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Athletic trainers require more administrative knowledge than ever before, and Management Strategies in Athletic Training, Fifth Edition, is designed to help them master that knowledge.
The latest edition of this respected text prepares athletic trainers to be successful in any setting and with any clientele. It does so by presenting new material that covers trends and issues that today’s athletic trainers are facing.
New to this Edition
Management Strategies in Athletic Training, Fifth Edition, offers a great deal of new content:
• A new chapter on the profession, addressing its history, differentiation between various NATA committees, the evolution of athletic training, and more
• A new chapter on professional advocacy that explains how bills become law, the need for advocacy in the profession, the value of youth sport safety legislation, and more
• New content on documentation, injury surveillance, NATA position statements, reimbursement and salary issues, and new athletic training CPT codes
• A new appendix that lists each state’s scope of practice, board and structure, and regulations for athletic training
Management Strategies in Athletic Training, Fifth Edition, also includes thoroughly updated content in many areas:
• Preparticipation physical exam standards and drug education and testing standards
• Emergency planning
• Health care financial management
• Legal testimony and depositions
• Ethical practices in sports medicine
• Legal standards
• Employment settings
• Negotiation skills
• OSHA requirements for health care facilities
Ancillaries
Management Strategies in Athletic Training, Fifth Edition, comes with these ancillaries:
• An instructor guide that is loaded with useful instructional aids, including student activity suggestions, extra case studies, suggested readings, and a sample syllabus
• Chapter quizzes with 183 questions you can use to generate tests and quizzes
• An image bank that includes the majority of the figures and tables from the text, which you can use in creating your presentations
Text Features
At the end of each chapter, you will find two helpful tools: case studies with questions for analysis, which will help students apply concepts and theories to real-world situations, and a key concepts review section that repeats the chapter objectives and shows how the chapter addressed those objectives.
The text also provides these pedagogical aids to enhance the student learning experience:
• Key words
• Pearls of Management sidebars that provide insights that readers will find useful during their careers as athletic trainers
• Glossary
• Chapter objectives
• Sample forms
• Key Points (nuggets of practical information)
Strong Content for Many Audiences
Management Strategies in Athletic Training, Fifth Edition, is a comprehensive resource for all athletic trainers, meeting the bulk of the discipline-specific content for an entry-level athletic training curriculum. The text is suitable for entry-level students preparing for credentialing and certification, graduate students preparing for credentialing or working toward an advanced degree, athletic training residents seeking to reinforce and apply leadership techniques in their residency, and practicing athletic trainers who want to update their knowledge and skills in athletic training administration.
Equipped to Meet Today’s and Tomorrow’s Challenges
Management Strategies in Athletic Training, Fifth Edition, is the ideal text to prepare athletic trainers of the future to deal effectively with the many administrative and managerial challenges they will face in an increasingly complex and changing health care environment. Practitioners will find the book’s contemporary approach to addressing today’s management culture very refreshing.
Chapter 1. The Profession of Athletic Training
Evolution of Athletic Training Education
National Athletic Trainers’ Association
Board of Certification
Appropriate Terminology
Women in Athletic Training
Ethnic Minorities in Athletic Training
Summary
Learning Aids
Chapter 2. Principles of Management
Foundations of Management
Three Management Roles
Improving Managerial Effectiveness
Summary
Learning Aids
Chapter 3. Program Management
Vision Statements
Mission Statements
Planning
Meeting and Conferences
Program Evaluation
Summary
Learning Aids
Chapter 4. Human Resource Management
Factors Related to the Sports Medicine Organization
Staff Selection
Personnel Deployment
Staff Supervision
Performance Evaluation
Fair Labor Standards Act and Athletic Training
Work–Life Balance
Summary
Learning Aids
Chapter 5. Financial Resource Management
Budgeting
Purchasing Supplies, Equipment, and Services
Inventory Management
Summary
Learning Aids
Chapter 6. Facility Design and Planning
Conceptual Development
Elements of Sports Medicine Facility Design
Summary
Learning Aids
Chapter 7. Information Management
Why Document?
