NASW Social Work Talks - EP50: Hospital Social Work During the Coronavirus Pandemic

Episode Date: April 14, 2020

Rosanelly Garcia is a trauma social worker in the emergency room at Mount Sinai Hospital in Chicago. She speaks with us about what it's like right now, working in the ER during the coronavirus pandemic. Read the show notes for related resources.

Social workers such as Rosanelli Garcia are on the front lines in a battle to overcome the coronavirus pandemic. Rosanelli, who is a member of NASW, has been a trauma and emergency room social worker at Mount Sinai Hospital in Chicago for three years. Illinois has reported more than 18,000 cases of the virus. Rosanelli is here to tell us about what she's seeing every day on the front lines of this pandemic. Welcome to Social Work Talks podcast. Thank you for having me. We are wondering if you could tell us more about your work at Mount Sinai Hospital in Chicago. So my role here at Sinai is I oversee the emergency room, our trauma unit and our surgical ICU. Part of my responsibilities here at the hospital are to

be in the emergency room for any trauma cases that come in. Those can be from anything from gun shooting to, you know, a fall to a car accident or a stabbing victim. So it's kind of a little bit of everything. Overseeing the other units, the ICU, which is our critical patients, all the way through our 2 North, which is our trauma surgical unit, and that's more of the patients who are not as critical and really focused on assessing their social needs and discharge planning. How has the coronavirus pandemic affected your work? Well, it's actually really shifted it, and I say more so in the ICU specifically. You know, I did a lot of, when we have our end-of-life conversations it's a lot of family meetings a lot of

working around the family coming in and being able to see their loved one being able to talk to the doctor sometimes it's having a family meeting in the room so that the doctor can say look this is where you you know your loved one is breathing they're not breathing over the ventilator or they're very ill you can see this and kind of pointing certain things out to make it more understandable it's just shifted so dramatically because we went from really focusing on making sure we're meeting with the families letting them know and in person you know medical updates to everything is done over the phone it's

done remotely this week especially it's been really difficult and it's been difficult because we're steering you know we we can no longer have family members come in and so it's a toll emotionally for if the family as well as you know for me because what we're having to do is we had a like a COVID patient this week that was very critical really end-of-life at this point the the virus just you know took over and unfortunately we the patient passed away without family at the site at the bedside and that's just because wow so So what we had to do is we had to have them FaceTime him the day before he passed.

It's like these hard stories to tell, but you know, we just want to do anything that we can to make sure that this isn't, it's hard, but if you can, if we can give you a chance and opportunity to see your loved one, one last time, you know, in our hospital that, you know, we want to do anything possible. And so it's, as you can see, it's like so dramatically different from meeting with a family in person, them spending time with their loved one to, we have to do everything over the phone. But the thing that we're seeing here at Sinai is we're starting to see more patients with

possible corona or corona rule out, right? Which is basically saying we have some symptoms, but I'm not really too sure if I have it. So we're trying to do the test to find out if you have it or not. And so we're seeing a surge of those patients, and we have been, and we're seeing less medical patients, and we're seeing a surge of those corona patients every day. Are there adequate tests available to know who actually has this virus and who doesn't? I think us, as well as any other hospital, really faces a shortage with having full access. And so we are mindful when we do these tests because we want to make sure we're utilizing

them effectively. And so it starts really from the beginning of we have a tent set up in front of our emergency room, you know, and that's kind of the entry, the entrance for a patient who we think or the patient thinks that they might have COVID. We want to utilize these tests as best as possible. And what we have is working for us right now. But I think that if we continue to see the surge I know that we're going to really need to get more of those resources into the hospital it's gonna it's difficult already simply because we want to limit how many people even essential workers nurses doctors we want to really limit the people that are going in and out of these these rooms because they're so

isolated and we want to make sure that the patient as much as the worker is protected but our role has really changed over the last I would say month at this point, because not only is it how are we discharge planning, what we're finding is we're seeing a lot of patients who have homes and are not able to go back to their home because they've tested positive. And so now we have to find, you know, appropriate housing, appropriate discharge planning options for a patient, not because they're previously homeless or because, you know, substance use, but because they've tested positive and have children at home. And so that really makes it different because, you know, they may not be appropriate for nursing home placement. And so where we find ourselves at a crossroads where we have, you know, somebody who is on the road to, you know, back to health from coming from a COVID place, but you're just finding it difficult to see where do I send you? I don't know where you go. Family doesn't want to accept you because they're afraid.

