Questions for discussion with a shelter monitor

Scenario 1. Ethical test. Will a monitor work by ethics?

Joe is a resident of the shelter. He comes to you and tells you that Douglas who is in the line outside your office seeking admission to the shelter is a former inmate (was in prison)./ How will you respond to Joe? How will you deal with Douglas when his turn comes?

The issue of confidentiality is of utmost importance and must always be adhered to. Discussing personal information of one client with another is not allowed.

Scenario 2. Procedural test. Will the monitor work by policy and procedure?

Shelter rules state that all residents must be inside the shelter by 9:30 pm. Doug returns and reports at 9:35 pm. What will you do?

A monitor must adhere to policy and procedure with empathy. The monitor must demonstrate an understanding of the mission and purpose of the shelter. Empathy makes the monitor interview put himself or herself in the shoes of the client without neglecting the standards of shelter.

Scenario 3. Relational test. Will the monitor take initiative and relate professionally with colleagues in the workplace?

Laundry must be washed and put away by each shift monitor. All clients’ green registration cards must be properly filed away. Kitchen tables and all floors must be clean. You arrive and find the previous monitor has washed but NOT put away linen and the stove has not been cleaned. What will you do?

A monitor in this situation must take action, i.e. put away the linen and clean the stove. He or she must be able to work and relate properly with others who share responsibilities of this office. The monitor must document the action taken in a non-demeaning manner to the colleagues in the previous shift.

Shelter encounter

She called me in the morning when I was alone at the switchboard.
"May I help you?" I introduced myself and asked.
"I wish to speak to someone in charge of the shelter there."
"Yes, I am the very person. Shoot away!" I said.

"Do you have room in the shelter for one person?"
"Yes, we do."
"What time can I come to take the room in the shelter?"
"What is your name and have you ever stayed in our shelter?"
"Oh, I thought you said you had room for one person? Is that not what you just said?"
"Yes, that is what I said. we have room for men, women, and families." I paused just enough to make the next point, "I did not say you can come in and take the room. I do not know you; I have not seen you to make that promise to you."
I went on, "There are two other shelters in town; have you called them as well? If so, what did they say to you?"
"Yes, I called one of the them and I was told they are full at this point, they cannot take me in."
If you want to come to our shelter the time to check in is 7 pm. I am here through the day. You will find me if you decide to come early."
She hung up; or should I say he hung up.

Two hours later she showed up; or should I say, he showed up. She looked like a woman, but equally looked like a man.
"I am here! I spoke to you an hour about shelter."
"Yes, I remember that you spoke with me."
"Please show me your photo identification document; I will check your shelter records to see when you were last served by us."
I saw the woman's picture on his government issued identification card. His name was on our database too.
"How do you want me to recognize, as female or male?"
"Female. Regard me as a woman."
"Okay. The government recognizes you as a man. How can I do differently?"
"I have both male and female parts; I prefer to be recognized as a woman."
"That is fine with me. Now, allow me to take this to my supervisor so that we can be all on one page. Is that okay?"
"Yes, that is fine."
"As I said already, we have plenty of room for men as well as women; these are dormitories. hat means, if we put a person in the men's dormitory he will share amenities with men. The facilities lack privacy. The same may be true on the women's side. I hope you are following what I am saying."
"Yes, I am." She, he said.

John

I will call him John. He came to the shelter after losing his abode in a nearby city. His lived with his daughter until a week ago when she was evicted for non payment of rent. The daughter went to live with her mother, John's ex-wife. John had no place to go, no friend, no family or church to talk to.

John spent the rest of the days and night numbering 10 under a bridge as homeless. That is when a passerby saw him and told him about the Salvation Army shelter. He came and found a bed.

John is a truck driver but in the last fw weeks has not been able to work because his left arm is in much pain at the shoulder joint.