Two Kinds of Information
Summary
Learning Aids
Chapter 8. Revenue for Health Care Services
Insurance Systems
Third-Party Reimbursement
Claims Processing
Purchasing Insurance Services
Revenue Models
Summary
Learning Aids
Chapter 9. Ethics in Sports Medicine
Defining Ethics
Relationship Between Legal and Ethical Considerations
The Act of Whistle-Blowing
Practicing Ethically as an Athletic Trainer
Cultural Competence
Summary
Learning Aids
Chapter 10. Legal Considerations in Sports Medicine
Legal Principles
Reducing the Risk of Legal Liability
Strategies for Dealing With Legal Challenges
Summary
Learning Aids
Chapter 11. Professional Advocacy
How Laws Are Made
Athletic Training Legislation
How to Become an Advocate for the Athletic Training Profession
Summary
Learning Aids
Chapter 12. Administration of Clinical Policies and Procedures
Development of a Clinical Policy and Procedure
Supervision
Appropriate Medical Coverage
Camp Coverage
Crisis Intervention Management
Summary
Learning Aids
Chapter 13. Preparticipation Physical Examinations
Why PPEs Are Performed
When PPEs Should Be Conducted
Where and How PPEs Should Be Conducted
What to Evaluate During the PPE
Legal Considerations
Summary
Learning Aids
Chapter 14. Drug Education and Testing
Why Drug Testing Should Be Performed
When Drug Testing Should Be Performed
How Drug Testing Should Be Performed
Pharmacological Policy
Summary
Learning Aids
Chapter 15. Emergency Action Planning
Personnel
Communication Procedures
Venue-Specific Plan
Equipment
Documentation
Special Considerations
Summary
Learning Aids
Appendix A. Health Care Professionals
Appendix B. SWOT Analysis for a Sports Medicine Program
Appendix C. NATA Code of Ethics
Appendix D. Athletic Training: State Regulation, Scope of Practice, Board and Structure, and Regulation
Jeff G. Konin, PhD, ATC, PT, FACSM, FNATA, is chair of the physical therapy department and a Ryan Research professor of neuroscience at the University of Rhode Island (URI) as well as an adjunct professor in the department of family medicine at Brown University. Dr. Konin is a founding partner in The Rehberg Konin Group, which provides scientific investigation, research, and litigation support services for incidents involving sports, physical activity, and rehabilitation. He is the author of the textbooks Clinical Athletic Training; Special Tests for Orthopedic Examination; Documentation for Athletic Training; Reimbursement for Athletic Training; Sports Medicine Conditions—Return to Play: Recognition, Treatment, Planning; Rehabilitation from the Perspective of the Athletic Trainer/Physical Therapist; Working as a Team Physician; Practical Kinesiology for the Physical Therapist Assistant; and Sports Emergency Care. He is a coauthor of the NATA position statement Preparticipation Physical Examinations and Disqualifying Conditions, a contributing writer to the NATA’s Best Practice Guidelines for Athletic Training Documentation, and a contributor to the NATA’s Sports Medicine Legal Digest newsletter.
Konin is a fellow of both the National Athletic Trainers’ Association (NATA) and the American College of Sports Medicine (ACSM). He is a recipient of the NATA Service Award (2008), the NATA Continuing Education Excellence Award (2008), the Southeast Athletic Trainers’ Association Education/Administration Athletic Trainer of the Year Award (2010), and the NATA Most Distinguished Athletic Trainer Award (2011).
Konin received his doctorate in physical therapy from Nova Southeastern University, a master of physical therapy from the University of Delaware, a master of education from the University of Virginia, and a bachelor of science from Eastern Connecticut State University.
Richard Ray, EdD, ATC, is provost emeritus and a professor of kinesiology at Hope College. He has been a member of the Hope College faculty since 1982 and previously served as the college’s chief academic officer, dean for the social sciences, and chair of the department of kinesiology. He was the college's head athletic trainer, and he developed the academic program in athletic training at Hope. He is the author of more than 40 peer-reviewed journal articles and three books on sports medicine, leadership in higher education, and health care management.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
How to become an advocate for the athletic training profession
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team.
One of the best ways that athletic trainers can serve the profession is to become an advocate. Serving in an advocacy role allows athletic trainers to let the public and legislators know why ATs are important members of the health care team. This can ensure that athletic trainers are allowed to use all their skills to provide high-quality health care to the patients they treat (National Athletic Trainers' Association n.d.-a). ATs can speak on behalf of youth athletes and other individuals who sustain injuries during sports, other activities, or while at work. They can work to convince insurance companies to reimburse for the services that ATs provide so that more individuals can benefit from the AT's expertise. While other groups often support these efforts, such as parents and other health care organizations, athletic trainers need to do the significant work in this area. This may seem like a daunting task, especially when considering the busy schedules of athletic trainers, but these goals can be accomplished if all ATs work together (McKibbin and McKune 2015).
