Kim is a 17 year old young woman who has been sleeping rough, working as a prostitute and using heroin. Nick, her youth worker, has a good rapport with her and is hoping to make some progress soon on the various issues Kim faces.
Kim calls Nick one day in a state of distress and asks to meet in a nearby park. When Nick gets there Kim is bruised and dishevelled. Nick ask what has happened to her and Kim says "give me a cigarette". Nick has a pack of cigarettes sitting visibly in a jacket pocket. Nick ignores the request and asks her again what has happened. Kim again says "give me a cigarette". Nick mumbles something about not being allowed to give cigarettes to young people, but Kim interrupts and says "Look. I've just been raped. I've just been beaten up. And I've just been robbed. Now give me a bloody cigarette!"
What should Nick do?
Give her a cigarette and then go to the pharmacy and get yourself some patches. Very hard to be self righteous if you very obviously have cigarettes yourself.
ReplyDeleteEvery now and again, a scenario comes along that can make professional and personal rules no longer seem so important and this could be one of them. I am a smoker who has always had a personal rule of not giving cigarettes to clients, regardless of whether they're over 18 or not. In this instance though, I may well be tempted to place the packet on the bench and if she happened to pick them up and take one, well so be it. I think I'd be asking myself whether it is more important in that instance to keep her engaged and talking or to implement a rule she'd learn nothing from under that particular circumstance? Who knows?
ReplyDeleteI would give her the cigarette and have no regrets or doubts about it!!!
ReplyDeleteI would give her the cigarette. We are in this industry to help these vulnerable young people. I would proudly stand before a court of law and say "yes your honor, i did give this client a cigarette. As a social worker i made a professional decision that i would connect with this young person and help them through this horrific moment of their life."
ReplyDeleteA note on the law in NSW:
ReplyDeleteIt is an offence to sell cigarettes to, or buy cigarettes for, an under 18 year old (NSW Public Health Act). It is not clear if buying your own cigarettes, then giving one of them to an under 18, would be judged to be buying for an under 18. The law is aimed at retailers and they are sometimes prosecuted. I believe that a case against a youth worker is unlikely. More information in YAPA's fact sheet at
http://www.yapa.org.au/youthwork/facts/ok/drug.php .
I think, rather than focussing on the (unclear) legalities, it is more useful to explore the ethics of this situation. So more comments please!
- Nick Manning, YAPA
Give her the bloody cigarette.... jeeze!
ReplyDeleteI work in youth health, but have been a youth worker since the late 80s and this issue just doesn't go away.
ReplyDeleteI don't think we should ever give tobacco to our clients. And by being more conscious of the role that we have might eliminate problems like 'having the packet of cigs visibly in my pocket', because we would be conscious of not having them visible when we were with our clients.
Nicotine remains this country's biggest drug killer, and I believe a youth worker's role is very much to provide healthy and safe options and alternatives to the young people we work with.
If we, as workers, were addicted to other drugs, say alcohol, marijuana or cocaine, I'm sure we wouldn't even begin to condone those drugs being offered to a client (regardless of age), and we also would expect that a) those drugs weren't used in the workplace or during work time; and b) that if our addiction did lead us to bring that drug to work, that we would keep it well hidden, and not permit our clients to witness its use.
I endorse the comments of someone else, that if we as workers have addictions, then addressing these for ourselves is an important first step in keeping ourselves healthy and providing a safe and healthy environment and modelling for the young people who meet us in our youth work roles.
I whole heartedly agree with the previous comments form Anonymous from April 30. We need to be encouraging health and safety for our young people and hopefully we can set a good example by walking that health and saftely walk ourselves. Put the lung bungers back in yur draw when you are with your clients
ReplyDeleteShe's been raped and robbed... now give her cancer!
ReplyDeleteIf you hadn't arrived with cigarettes, then you wouldn't have been able to offer the client one and you would get on with working with what the client really needs. Just because you have cigarettes doesn't mean you are justified in giving the client one. By giving them a cigarette you, as the worker, are just taking the easy, less confronting, option, which in the long term doesn't help the client and makes it difficult for other workers to enforce the right thing. Don't make yourself the "good cop" by taking the easy option, making others the "bad cop" for enforcing the right action. By the way, despite popular belief, smoking doesn't actually calm people down, it heightens anxiety, which is the last thing the client needs.
ReplyDeleteNick will make no progress on Kims various issues, and will destroy any good rapport if he is going to get into an ethical argument over refusing a ciga to a 17year old heroin using prostitute who has just been raped and beaten up. A no-brainer.