I sat down to see him in the evening of day two in the shelter. As he spoke John broke down and wept like a child. "I have sunk so low, I never thought anything like this could happen to me." He said between th sobs.
"I am not able to take care of myself. My family is not there for me. When I tell them my situation they tell me thy understand but are not able to consider taking me in. I can not work becaus my arm is in pain. If I go out looking for work I am told I can't be hired because I am not able to lift more that 5 lbs."
Then John told me what happened last night.
"I could not sleep. I had these loud noises in my head. They told me to end it. Get a gun. Find a rope. But I told myself that was not the way. I told myself I will make it. I knelt down by my bed and prayed to God. I asked God to help me, to bless me this day. I prayed that He would take me out of the place where I am."
I asked him how his day went.
He repeated what he already told me, that his day was very blessed indeed. This coming Sunday he would go to the Methodist Church close by. He told me he wants to renew his life in the LORD. I told him that was the way.
I spent time praying with John. He wants a large print Bible. He is not able to read out of small print because his sight is not very good.
As I prayed with John I felt the awesomeness of the occasion. He was determined to see God. H is determined to change the course of his life.

The next day John would go and find something to do.

Please pray for me, in the name of Jesus

Today a big man came to my social services office asking for prayer in the name of Jesus. The mystery guy probably weighs 280 lbs, is slightly taller than me, perhaps by quarter a foot; I stand at 5" 10".

At first it looked rather awkward if not purely funny that a man smelling of alcohol could walk to my office by broad daylight asking for prayer. I found him sitting in the waiting room of our social services office. He looked a little disoriented but he was clearly articulate and knew what he wanted. He wanted someone to pray for him.
Initially, when I saw him he stood up and approached me directly, "I need prayer. Please pray for me in the name of Jesus," was his request.
I pretended not to hear him. After all, when did anyone come to social services office asking for prayer? Never! It never happened. Occasionally, I may offer to pray with a client in distress who seems to express the need. Expressing one's religion can be tricky and I exercise it with great sensitivity. For that reason I prefer to wait for the client to state a need for prayer.
I went away past him to the church building one hundred yards from social services building. Upon returning I used a back entrance into my office hoping that way to avoid meeting him.
As I turned the corridor I found the gentleman speaking with my colleague.
My colleague in turn said to me, "This guy is asking for a Pastor to pray for him. So I told him to wait until you returned." She said, motioning with her hand to me to take over from there. Two colleagues were standing there besides him.
"Okay, I will walk to the chapel with him." I said, indicating to the man to follow me. I walked out of the building to the chapel. There I led him to the 'penitent seat' where I told him to kneel down before the LORD.
I prayed for him in the name of Jesus Christ of Nazareth. I rebuked the devil and demonic forces for messing up his life; I prayed for forgiveness and restoration in his life and family. I prophesied a whole lot concerning him and his family and his wife. After 25 minutes of praying there I asked him to stand up and follow me out of the chapel. He was so broken, crying like a baby, his entire face filled with tears. I rushed inside the service room toilet to get some tissue paper for his face.
As we walked out he showed me the bicycle he was riding. Then he pointed to a picture of a helicopter on his T-shirt:
"I used to drive these and now I am riding this." I nodded my head in understanding, wondering what his life is like or where he has been.
Such is life, there are ups and downs. Only Jesus makes the difference that prevents the downs from becoming down-and-out. Jesus is the equalizer in life. he came to give us full and rich life. He comes in to save, restore, and bless. He protects and guides.
One day perhaps this man will return to tell me what happened. I took authority in the name of Jesus; I bound the powers of the devil in the name f Jesus, and I released the working of the Holy Spirit in the life and family of this mystery man, in the name of Jesus. See this video: http://www.youtube.com/watch?v=cF_gJgILBiE

So, what exactly do you do as case manager?

Finally, today, April 24 and nearly 10 months since I took up the job of case manager, a client asked me, “So, what exactly do you do? ... what do you mean you work with me?” The question sounds so personal when a client asks it this way.

     This question goes to the heart of who I am, why I am here, and why I do what I do, the way I do it. I have probably said it many times already in different ways. This is different because clients do not generally ask these kinds of questions. I was caught unawares by the client and I had to give my honest and sincere answers through a conversation.

