the transition is possibly changing as I will be working the majority of the nights. Therefore, the times allowed during my shifts, and the rewards/ consequences, can be everchanging while a fit is found.
Collaborative – speaking with the clients to see if they have solutions (eg. perhaps they would like staff to ration out their cigarettes, or remind them when it is closer to smoking end times)
Metacognitive – maintaining mindfulness of the power dynamics between clients and workers, and that these are considered at-risk populations.
Coworkers
Human-centred – I need to be empathetic to their concerns about work restrictions. Although laziness seems to be a predominant factor, perhaps there are additional reasons.
Experimental – speaking with staff about the different tools that are available to help in shaping behaviour and that documenting the team approaches during the transition.
Collaborative – trying to reinforce that as a group we can be more effective in solution finding, and maintaining of a healthy habit.
Metacognitive – being mindful of the power dynamics between the workers. I am the “new guy” and three of the six workers there have been there for over twenty years.
Mission Possible?
Okay, back to you. Since you have continued to read this (way over the word count, but I don’t mind and can take a penalty) I am assuming you have accepted the mission. What I am asking of you is for your perspective. I think that a collaborative approach can yield incredible results.
This is your Windaloobah experiment. This is your mission.
What do you recommend?
Reference
Goldman. S. et al. (2012). Assessing d.learning: Capturing the journey of becoming a design thinker. In H. Plattner, C. Meinel & L. Leifer (eds). Design Thinking Research: Understanding Innovation. (pp. 13-33). Berlin: Springer.