Focus Area 4: Ethics
5. Consult or Refer: Know the Limits of Your Role

Most likely you have visited a hospital or perhaps you’ve been a patient yourself. Hospitals are fascinating, complex social environments. In well-functioning hospitals, the various staff members know their roles and they know the limits of their roles.

For example, for the most part nurses do not diagnose and they do not prescribe medicine or other treatments. Nor are they expected to diagnose or prescribe, because these activities are outside their “scope of practice.”

Youth workers often function as part of a complex social environment where knowing your “scope of practice” is important. For the well-being of the youth you serve, it is crucial for you to know where and when your skill set ends, respect your scope of practice, and know when to consult or refer.

For various reasons, a youth worker may be reluctant to consult with or refer a youth to a colleague or supervisor. Why? The top 5 reasons given by youth workers are:

1. Fear it means they are somehow inadequate
2. Fear of becoming unpopular with youth or other youth workers
3. Concern about upsetting youth
4. Fear of legal problems
5. Fear of damaging trust in the relationship with youth

Knowing your scope of practice is a strength, not a weakness. Your supervisor will help you know the details of your “scope of practice” and roles. When in doubt, talk it out - consult.

If you’re feeling like a situation goes beyond your role or your training, it is better to consult with other staff or with your supervisor. Consulting does not demonstrate incompetence; in fact, it shows true competence.

Also remember, consulting is not snitching. If you’re concerned about confidentiality, you can discuss a situation - without using names - as a hypothetical scenario.

• Begin talking with your supervisor about the situation in a hypothetical way:

“There’s a situation I’m concerned about and I need some input but I’d like to talk about it for the moment without naming names.”

• After hearing the situation, your supervisor can help you determine whether or not it is necessary to divulge names. And they will undoubtedly be happy to provide guidance and advice to help you resolve the situation you’re dealing with.

Lastly, remember that referring a youth to someone else does not mean you are inadequate or a ‘bad youth worker.’ Sometimes, youth need more than a youth worker.

In the medical field, if a patient needs physical therapy rather than surgery, they should get treated by a physical therapist rather than a surgeon. This doesn’t mean the surgeon is bad.

The same is true in youth work. Sometimes a youth will need more than what you as a youth worker have been trained to do.