So we've had to really become creative with what we're doing with our discharge planning. Yes. So when you say that you're being creative, what are the housing options that you're finding for these folks? So really kind of looking at extended family members. one of the initiatives that Chicago is doing is setting up hotels for patients who are either homeless and have COVID and they want to make sure that they're isolated or patients who are maybe were not homeless but are not really able to return back home and so those patients are accessing the hotels that are now you know being run or have contracts I believe, with the city so that they can be in a place away from their family so that

they're able to quarantine themselves and, you know, figure out, you know, what their next, how long, well, they needed to quarantine themselves and be away from family to reduce the spread of it. I'm also wondering, how do you work with the live family members back home? They are worried. Others are grieving. Others are feeling a guilt because they aren't able to be at the Lyme hospitals with them. So how are you addressing that angle of this? it's really difficult to be on the front lines as a social worker especially in a setting like an emergency room or or a sick you a surgical ICU when we're dealing with COVID patients because we have to keep them away from you know from people to reduce again to reduce the risk of

it spreading and so I'm dealing a lot with family members who are grieving and kind of not what I'm feeling is from them is like not really able to get that closure because they're not able to be a part of this person's last moments where in any other situation in any other time they would have been and so I think that they're what I'm seeing is like guilt from families I'm seeing that families are finding it really hard to not be present physically for the person it's just taking a really emotional toll on I think the workers as we see these patients coming in and then, you know, maybe rapidly declining. Declining just because

the COVID becomes so complicated with their breathing and their respiratory. And so it just becomes really difficult to continue to have the family come in. And so everything, because everything's being done remotely, it's really hard to say to a family, look, I know your family member's passing away, but I can't have you come in. It's really, really hard to relay that message because, you know, you kind of put yourself in their shoes and you'd say, well, what would I do if I was in their situation? You're kind of powerless in that sense because it's essentially, you know, such a risk to have you in the hospital. But I can understand for my families, that's all they want to do is be with their loved one. It's really difficult.

Yeah. Wow. Rosadelli, what are you and other social workers doing there for like self-care, because you're in a Chicago area. There's a lot of gun violence there. This is a different thing. So how are you kind of handling this emotionally? I think right now it's really difficult for all of us. I know for myself, because I'm still working the traumas that come in. And so it's hard balance. Like this week, I had, you know, a couple individuals that came in from injuries of gun shootings. And unfortunately, this week, I had to tell with the doctors, we had to tell two different moms from two different situations that their sons passed away from gun violence. And so then you go and you, you know,

you have these patients who are so critical that are COVID positive, and you can't even have their families come in and say goodbye in person. And so I think it's difficult on everybody and not to social work but I think anybody that's in the hospital setting it's taking such an emotional toll on us really I think right now what's helping us get through this and and part of our self-care is that even before this this kovat you know pandemic is happening it's it's about family I think when you're in when you've experienced so many traumas with so many people in a hospital and your team you can't help but to be a family with them and so

