Social Work and Palliative Care in Unprecedented Times

May 5, 2020

By Gabrielle Winther, LCSW

I have been a social worker for 10 years, I have worked in hospice, oncology and currently palliative care. When I started my new position as a clinical social worker in August 2019 in a small community hospital in Hunterdon County, N.J.

I never imagined six months into my new job our world would be turned upside down.

Pre-pandemic, my days were spent talking with patients who had a chronic or terminal illness. Our conversations consisted of their goals and hopes for the future, life reflection and how to cope with their illness and treatment. We had time to form a rapport with patients and families; they knew they could trust us to help guide them as tough decisions had to be made.

Now my days are mostly spent on the phone with family members of critically ill patients infected with COVID-19.

The palliative care team is consulted for many critically ill patients either once they are already on a ventilator or prior to that, when we need to talk about how aggressive they want to be in their care.

Now, when I call family members I am listening to their fears, concern for the future, these conversations cannot be rushed; there are several moments of silence as the person I am talking to on the other end is sobbing. Visitors are not allowed in the hospital. At a time when human connection is vital, our support systems are far away. When patients are admitted to the hospital, family does not think this will be the last time they hear their voice or feel their embrace, but far too many times it is.

I form bonds with people on the phone I have never met. I become someone they can talk to, as often as possible, someone who can empathize with the pain they are feeling. Someone who is a connection to their loved one.

When a patient continues to decline, the palliative care team talks with families about what to do next, continue care knowing there is a small chance for improvement or initiate comfort care. When comfort care is initiated, as often as we can, we allow family members to visit their loved ones. To see them one last time, hold their hand one last time.

The patients cannot talk, most are still intubated. If a patient dies before family has seen them, we allow them to come in. I have been with many families as they say their last words to their loved one, their husband, father, mother.

We provide support and allow them to stay as long as needed. Once they leave, we move onto the next critically ill patient. There is no time to debrief, no time to collect your thoughts. We continue to wear our shield of armor to protect ourselves from the heavy emotions emanating from the families we talk with.

While this job is not what I initially thought it would be, there is no doubt this is where I am meant to be. I feel truly honored to be on this journey with all of our patients and family members. This experience has made the palliative care team rely on each other more than we ever imagine. That is how we get through these days; we are the ones who understands what everyone else is feeling. We recognize the importance of leaning on one another to get through the days.

Without my team, which includes our medical director Dr. Doddapaneni, Mary Balut, APN, Julianne Wilson, APN and our chaplain, Chris Small, this job would be impossible.


NASW asked social workers nationwide to reflect on their work on the front lines during the pandemic. If you’d like to share your story and/or photos of yourself, please send them to media@socialworkers.org.

 

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