Advocacy can start with small steps that do not have to take up a large amount of time. One of the simplest things that every AT can and should do is contact his state legislators. Most states have an easy link on the state legislature page titled something like "Find my legislators." For some, there may be a separate link to find your state representative and your state senator. Typically, you just need to enter your home address and the website will show you who your legislators are and will provide you with their website's address and contact information. You should write a letter to each of your legislators to introduce yourself. This can be a simple e-mail or letter where you identify yourself as an athletic trainer, explain where you work and what you do (or if you're a student, explain where you are enrolled), invite her to observe you on the job if possible, and thank her for the work that she does to represent you and your interests (See figure 11.4 for a sample letter). Always begin the letter by stating that you are one of her constituents, meaning that you are a voting member of her district. The legislator will likely reply with a thank you letter and may or may not accept your invitation to visit your school or workplace. Keep in mind that not all states allow legislators to accept game tickets, so she may have to observe you during practice or in a clinic setting to maintain compliance with state laws. If the legislator does accept your invitation, be sure to follow up with a thank-you letter after the visit. The legislator would likely also appreciate a picture of you with her and a public thank-you on your social media page or her social media page or both. If she is not able to accept your invitation, you could instead ask for a time to meet with her in her office, just to get acquainted (Herzog, Sedory, and McKibbin 2016).
If you would like to get more involved with legislative activities in your state, you can volunteer to serve on your state athletic training association's governmental affairs or legislative committee. These committees often organize events to raise funds to support legislative efforts and meet regularly with the association's lobbyist to develop effective strategies. They may also testify before legislative committees when needed and meet with individual legislators to discuss issues. If the state holds a Capitol Hill Day, this committee would organize that event. Even if you're not on this committee, the group might need volunteers to assist with Capitol Hill Day by talking with individuals at the capitol, passing out brochures, and so on. The group may also be looking for individuals in each district who are willing to write letters or meet with legislators to seek support for various issues and bills (McKibbin and McKune 2015).
Athletic trainers may also have opportunities to get involved in the same ways with federal legislation. NATA has developed a webpage dedicated to advocacy that provides information about bills that it is supporting, with details and talking points for each. You can contact your national legislators in the same way that you contact your state legislators. Begin with an introductory letter or e-mail, invite them to visit you where you work, and thank them for their service. You can attend their town hall meetings and meet with them in person when they're in town. You can also sign up for NATA Capitol Hill Day, held almost every year, and visit them in their offices in Washington, D.C. (figure 11.5).
NATA members at Capitol Hill Day in Washington, D.C.
Photo courtesy of Renee Fernandes
Athletic trainers can also advocate for the profession through their interactions with their patients, parents, clients, and members of the public. To prevent misconceptions, it is important that the members of the public understand the athletic trainer's vital role as a member of the health care team. This means that ATs need to dress, speak, and conduct themselves professionally at all times. Athletic trainers should look and behave like other health care providers. Athletic training clinics should look like other health care clinics. Athletic trainers serve a vital role in injury prevention and treatment and can offer this expertise through seminars and guest presentations to community groups, youth sports leagues, parent - teacher organizations (such as the PTA), and to other groups of health care professionals. The more that the public understands who athletic trainers are and what they do, the easier it is to accomplish their larger legislative goals.
Learn more about Management Strategies in Athletic Training, Fifth Edition.
Work-life balance for athletic trainers
Work - life balance is a theory that focuses on blending and prioritizing a person’s work responsibilities and lifestyle (e.g., leisure, health, family, social needs).
Work - life balance is a theory that focuses on blending and prioritizing a person's work responsibilities and lifestyle (e.g., leisure, health, family, social needs). The concept focuses on the recognition that people assume multiple roles within these two areas, and thus the demands of one may affect the others (Kalliath and Brough 2008). Work - life balance is a multilevel construct, and because the athletic training work environment makes many demands on a person's time and energy, concerns have emerged within the profession (Kossek, Baltes, and Matthews 2011; Kossek et al. 2014). These demands associated with working as an athletic trainer can make it difficult to find balance, creating a work - life conflict, and have led to concerns about professional commitment and a career that is viewed as transitory rather than steadfast.
Defining Balance
Two perspectives exist regarding a person's ability to achieve balance. Work - life conflict takes the view that work and life are incompatible, and conflict results. Conversely, the idea of work - life enrichment assumes that harmony can exist despite engaging in multiple roles. The first perspective centers on the idea that conflict is inventible because the requirements of multiple roles create competition for time, energy, and resources. These demands lead to the inability to meet all expectations (Goode 1960).Conflict, therefore, has an adverse effect on overall work performance and a person's health because it spills over into each role. Although conflict is suggested to affect work and lifestyle roles equally (Greenhaus and Beutell 1985), often family and personal time is most affected or even sacrificed because it is viewed as less flexible. The emphasis of work - life conflict is on the negative effects that filling multiple roles can have on work, home, and personal life.The second mindset, work - life enrichment, offers a more positive outlook: When engaging in multiple roles, people gain strength from each role they participate in, enhancing rather than depleting resources (Greenhaus and Powell 2006). Proponents of the idea of work - life enrichment believe that work and family roles are interdependent, and that they work together to promote positive relationships. When one experiences work - life enrichment, development of skills and knowledge in one role can increase performance and success in the other roles.