And self-care, I think self-care for us right now is the sticking together, is being able to be a shoulder to cry on when we have to walk away from, you know, a really hard phone call where we have to tell a family member that unfortunately they can't come in and spend, you know, the last moments of their family member's life with them. It's it's being able to know that hopefully good days are coming and it can't rain forever. And and really the self-care here is just staying hopeful and being a family with one another and knowing that, you know, we're going to get through this. Wow. Are you wearing like PPE is what it's called, Rosanelli? yeah yeah we are yeah so i mean is it like available readily or are there you know problems getting it no it's available um it's available we are trying to you know you're always on at least for us we're always on the hunt for donations and you know whatever people can give us from their hearts not all of us can just come out of pocket and pay for a hundred masks but

you know we're all working together if we ask for a mask we'll get one it's not like impossible to get the things that we need i think we're just trying to be mindful that you never know when you're running low so you want to make sure that you you take care of what you have and i mean like masks and and gowns and and like the head covers and stuff like that you just want to be mindful of how you're using these things and i think everybody in the hospital is making that effort to be mindful. What do you think folks need to like do to help us overcome this pandemic? Well, I think one of the biggest things that people can do is, I think I'm going to sound like every other commercial right now, but washing your hands, making sure that you are being mindful

of if you're using your gloves, not throwing them on the ground, appropriately disposing of them, constantly watching your hygiene and making sure that you're really being mindful of the things that you do when wearing a mask when you go out. You know, I think one of the other things that people can do is stay inside. I know that everybody knows that we need to stay inside, but I'm seeing people aren't really following that. So I think people need to take this seriously. I mean, we're not going to be able to flatten this curve if we're still going to the park, we're still doing things outside we're still hanging out we're just never going to be able to we're not going to expedite getting rid of this if we don't really start taking and heeding the warnings that are

being put out there um i've also heard from a few social workers that they are isolating themselves from their families so if they um are working with a client or a patient who um has had this virus, they aren't actually going home themselves. So they're being like isolated from their family's loved ones. Are you seeing that too? Yeah, I'm actually doing that myself. You know, I lost my dad a couple years ago. And so I make a point to see my mom every single weekend. And I haven't seen her in well over a month. And I FaceTime her every single day. But it's hard because, you know, she's a little older, and I just don't want to risk me being in a hospital setting and unknowingly bring something like, you know, and having it

passed on to her. And so I'm not necessarily isolating myself from like my husband or my child, but I haven't seen my mom in well over a month. I probably won't see her maybe until May if the thing, if things keep going the way they are. And it's heartbreaking. I have a really good friend that she's actually a nurse and she hasn't seen her husband and I think about a month and a half because she's self-isolating as well so it's just hard on everybody I don't hug anybody my husband I don't hug my kid when I get home I don't do any of that until I've made sure that I am you know I've washed my hands I've taken a shower I've brushed my teeth it's it's like getting ready all over again in the afternoon when I get off work because I just don't want to run the risk of

spreading it. You've worked with flu patients before, so this is more spreadable than like flu is even? I don't know if it's more spreadable, but I do know that, you know, we definitely take extra precautions. The rooms for our COVID positive patients are labeled. You cannot go in there without any, without being gowned from literally from head to toe. Even your shoes have booties on them you have your mask you have your your cap you have your you know if you don't have a face shield you have glasses you have multiple layers of masks you have a gown on so you're going in there with your with your PPE fully armored because you just need to make sure that you are you know protecting

yourself from every angle is there anything else you would like to add you know, I know that social workers, we work in so many different capacities. Not everybody's in a hospital. And no matter what capacity, social workers are making big differences in the world. And we're facing a big struggle right now. And, you know, times are hard. But we need to keep the hope alive. And we need to be the strength for a lot of our patients, and a lot of our clients and the people that we work with. Thank you. That's amazing words. We are so happy that we're to be able to, like, share those. We really are.

Rosanelli, we really appreciate the, like, hard work that you are doing. And we also thank you for giving us a few minutes of your time. Thank you for being on our podcast. Thank you so much for having me. I really appreciate it. You have been listening to NASW Social Work Talks, a production of the National Association of Social Workers. We encourage you to visit NASW's website for more information about our efforts to enhance the professional growth and development of our members, to create and maintain professional standards, and to advance sound social policies.

You can learn more at www.socialworkers.org. Don't forget to subscribe to NASW Social Work Talks wherever you get your podcasts. Thanks again for joining us. We look forward to seeing you next episode. Thank you.