Wednesday, April 30, 2008

What a social worker does . . . and feels

Each year, we give out the Bernice K. Snyder Award for Excellence in Social Work, and this year the recipient was Sarah Porell. In a previous post, I have talked about the essential role of social workers in the hospital. Sarah's acceptance speech, though, was a marvelous "job description" of what a social worker does, along with the doubts and joys associated therewith. Here are excerpts:

I feel like the work we get to do is incredibly privileged, sacred work. To be present to people in their most vulnerable moments is a privilege I pray I never take for granted or stop learning from. And I have to say, quite honestly, that while I am very grateful for my social work education and the skills it has taught me, I really believe that all the schooling in the world cannot fully prepare you for this work. Daily, I continue to fearfully pause at the threshold of patients’ rooms praying for the wherewithal to know how to handle God-knows-what tragic situation I am about to walk into. As we all know, some days are harder than others, and there is always a sigh of relief when all someone wants is a parking sticker.

I remember one of my first weeks back here as an MSW, I got a call from the ICU letting me know there was a 40 year old woman, mother of three young children, dying of cancer. Her parents and husband were at bedside and could I come see them. I PANICKED. I remember cataloguing my brain for the grad school lesson on young dying woman with children and was at a bit of a loss of what to do. It was my first experience of a dying patient, and I was terrified. Thankfully, I had the sense to ask for help and I paged Amy T, who graciously stopped everything she was doing and came to the ICU. We read through the chart, and she gave me a few words of guidance and assured me she would walk me through it. As I nervously followed her seemingly fearless stride into the room, she turned to me and whispered, "Just remember, lead with your humanity." Those profoundly simple yet wise words guide me everyday. And I have to say, some days I do this much better than others.

I think it's both the blessing and the struggle of this work that in addition to (or maybe even beyond) our clinical skills, our greatest asset to our work is who we are and how we use ourselves to connect with the patients, families and staff we serve. I think the clinical term is "differential use of self." When I have the opportunity to watch my colleagues in action or listen to case presentations, I am always amazed and inspired how each of us uses the uniqueness of who were are in our work.

But as we use ourselves, I know for myself, I continually struggle with questioning the efficacy of my work and wonder, when there isn’t anything concrete to measure success, if what I am doing makes any difference. However, I have come to learn through my colleagues that this is a question with which we all struggle and which keeps us humble.

To end, I would like to share with you a quote by Thomas Merton that has really helped me and I really feel speaks to this struggle and the work we all do:

"Do not depend on the hope of results. When you are doing the sort of work you have taken on, you may have to face that your work will be apparently worthless and even achieve no worth at all, if not perhaps, results opposite to what you expect. As you get used to this idea, you start more and more to concentrate not on the results, but in the value, the rightness, and the truth of the work itself. And there too, a great deal has to be gone through, as gradually you struggle less and less for an ideal, and more and more for specific people. The range tends to narrow down, and it gets more real. In the end, it is the reality of the personal relationships that saves everything."

5 comments:

Anonymous said...

How do hospitals measure compassion? Because this is surely health care Quality.

Paul Levy said...

I agree, and the kind of self-awareness Sarah exhibits is a key component of that. Being well intentioned, by itself, does not do the job. When I first heard her remarks -- and each time since that I have read the words -- I felt that I was in the presence of great wisdom and had so much to learn.

nana said...

beautifully said. I have forwarded the remarks to my daughter, a LICSW working with troubled children and families in Springfielf (and her husband, also an MSW, working with really trouble adolescents at Amherst High School)
Too often those of us on the "front lines" feel as though we're "digging a hole in water" and need a reminder about what and why we "do"
thanks for sharing
BIDMC RN

Anonymous said...

Thanks for sharing the speech. It makes me proud to be a social worker. (Well, I was already, but reading those words reinforced why I chose this profession above all others.)

Mika van Raalte, LCSW
Asheville

Anonymous said...

Wow, Sarah's speech sure hit the spot- so honest and powerful. As a Social Work student it's often easy to get bogged down in the rights and wrongs, processes and proceedures of the field. Reading accounts like this make me remember that although this is all important, my intuition and 'humility' will be my best asset.