Barriers to Balance
Specific variables create conflict between work life and family and home life for athletic trainers, and these variables can be classified into three broad areas: individual (i.e., personality), organizational (i.e., the nature of the job), and sociocultural (i.e., gender stereotypes) (Dixon and Bruening 2007). Organizational variables have been the primary focus of research, and factors leading to conflict include long working hours, travel, and limited control over one's work schedule (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011). For people working in sport settings and health care systems, including athletic trainers, the concept of facetime is important (Dixon and Bruening 2007). The need to be present to complete all work-related tasks is a requirement and job expectation that can limit time for other activities as well as create an emotional and physical strain on the individual. Although the employment setting can influence the structure and length of the workday, most athletic trainers work more than 40 hours per week (Mazerolle, Bruening, and Casa 2008; Mazerolle et al. 2011), and that is the most frequently cited source of conflict. Concerns with salary, supervisor support, and lack of adequate staffing also impose barriers to work - life balance. Figure 4.17 illustrates the factors described as inhibitors to finding balance in athletic training.
Factors that inhibit finding balance in athletic training.
Facilitators to Finding Balance
Concerns about work - life balance are not isolated to athletic trainers; considerable attention has been given by researchers, professional organizations, and government agencies to developing and finding work - life balance strategies and policies.Much like the barriers to balance, facilitators are viewed from an organizational, sociocultural, and individualized level (figure 4.18).
Facilitators to work - life balance.
Workplace Initiatives
Workplace initiatives to establish work - life balance can be formal or informal (Kossek, Lewis, and Hammer 2010). The human resources department of an organization establishes formal workplace initiatives. Formal policies are often referred to as organizational or structural support for work - life balance and are designed to provide employees some control over their work schedule as well as enable them to combine employment with caregiving. Common examples include flexible work arrangements, dependent care initiatives, vacation time, sick and personal leave, and childcare and eldercare benefits. Informal initiatives can be defined as cultural work - life support. They are socially based within the organization and help create a climate that supports work - life balance. Cultural support takes place during interactions between the AT and her supervisor and between the AT and her coworkers. Despite the informality, cultural support is as critical as formal workplace initiatives to supporting work - life balance and creating a climate that promotes a positive view of this balance (Kossek and Hammer 2008; Hammer et al. 2009).
- Flexible work arrangements (Kossek and Lautsch 2008) allow employees to establish their own work schedules (e.g., work from 10 a.m. to 6 p.m. instead of 8 a.m. to 4 p.m.); these flexible work schedules can be classified as compressed (i.e., 10-hour days, over four days), split shifts, or part-time (through job sharing). The flexible work arrangements allow employees more freedom to organize their work so it fits with other aspects of their life. Flexible work arrangements increase employees' control over their work time and their ability to make decisions about their workday.
- Mobile workplace is an arrangement in which an employee works remotely, often from home, but it can be anyplace outside the office. This arrangement allows employees flexibility in how they perform their job. Tasks such as documentation and preparing bids for ordering supplies can often be done from any location with a secure Internet connection.
- Dependent care initiatives provide employees support to help them manage their family responsibilities more easily. Common initiatives are on-site dependent care, financial assistance toward dependent care, and allowing an employee the flexibility to take personal days instead of vacation days to deal with appointments and unexpected dependent care issues.
- Leave of absence refers to time allowed away from work because of an unusual circumstance, such as jury duty, a death, or the birth or adoption of a child. During this time away, employees receive their normal compensation for a predetermined period of time. Common leaves of absence include maternity and paternity leave and bereavement leave.
- Employee assistance programs (EAPs) are on-site workplace programs that assist and support an employee who may need short-term counseling. The programs are confidential and voluntary, and provide employees an outlet for services related to personal and work problems that may be influencing their lives. EAPs address a broad spectrum of issues, and consultants provide the service.
- Health care initiatives, or wellness programs, aim to improve an employee's quality of life through initiatives such as fitness programs, healthy lunch options, stress relief workshops, and discounts on prescriptions. By encouraging employees to invest in their health through measures such as annual checkups, these initiatives can lower employees' medical costs.
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Practicing ethically as an athletic trainer
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.
- Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
- Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
- Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
- Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
- Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
- Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
- Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
- Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
- Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
- You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
- The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
- Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
- Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
- Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
- Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.
These actions, when combined, dramatically reduce the occurrence of ethical conundrums.
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