Tuesday, November 17, 2009

What do you do?

The age old question asked of all social workers. As one specializing in hospice, I have a "script" I fall back on to explain my job title. Of course, it's not all-inclusive. In fact, the longer I work in hospice, the more I realize how unorthodox my job can be at times.

For instance, I tell patients that I'm there to provide emotional support, which includes stress management, developing coping skills, and offering a listening ear, as well as normalizing their experience. I also assist with long-term care planning and linking people to community resources. I can guide them with funeral plans and help set up Advance Directives. I assess their need for a hospice volunteer and/or pet therapy. I facilitate life review, provide prebereavement counseling, and encourage self-care for the caregiver. I provide respite at times. I read to patients, play music, lead them through guided imagery exercises, and provide companionship. I help with goalsetting and improving quality of life. I tell families that my role is the most flexible and that if I don't know the answer to their question, I'll find someone who does. Mind you, most families get the condensed version of all this!

Of course, there are times that my role doesn't fit the social work stereotype. The hospice team roles can blur. I figure I am there to help even if I'm not the RN/chaplain/handyperson. I don't do anything above and beyond my own abilities and I keep ethics in the back of my mind. But if someone needs help, I'm going to do it. So here's an incomplete list of other things I've done over the years that don't quite fit in to my normal job description:
-Moved furniture (making room for the hospital bed or setting up a TV in the patient's new room)
-Held a patient's leg up while the RN changed a dressing on his gangrenous foot (this has ensured that I will never ignore a cut and I will always take the prescribed ABTs)
-My Bucket List patient (almost skydiving, going to Springfield, etc.)
-Helped families dress their loved one after death before the funeral home arrived
-Helped RNs reposition patients in bed
-Sung hymns with families at vigil
-Prayed with the patient at their request
-Discussed a patient's bowel regimen at length. I hope I never care that much about my own habits!
-Helped with computer tech issues for the technology-challeneged and typed correspondence for the visually impaired

Hope you enjoyed this behind-the-scenes look. Any examples of blurred lines in your respective professions?


Anonymous said...

Thank you for this description of what you do. I too am a hospice social worker and do most of these activities with one exception, guided imagery. Will you please explain how you do this? Thank you.

LeighSW said...

There are plenty of guided imagery exercises out there- the most popular one is probably The Beach (For example: http://www.twc-wla.org/images/GuideImg_files/GuideImg.htm is longer and more intense, or http://students.georgiasouthern.edu/counseling/relax/beach/beachscript.pdf). I have a couple of others that are more along the lines of our bodies as temples and one that is about peace, hope, and love. It helps to have a calming voice and creating a comfortable space. It can work well with patients who have anxiety or depression.

It's nice to hear from more hospice social workers!

Anonymous said...

Thank you for the websites! I have participated in guided imagery many times and know it's calming effects. I am happy to be able to share it with my patients.