Friday, May 22, 2009

Sustainable Massage practice

How principles of sustainability relate to massage practice

In massage practise today we need to consider the effect our business has on environment, social and economic sustainability and that we are not causing pollution to our environment, using health-damaging products, having industrial accidents, stressed employees with illness and exploiting labour (Inkson & Kolb, 1998).

Economic Sustainability

Economic sustainability in a massage business is not just about continually achieving economic growth each year. We need to understand that it is only sustainable if it also improves our quality of life and the environment. (NHS Purchasing and supply agency, 2009).

Initially setting up a massage business requires financial budgets to be completed. Income needs to exceed expenses so that the business is profitable. Cash flows need to be completed regularly to ensure this is maintain so income can be drawn to improve your quality of life.

When spending money, purchase New Zealand made equipment and materials. If New Zealand made products are unavailable, purchase imported products but do this through a New Zealand business. Use business partners that also have an environmental, social and economic focus.

Whenever possible spend locally to support local business. This has a flow on effect through the community to help other.

Social Sustainability

Social sustainability in a massage business will ensures that basic needs are being met to help human life to flourish (Ministry of Environment, 2009).

A business has a roll on effect from the owners who have a financial stake to clients and customer who use the products and services. Employees and contractors depend on the business for their livelihood, these people live in the community where the business is located as well as creditors, bankers and suppliers (Inkson & Kolb, 1998).

We need to maintain a work/life balance. To take time out from our paid work of massage to enjoy family and community activities for social, sports, religious or cultural occasions. With working from home it is sometimes harder finding that balance. You do not walk into your business at 9.00 and walk away at 5.00. Work eats into leisure time with such things as cleaning, washing and ironing as well as phone calls.

Providing a massage business maintains the physical, mental and social well being of your clients and the remainder of the community that decide to use your services.

Joining support networks and have relationships in the community - Women in Business, Lions Clubs and the local promotional group all have flow on effect to help the community.

Membership to Massage New Zealand gives opportunity for learning by attending conferences as well as making contacts within the massage network.

Provide safety for staff with a healthy work place. They will enjoy coming to work. Ensure massage tables are set up for staff safety and that staff have manageable workloads.

In New Zealand food is considered as an important element affecting health (Inkson & Kolb, 1998).

Have nutritional food available and provide cooking facilities in favour of processed snacks from vending machines or local cafe. Supply filtered water for drinking and encourage intake of fluids for staff and clients. A saving on heating water for coffee and tea.

Environmental Sustainability

Environmental sustainability in a massage business is the use of resources and the impact it has on the environment now and in the future so that we can ensure we are meeting the needs of people today but at the same time safeguarding the interest of future generations.

The main materials I use in massage are electricity and physical materials.

Electricity - heating my room and lighting. A thermostatically controlled heater and energy efficient lighting can be used to reduce power consumption. Turn everything off at the plug when not in use. Dry linen on clothes lines and use a dryer only in emergencies. Use a green electricity company to provide your power.

Physical materials - recycle paper by using both sides. Only print off what needs to be printed from a computer. Ink cartridges can be refilled. This is also a cheaper option than purchasing new ones.

Pay accounts by Internet banking which saves paper on envelopes and cheques, no postage cost, and also lower bank fees. Bank statements can be received electronically.

Use bio degradable washing detergent and hand wash.

When shopping for materials take environmental bags with you so you do need the plastic bags used today by many businesses.

How I can make my massage business more sustainable

To make my massage business more sustainable I plan to do the following:

Insulation put into ceiling to reduce heat loss. Wool may be the option. It is natural and is recyclable.

Use energy efficient light bulbs.

Use biodegradable rubbish bags.

Use time effectively - Have more clients in a day and make sure I don’t have gaps between clients thereby reducing the time worked which will save on electricity for lighting and heating.

Become a member of Massage New Zealand for social networking. Attend local promotional meetings for my community.

Additional thoughts

Make sure that what we are doing towards sustainability is not having a negative impact on other areas such as hygiene.

Rooms have to be warm for massage. Thermostats need to be set at a high enough temperature to maintain this. No point in using a lower temperature to save electricity and then have the room cold for the client.

The use of a green electricity supplier may be more expensive. You need to way up the economic viability compared to the environmental viability.

There is no way I am going to save the planet but if we can lead by example maybe the following generations will be more educated towards sustainability than the past generations have been.

Resources

Class notes
McQuillan, D. (2009). Ethics. Dunedin, New Zealand: Otago Polytechnic.

Experience in setting up my own business

Internet

Previous Learning

Text Books

References

Inkson, K & Kolb, D (1998). Management - perspectives for New Zealand. (2nd ed). New Zealand. Longman.

Ministry of Environment. (2009). Govt: towards sustainability practise. Retrieved May 22, 2009, from http://www.mfe.govt.nz/issues/sustainable-industry/govt3/topic-areas/social-sustainability/index.html

NHS Purchasing and Supply Agency. (2009). Economic sustainability. Retrieved May 21, 2009. from http://www.pasa.nhs.uk/PASAWeb/NHSprocurement/Sustainabledevelopment/Economicsustainability

Friday, May 15, 2009

The Ethics of Professional Practice

Ethical considerations are covered under a code of ethics. These are standards that cover conduct of a person or member of a profession. Integrity of professions relies upon these.