“I am your friend and advocate; the person who listens to you, to hear what you have to say ...as to why you are here in the shelter; where you want to go from here, what you want to do ...now and in more generally in life, and to find ways by which I can be helpful to you.” I explained.

“Do I make sense?”

He nodded his head and went on to ask, “So, what more can you tell me about your work?”

This sounded to me like an educated question asked by someone who knows something about this work. I gently sat back in my chair to search the vocabulary of case management studies that I did over four months earlier to come up with appropriate details of what this work involves and what I do.

“The client is the most important person in this work. You are the client and I am your case manager. I might have some good ideas for your life, but I cannot tell you what to do. Most of the time I will ask you questions to clarify your own direction in life. The main thing is that it is all about you; you are speaking to me and I am listening. Together, we are doing.” I explained.

“Are you a counselor?” He said.

“Not exactly a counselor. I am a steward. In this kind of stewardship perhaps 10 percent of what I do is counseling. The major part of my work is advocacy. An advocate is like a lawyer. I am not a lawyer. In a major way I function as your advocate, knocking on some doors for you, pointing you to social service organizations and human service resources available in organizations locally and beyond.” I explained.

He nodded and said, “Okay, now I understand.” He nodded his head some more.

I continued to explain, “You can look at me as your friend while you stay in the shelter. If you encounter challenges during your day out while looking for a job, give me a call so that we can talk about it. If you anticipate problems, for instance you are delayed by some unforeseen circumstances you can call me so that we talk about it. I will listen to you.”

"Your success is my success. Your success today is a milestone for tomorrow. Your milestone today is determined by the goals you set for today. Equally true, your success in future is determined by the goals you set for yourself."

     Many case managers are social workers and nurses; however, a case manager is not a social worker; neither is case management nursing. It is a relatively new system in terms of how to define it. Although case management has been practiced by many people in some ways, only recently has this occupation been given meat and bones to bring it to full life. 

     Even then, many times people refer to case management when they are talking about one of a nurse's tasks of nursing care. Case management is a collaborative process involving many human service organizations. At the center of this system is a client; the case manager's role is helping the client access the services available to him or her.

     A good case manager has a deep understanding of human needs and human services available to clients, is aware that some of the needs of clients cannot be fully met; is compassionate and prepared to show it by doing what he or she can for the client without dis-empowering the client.

     Nursing care, counseling, funding, sympathizing, advising, and psychotherapy are some of the traps a case manager faces. Case management is not one of these; it is at most a small fraction of some of these activities. Many clients have the wrong impression that a case manager is there to solve the client's problems; others think the case manager is a counselor and adviser to tell the client what to do, or perhaps that the case manager is a sympathizer who feels pity for the client. This is why it is important to draw boundaries and define expectations in the first meeting with the client.

     In my experience, the case manager is misunderstood by clients as well as by other professionals who do not take the time to ask, "What exactly do you do?" I have encountered some problems relating with some colleagues who are surprised when I seem to side with the client as if I am making a stand against my own organization. Such colleagues either forget or are ignorant of my role as advocate for the client. I am expected to stand for my clients and to fight for their rights without compromising my organization's integrity. 

     Of such I am one. My background is in medical laboratory sciences. I worked in the blood bank and general routine medical laboratory, taught hematology and blood banking in colleges of laboratory sciences for 20 years, and I worked as a manager for community health and development systems in rural Africa for more than five years. I have deep Christian convictions and faith in Jesus. As a soldier of the Salvation Army, case management is one more example of how I can exercise my faith in Jesus. My uniform has two S's; one on my right another on my left. The one says Saved, the other: to Serve. SS: saved to serve.

     A good case manager has a deep respect for the organization he or she represents, understands the ethos and positions of the organization vis-a-vis human needs and human services available to clients, is aware that no one organization can meet all the needs of every client; remains sensitive to organization needs and is prepared to show it by doing what he or she can for the client without discrediting the organizations involved.