Supports rights, independence & choice

Holding the Line on Someone's Rights Under Pressure

A CORA decision skill · about a 4-minute read

Rights are simple until somebody with more power in the room wants something different. Holding the line is what the person's choice is worth when it is inconvenient.

Hold the Line means

Keep the person's rights and choices steady under pressure (family, org, routine, peers).

What it looks like on shift

  • A family member tells you what the person will be doing today, and you check with the person.
  • The routine says shower now. The person says not yet. You ask them what would work, and you find out what actually has to happen by when rather than assuming all of it does.
  • A co-worker overrides a choice because it is faster, and you say something at the time rather than after.

What it looks like when it slips

  • Deferring to whoever is loudest, then recording it as the person's decision.
  • Letting the roster decide something that was the person's to decide.
  • Going quiet because the pressure is coming from someone senior to you.

Three things to try on your next shift

  1. When somebody else in the room makes a decision for the person, ask the person directly. Out loud. It changes the room.
  2. Separate what is genuinely fixed from what has just always been done that way. Most routines contain more of the second than anyone thinks.
  3. If you could not hold it in the moment, say so afterwards rather than letting it pass. Naming it is how it gets addressed instead of repeated.

When it is a report, not a conversation

Everything above is about having the conversation. Some of what you will see is not a conversation. If somebody was hurt, frightened, or had something done to them that they had said no to, that does not get raised at handover and left there. It goes through your organisation's incident process, in writing.

Blocking a doorway, taking something off somebody, locking a cupboard that is theirs, or holding them, even briefly and even kindly, can be a restrictive practice. If you see one of those happen, write it down and report it, whether or not you think it was authorised. You do not have to work out which category it falls into or what the timeframe is. Report it and let the people whose job that is sort out the rest.

If you genuinely cannot tell which of the two you are looking at, treat it as the report. Getting that wrong in the cautious direction costs somebody twenty minutes and a form. Getting it wrong the other way costs the person.

Before you act: Always follow your own organisation's policy first. For a suspected poisoning or medication error, the Poisons Information Centre is 13 11 26. In an emergency, call 000. That includes your organisation's incident reporting process.

More in Supports rights, independence & choice:

  • Honour the RiskSupport dignity of risk and informed choice even when you'd choose differently.
  • Open CommunicationMake space for the person's voice and choice, don't take over, pressure, or assume.
  • Step BackBuild independence, do with, not for; resist over-helping.

All ten decision skills →