Ethics are about the relationship between the massage therapist who is the professional and the client. They come into effect each time the therapist and client come together for massage therapy.

In massage therapy ethics cover the following:

Client-centred care

As massage therapists we take responsibility for our clients comfort and safety and provide this by understanding their needs and rights. Legal requirements cover clients under the Privacy Act 1993, Consumer Guarantees Act 1993 and Health and Disability Consumers Act 1994.

The primary responsibility is for the health and safety of the client. Work must be carried out with due care and diligence (The health information network (n.d.).


We should serve the best interests of the client at all times, putting the client first and giving them the highest quality service. Focus on the best interests of the client and avoid any activity that takes the focus away. Therapeutic relationships with clear boundaries and good open communication will help to ensure that the client feels safe and attended too as we as build trust and respect. Involving the client in the decision making enables you to be aware of their goals and gain consent to the treatment discussed. This will ensure the massage is beneficial to the client.

Informed consent

Before any treatment takes place you need to obtain informed consent from the client. Your client needs to understand exactly what they are consenting too and what their rights are. Obtain feedback to reassure yourself that they understand. If working with a minor written consent from a parent may be appropriate.

You need to advise your client on the clinical procedure of your business such as the terms of payment - cash, cheque, eftpos, the cost of treatment, your scope of practise and your referral system to other professionals as well as the way in which you are going to proceed with the proposed treatment and the likely after effects of the treatment.

Scope of Practise

These are the parameters that you work within to provide massage treatment. It defines what services you can and cannot provide as a massage therapist (Salvo, 2007).

Training, experience, competency and qualifications will define your scope of practise. By understanding and working within your capabilities you are taking the safety of the client into account as well as feeling safe about what you are doing.

Confidentiality

Client information is confidential. It is only to be used for the purpose it is provided. All information should be locked in a cabinet or if held on a computer accessibility is only with a password. Only record information about client treatment not the personal thoughts or feelings that are discussed. Records can be requested by a court of law so they need to be accurate and legible. Information is only released to a third party after receiving written consent from the client. Leaving messages on answer phones can be another breach of confidentiality. Who clears the messages?

As client trust increases they will open up and talk more about their thoughts and feelings. This stays between the therapist and client. When a client talks about their personal problems at one session then it should be the client that brings this up in future sessions not the therapist. Situations and emotions change and a client may regret what was discussed.

If you meet with a client socially ensure that confidentiality is respected. Eye contact and a smile will acknowledge the person but anything more should be initiated by the client.

Boundaries

“Professional boundaries create a healthy, professional distance between the client and the therapist. In fact the distance makes the therapeutic relationship a safe place for the client’s experience” (Salvo 2007, p 28).

Boundaries clarify roles, responsibility, expectations, and limitations as well as creating and preserving safety in relationships. Boundaries may be changed by use of effective communication to reduce misunderstandings.

Power Differentials

The imbalance of power - i.e. the therapist is the professional and the client has a need, the client has come in for a treatment and the therapist has knowledge and skill to provide the treatment, the client lies down and the therapist stands over the client. These are not problems but would be if the power is misused by the therapist. In these situations the client cannot say no easily.

Situations should not be used to the advantage of the therapist such as when a client is in deep relaxation as the client may agree to something that they would not normally agree to.

Relationships

These have to be therapeutic or personal but not both. Therapeutic relationships are unequal as a power differential has formed. Having both of these relationships with a client can make maintaining boundaries difficult also the therapist is responsible for any negative consequences of these relationships. Professional relationships need to be closed off before starting personal relationships.

Transference and Counter-transference

Transference occurs when client’s feelings for a person that was of importance in their life are transferred to the therapist. Warning signs can be that people may be dependent on you, they may give personal gifts, invitations to social events or have unrealistic expectations. To deal with this you need to maintain clear boundaries, have regular supervision and consider referral of clients to other therapists.

Counter-transference is when the therapist tries to meet their personal need through a client and can also occur when the therapist finds it hard to maintain boundaries. Warning signs are attachment to a client and the desire for more than a therapeutic relationship. To deal with this you need to know how your personal needs are related to your client’s relationship and undertake regular supervision.

Further thoughts

To have a code of ethics is not enough. Therapists have to have their own ethics and morals to be able to uphold the professions code. These standards come from such things as our education, peer influences, life experiences as well as beliefs which have been embedded by our parents. They include such things as honesty, integrity, respect and loyalty. You need to have a caring attitude to be able to show understanding and empathy to the client as well as enjoying your job. This has to be genuine and cannot be taught, it needs to come from the heart of the therapist.

Resources

Previous Employment
Previous Learning
Text Books
Class Notes
Internet

References

Salvo, S. (2007). Massage therapy - principles and practice (3rd ed). Missouri, USA: Saunders Elsevier.

The health information network (n.d.), A massage introduction, 5. Retrieved May 23, 2009. From http://www.nzhealth.net.nz/massage/ethics.shtml