Frontline Initiative Professionalism

Almost twenty years ago, I started my first shift as a direct support staff in a large institution. I was quite nervous, having no experience working with people with mental retardation, no training, and very little self-confidence. As I entered the building, I was greeted by a shift supervisor who took me to a room about 12’x12’, where twelve children sat. Each had a small carpet square as his or her designated space, and one staff person was there to supervise all twelve. The staff person quickly introduced me to each child and then announced that her shift was over and she had to leave. As she was leaving, she said “dinner is at 5:00, showers are at 6:00, meds at 7:00 and bedtime at 7:30.” She also pointed at three of the children and said, “Don’t take your eyes off of those three — they run.” I was entirely on my own the rest of the evening. After observing a person having a few seizures, watching someone nearly choke, wondering how to respond to people who seemed to be having “tantrums,” responding to a missing child (not one of the three), observing children banging their heads, and responding to a broken window, we all somehow managed to “survive” that first shift.

That experience has always reminded me of the importance of communication, training, and support to new employees in this field. Back then emphasis was on health and safety, and direct staff were only expected to take care of basic needs. Direct support staff were seen as caretakers rather than contributors and as subordinates rather than professionals. Consequently, valuable human resources were often overlooked. I was fortunate that within a year after starting, a new administration came in and made changes, which increased the opportunities for Direct Support Professionals (DSPs) to participate in professional growth and development. Now I am also fortunate to work for a private provider in the community that believes that they get back what they put into the development of direct support staff, a philosophy which I believe can serve as a model for professionalism in direct support. To cite some examples of this philosophy in practice our company benefits by allowing input from DSPs in forming policies and procedures and including them on committees, addressing issues such as human rights, program management, grievance, staff development, etc. In addition, the agency has developed a mentoring program for all DSPs that offers management and programmatic responsibility and experience. New employees receive hands-on training and support, as well as ongoing communication and technical assistance.

As a provider of community residential and employment services, we recognize the need to train, educate, and reward DSPs. Asking for help is considered a strength rather than a weakness, and necessary supports are available to minimize problems. A formal educational assistance program has been implemented as well as internal curriculum for management and programmatic training. A resource library that includes videos, books, articles, training packets, etc. is open to all employees. Offering a forum for direct-support input and involvement in service delivery, including two-way communication and decision making, enhances continuity and promotes progress. The company promotes people within the company who have the hands-on experience and organizational commitment as another way to ensure the delivery of best-quality services. These practices are only a few examples of how providers have changed from seeing support staff as caretakers to recognizing them as professionals.

Not all agencies have made the shift to seeing direct care staff as professionals, but they should. DSPs should be recognized and respected for what they do. They should have access to the information, training and education they need to do and improve their jobs, and they should be directly involved in the formation of agency policies and practices. The Direct Support Professional should not just be called professional, but also be recognized, supported and respected as a professional.