ReplyDeleteIn general, I feel that the youth worker acted irresponsibly by having a pack of cigarettes visible while meeting with a client. People can do whatever they want outside of work, but should strive for professionalism while on the job. Nick should have been aware of his role and presence. In this situation, I think it would be just fine to give Kim a cigarette. From Kim's history the youth worker knows she has already engaged in high risk behaviors so trying to shelter her from a cigarette in this situation would be a waste of time. With this extreme situation I feel it would be appropriate to compromise personal and professional beliefs to meet the need of the client. A youth worker would not want to add to Kim's problems and have conflict over cigarettes at a time like this. I think a difficult situation like this one is one time it is okay to give into a client even though you know you are crossing a boundary. Nick should be most focused with getting the facts from Kim, helping her report the attack, and making sure she's safe now.
ReplyDeleteIn this instance I certainly would give the girl a cigarette. The bad that would come from a 17 year having one cigarette is far less severe than the youth worker losing her trust. This situation could have been avoided by not having a pack of cigarettes visible, but since that was not the case then I would give her a cigarette.
ReplyDeleteBefore I read this scenario I don’t think I could have imagined a situation where I would have given a cigarette to a 17 year old, but the stakes are just too high in this case. The girl clearly went through a horrific experience and the last thing she needs is someone giving her lecture on the dangers of smoking. A youth worker needs to always have the bigger picture in mind. In this case the picture is far bigger than one cigarette.
I agree with the [Dec 3rd] post. Although Nick has made a mistake carrying the cigarettes in a visible area, there are much more serious circumstances at hand, and in certain situations, some values can be compromised if the well being of the youth is at stake. Kim is obviously in a state of serious emotional and physical distress, and as a youth worker, I would do whatever it would take to help her feel comfortable and safe. As soon as I gave her the cigarette I would take her to the hospital and I wouldn't take no for an answer.
ReplyDeleteThis news story from the mental health sector provides an interesting parallel:
ReplyDeletehttp://tinyurl.com/cee43b
In a situation like this, being precious about your health ethics isn't going to a) have any positive impact on the young person, b) isn't going to help you to help them, and c) could erode the rapport you have with them!
ReplyDeleteAs a worker who did once smoke, and certainly never gave a ciggarette to a young person, I think this rule would go out the window in this ONE situation.
so we give her a cigarette... what happens next time we work with this client and they ask for another, we say no and she says but you did last time. We try to justify why we gave her one last time and she then threatens to self harm if we dont give her a cigfarette this time....
ReplyDeleteYou weren't doing your job properly if young people know you smoke. And yes, just like a politicians and professional footballers, your public life invades your private life, just something you need to get used to, OR you could not work in the area you live in and frequent!!! Working outside your own neighbourhood is a tactic that youth workers, doctors, counsellors and even police officer use. And it's just a simple way of separating your job from the rest of your life.
ReplyDeleteGive a young person a cigarette in this situation = keeping her engaged, providing her with her own form of comfort for just one instance. Not giving her a cigarette= being far to precious about your own health ideals, possibly loosing her as she goes off to find one, and making a petty decision.
ReplyDeleteIf i was a smoker and had just been through that situation, would i want a cigarette? yes i blimmin well would!
First of all in this situation as a youth worker you need to assess weather Kim needs urgent medical attention as in the case study it says she is visibility bruised and disheveled.in this case you have to way up the law,policy,and your own boundaries and personal views around smoking and the clients needs and safety around how they may acquire a cigarette later on .In weighting these options up i would try to engage the young person in a healthier option i.e coffee, walk,gum.
ReplyDeletethe youth worker acted irresponsible by having cigarettes in full view of a client whilst meeting in the first place, but in this situation i think if i was the youth worker i would give kim a cigarette , shes 17 a prostitute and uses heroin a cigarette is not going to kill her in fact it may help to calm her down enough for her to be able to tell you everything that has just happened to her , also after everything she has just been through the last thing she needs from the youth worker ( the only person she trusts ) is refusal and a lecture over cigarettes this would only cause conflict between the youth worker and kim that is not needed at this time. the main focus here should be to help kim report her attack and ensure here safety now.
ReplyDeleteMeeting a client in a park could be dicey in the first place. Hope it's daytime and there are other people around. Nick's first thoughts need to be for her medical needs and he needs to call an ambulance. It's the quickest way to go to the front of the queue in a hospital emergency department.
ReplyDeleteLet the paramedics deal with the cigarette issue. We all know what they'll say. Then Nick's not putting himself in a compromising position. Tough love is something Kim obviously needs.
Ethical principles considered, it would go more on my moral standing and understanding of my clients needs.
ReplyDeleteGiven the situation of the young ladies circumstances I would give her a cigarette not a lecture about ethics. Giving Kim a smoke may calm her down enough for her to explain what has happened. You can also use that time to notify the hospital and the police. Your rapport and responsibility with your client is very importanr. Keeping her safe and calm untill help arrives. Even if that means giving her a cigarette.
As a student doing my diploma in youth work. I think as a worker there will be times when the rules will be bent and this scenario is one of them.I would give the young person a smoke and light it for them if they needed it.
ReplyDeleteI am there because this young person has trusted me. Considering the horrific thing she just went through giving her something that will comfort her isnt a bad thing.I would acknowledge to myself and inform the client that i understand that this is an extreme situation.Normally i would not give any client a smoke.
