STAYING FAITHFUL TO THE PEER ROLE: MISSION CREEP
According to the Oxford English Dictionary, the term mission creep refers to “a gradual shift in objectives during the course of a military campaign, often resulting in an unplanned long-term commitment.” The term developed from military operations that started with a specific objective, but over time, the goals of the operation shifted in ways that were unintentional and typically led to failure.
Mission creep happens in virtually all organizations and can reduce the likelihood that the original goal will be accomplished, often because of problems resulting from unplanned efforts. This is common in healthcare organizations, as teams may initially organize around a specific goal but, over time, lose focus and become distracted by other agendas, leading to less focused and less successful efforts.
The terms co-optation and peer drift have been used to specifically identify unintended mission creep in the role of Peer Support Specialists. This may happen in the typical ways, but it can also occur specifically because of the close working relationships between Peer Support Specialists and clinicians. You are likely to be working closely with clinicians on teams, and yet you have very different roles. The 2019 National Practice Guidelines for Peer Specialists and Supervisors describe peer drift as “over time the work of many Peer Specialists begins to resemble the work of clinicians on the team, taking on quasi-clinical roles rather than practicing as peer supporters according to peer support guidelines and standards.” The specific risks of peer drift include the loss of the very advantages of Peers that are helpful to clients.
Mission creep and peer drift are serious threats to your work. They are common and happen with limited awareness. As such, they are dangers that you want to be vigilant about. When you see them, take action to correct their impact.
EXTERNAL PRESSURES THAT DRIVE MISSION CREEP
As a Peer Support Specialist, your primary objective is to support the recovery of your clients. Any other agenda that distracts from or undermines your efforts to achieve that goal is a threat to your success. You have other objectives, including getting paid, enjoying your work, and being a good team member, but these are secondary to your primary objective. Mission creep is often the result of other agendas driving efforts away from the primary objective. Consider the following common pressures that can cause mission creep.
Getting Rewards. As a Peer Support Specialist, you should receive a fair wage and benefits to compensate you for your labor. That is supposed to be a fair “reward” that allows you to pay your expenses while you do this important work. If you pursue the rewards more aggressively than you pursue the objective of helping your clients, you may find that you’ve lost your focus. I’ve seen this happen as people make small and large changes to how they do their work in order to make their jobs more rewarding, while failing to see that some changes are undermining their work. The Peer Support Specialist who starts working from home because it is easier and they don’t have to spend money on gas or the Peer Support Specialist who pursues a job that has greater prestige but less actual involvement with clients may find that they are victims of mission creep.
Avoiding Trouble or Conflict. Doing your work well and with integrity may occassionally lead to situations where you will get criticism or resistance from other people. For example, if you are advocating for a client, you may ruffle the feathers of some of your coworkers who need to change what they do in order to better serve that client. There is a natural temptation to avoid actions that will “cause trouble” with your coworkers or supervisors. To the degree that you choose that agenda over the welfare of your client, you may become a victim of mission creep.
Compliance. Healthcare organizations have many rules, policies, and procedures that are designed to make them more efficient and effective. Rules and procedures have their own “mission creep” as they tend to grow and expand over time in ways that may create safety for the organization but compete with, or undermine, the care that is provided. You are likely to face pressure at times to favor compliance over the welfare of your clients. Rules have both short- and long-term benefits, but when they distract from the primary mission of your work, you may be a victim of mission creep.
Peer Influence. A supervisor of mine once commented that “if you look at the small decisions made by most healthcare organizations, many of them have more to do with increasing the comfort of the employees than supporting the mission of providing excellent healthcare.” My years of experience in healthcare are consistent with this observation. I feel the pressure of coworkers to pursue ways to work that are more rewarding for them but not related to the overall mission. That peer pressure is powerful and often is a driving force for mission creep.
INTERNAL PRESSURES THAT DRIVE MISSION CREEP
Ease and Comfort. We all want to have a work schedule that works well for us. We enjoy having nice offices with attractive views and comfortable furniture. I have been surprised by the continual desires inside myself and my coworkers to pursue those work comforts—often in a way that distracts from the work.
Ambition and Status. Work is a setting in which we can achieve in our own eyes and in the eyes of our peers and the community. Attractive titles and promotions are good for our self-esteem, but at times our ambitions can compete with our ability to meet the primary goal of our work. I once had a coworker who would openly say that he did not like our clients, did not like doing the work of helping those clients, but he liked the status of his job title, and it was the status that motivated him to work. I am sure he was not doing particularly effective work, and I suspect his clients knew that he did not truly like or respect them. Be alert to your own desires for status and how they may undermine the focus of your work.
Control. Working in healthcare, you have to accept a limited amount of control in your work and your environment. You need to collaborate with other coworkers, supervisors, and programs, and you will often have to perform tasks because of these other people. There is a natural desire that develops over time to find ways to control your work environment, whether it’s your schedule, what work you do, where you do it, and so on. That is not necessarily a problem. It becomes a problem when the desire to gain control of your work becomes more important than the work itself. At one point in my own job, I had a conflict with another manager around the control of our program. The result of that conflict was that we did not collaborate in our work and our clients suffered. When I realized that my actions were leading to mission creep and that I was not giving my clients the top priority, I recognized the need to change. I quickly talked with that coworker, apologized for my actions, and pledged to renew my support for the work.