Human services is a broad and somewhat ambiguous term, but support work falls under its umbrella. In traditional institutions, there were registered and enrolled nurses and support workers, though the latter’s roles were quite limited. When deinstitutionalisation occurred—essentially, when we closed these facilities—support staff found themselves unsupervised, untrained, and navigating the community independently.
There was no formal development of competencies, pathways, or roles; everything developed chaotically. Unfortunately, support staff have been largely left out of the conversation. The workplace has become hostile for many, leading to the loss of exceptional individuals who contributed greatly. The hours are unpredictable, and we often spend considerable time travelling. The role has become increasingly adversarial and controversial.
There is pressure to revert to institutional models and redefine support work as merely an extension of nursing. However, I believe this is incorrect. Support work is an entirely different role that requires distinct skills and aligns more closely with other human services roles, such as childcare, mental health, and aged care.
There is a significant misunderstanding regarding what constitutes support work, the scope of practice, and our responsibilities. In some cases, this has led us to become “jack of all trades.” In others, people perceive us as merely proficient in scrolling through social media.
Support workers do a wide variety of tasks, including:
- Personal care
- Bowel care
- Catheter care
- Ventilation management
- Medication management
- Cooking
- Cleaning
- Babysitting
- Driving
- Coordination
- Social work
- Advising
- Companionship
- Recreational coordination
- Case management
- Acting as substitute guardians
- Mediation
- Advocacy
- High-intensity care
- Hairstyling
- Life management and proxy guardianship
This list is extensive. What worries me is that the scope of a support worker’s role is poorly understood, and there are no standardised qualifications that truly fit for purpose. Our level of competence directly influences longevity, comorbidities, quality of life, and other crucial outcomes.
We have reached a point of being undervalued, which could lead to a potential workforce failure. Some believe that all that’s needed is a positive attitude, while others attempt to label us simply as nurses. What is clear is the need for a focus on competency and a proper understanding of what this role entails, along with appropriate and effective training.
We often perform more support coordination than many coordinators, take on more organising tasks than social workers, and manage more medication and case management than most nurses. Yet, we continue to find ourselves in an undervalued position.
This role is vital and a crucial gateway to safeguarding medical outcomes and intrinsic quality of life. We are the guardians of inclusion, and our competency directly influences the outcomes and quality of life a participant will experience.
We typically work an average of 30% extra unpaid, and we endure significant levels of violence and psychological trauma. It’s time we address these issues.
Your Human Services for Disability (HSD) staff are your best allies, advocates, and facilitators. However, we must clarify our roles, define our purpose, and train accordingly. There must be clear career pathways and job security. If a participant trains their staff, those staff members may not possess valid credentials to be viable in the industry, which undermines participant choice and control.
While I acknowledge that understanding a participant’s individual life is essential, this should not replace the need for competency-based national standards.
We must remember that a rising tide lifts all boats, and to elevate ourselves, we must also lift others. It’s crucial to end toxicity, bullying, and poor working conditions from all sources.
We need to reinstate the joy in our work because, to me, it will always be the best job in the world. Our training is both online and onsite, with apprentices able to live with us and gain competency-based skills. This training will enable us to meet the role’s needs and effectively serve people with disabilities—at home, in the community, or in hospitals.