Whilst tring to get the facts about what has happened to her i would inform the client that she needs medical assisstance.She also needs to go to the hospital get a rape kit done and the police have to be informed i would assure her that i could be an advocate if necessary in reporting the attack and making her feel safe
This girl will probably need several cigarettes before she begins to calm down. I agree with anonymous-get some patches for work at the very least. Hypocracy does not wash well with youth. In the circumstances the rape and beating are the most important issue, not giving her a cigarette.
ReplyDeleteHaving recently given up smoking, I find this very interesting. In my curent situation, I wouldn't be giving a smoke as I don't have one- the easy way out. However, I used to smoke and the people you work with( co workers or youth) , know this. They smell it on smokers even if they never see you smoke. As for the age of this girl, she is doing all of those adult things before asking you for a smoke. If there is damage from smoking, she will already have it and your 1 cigarette won't hurt. There are more worrying issues at this time. The worker needs to give all the trust and comfort he/she has for this young person. To refuse the cigarette would cause rejection and this is not the time for that.
ReplyDeleteI would give a person a smoke in this situation. I know it's not always professional to do so but to gain some trust and rapport, I can’t see the harm in it. I read other posts about the legalities on this matter but I can’t see anyone bothering with a cigarettes fine over the welfare of a young girl. To show some empathy is not always a bad thing. Arguing about a cigarette is not the most important issue here. She has chosen to disclose to you and this could be the one and only opportunity. For future reference the worker could leave there smokes in the office or car.
ReplyDeleteFortunately, I quit. When I did smoke though, I would never give cigarettes to clients and never to someone under 18 and would never give someone a cigarette who demanded one without asking with proper manners. However, I had never met anyone in this situation either. Given this, I probably would give her a cigarette, if I knew she was a smoker. My focus would be on determining what happened, and if she would need medical help or not..
ReplyDeleteThere also the matter of how she would react if the worker insisted on following policy to the letter no matter what. Which is more important, the clients safety and well being, or never breaking a law. Also, how serious are her injuries. I'm guessing the worker isn't a medical practitioner to determine this, and the reality is, she could have serious internal injuries that needs urgent treatment, such as internal bleeding or something (unlikely, but still possible non the less). The worker needs to know what happened and if need be, get her some medical treatment or first aid. If he has to give her a cigarette to achieve this, then so be it.
Nick needs to help Kim understand that he cares for her safety and wellbeing. He needs to let her know that as her youth worker there are rules and regulations that prevent him from giving her a cigarette and that he has already been foolish enough; carrying a packet of cigarettes on him and (turning up alone).
ReplyDeleteHopefully Nick also carries a packet of chewing gum around and can offer a chewy…
That being said, I asked my 13 yr. old daughter her thoughts on this dilemma and she said ‘Oh just give her a cigarette Mum’!
Give the girl a cigarette What sort of a youth worker would have them hanging out of there pocket anyway. This young person has many more demonds to deal with than a cigarette I belive the cigarette is the least to be worried about at this time getting her to attend a hospital for medical help is a much higher pirority
ReplyDeleteOne of the things that I'm currently learning while studying to become a youth worker, is that the young person's safety and welfare comes first. In this particular dilemma we find out that Kim is bruised and battered. She is in a place of emotional distress, we find out the reason for this later on. But the point being that cigarettes do have a calming affect. I understand that it is illegal to supply young people under 18 cigarettes, however I am also very conscious of the fact that being so distressed, she needed something that would allow her to focus, and let her story be heard, so that she could be further helped.
ReplyDeleteYes it is a legal issue, however ethically, if Kim smoked, and chances are she did that is why she is asking for one. Then does it really matter? And I don't think it does.
AS a studying youth worker and mother of four boys i believe this can clearly be resolved by not having cigerettes on my person whilst dealing with youth of any age, regardless of whether i smoke or not.
ReplyDeleteSo much wise hindsight. A colleague of mine feels that the youth worker was foolish to have the cigarettes sitting visibly on him. I say "Nick it is too late you are caught" but he could always deny that they are his. On the one hand a consumer in need of help, requiring medical attention and assistance requesting a cigarette while on the other hand a law that makes it illegal to give someone a cigarette under 18 years of age and the knowledge that while some may think the cigarette will have a calming effect, in reality tobacco/nicotine increases blood pressure among other things. Does it go against the policy of the employer? All the while, a consumer awaits a yeah or nay with with her nervous system embarking on the flight or fight response. I would say "accidentally" drop the cigarettes and deny any intention.
ReplyDeleteWhat a situation Nick is in!
ReplyDeleteKnowing that a youth worker should not be supplying a youth with a cigarette as it is against policy and procedures.
With understanding of what traumatic experience's the youth has just been through I would allow her to smoke a cigarette.
If i was to drop my cigarettes and the youth returned them to me one less I would let it go, this time only due to the circumstances.