Social Work Spotlight - Episode 39: Scarlett

Episode Date: September 17, 2021

In this episode, I speak with Scarlett, who started her career in the drug and alcohol field before moving into acute hospital work. She currently works in the Intensive Care Unit and Emergency Department of a busy Sydney hospital. Scarlett has previously worked as the General Manager of two homelessness/drug and alcohol NGOs in Sydney and in the juvenile justice field. She is a child protection trainer and has experience in and a passion for disaster work.Links to resources mentioned in this week’s episode:Australian Centre for Grief and Bereavement - https://www.grief.org.au/End of Life Essentials - https://www.endoflifeessentials.com.au/This episode's transcript can be viewed here:https://docs.google.com/document/d/1UNWdu0FaHBdfhQSA3HaVqqDcsnwozDIYklWWpRb3QcY/edit?usp=sharingThanks to Kevin Macleod of incompetech.com for our theme music.

Hi and welcome to social work spotlight where I showcase different areas at the profession each episode. I'm your host, Jasmine McKee Wright, and today's guest is Scarlett. Scarlett started her career in the drug and alcohol field before moving into acute hospital work. She currently works in the intensive care unit and emergency department of a busy Sydney hospital. Scarlett has previously worked as the general manager of two homeless drug and alcohol NGOs in Sydney and in the juvenile justice field. She is a child protection trainer and has experience in and a passion for disaster work. Thank you so much, Scarlett, for coming on to the podcast. Really happy to have you here to chat about your social work experience.

Thank you. Thank you so much for having me. Pleasure. I'll start with asking when you started as a social worker and what drew you to the profession. So I think I actually was one of those kids, adolescents, that had every kind of few months. it was a new thing. So, you know, it was criminal profiling and then it was psychology and then it was firefighting and there were so many random ones. But I actually kind of towards later in schooling, I kind of got settled on war and criminology.

That's where I kind of thought I wanted to head. So I kind of had gotten, you could do like an early entry into it when you were pretty sure that's what you wanted to do. It was already accepted, I think, partway through year 12 into the long. in criminology and then I actually went to one of the open days that I grew up in Newcastle so I was at Newcastle uni and I went to the social work discussion and for some reason it just clicked with me so well and I think I've actually heard a few people say that it was the open day that actually got them thinking about it I don't know that it's maybe that we just don't hear that much about it

in school or not really sure exactly what it is but then when I listened to that and it just sounded right up my alley, you know, like really hearing people, hearing their stories on a really kind of grassroots level, you know, not about kind of apologising. It's not just kind of sitting one-on-one in a clinic room necessarily, like it, you know, had so much diversity as well. So pretty much as soon as I heard that, I kind of shifted my preferences and decided on social work. And yeah, so glad that I did do that and then all through uni found it really interesting, really fun course to study. I think, yeah, I always had particular interest and kind of where I thought I was going to head in social work, which was kind of the forensic or the criminal justice side of social work.

So kind of have gone in a bit with that, but then I've also gone totally left afield to what I thought I was going to be doing as well. Yeah. And what has brought you to this point in your career? What's been your experience up until now? Yeah, so I actually, I was really lucky to, when I went through uni, you did three placements and they were kind of, you know, three to four months long and you did second year, third, year, fourth year.

So, and in Newcastle as well, there was much less options in terms of placements. So to kind of get a placement in a particular, interest area, especially that mine was that little bit more niche around, you know, corrections or juvenile justice and things like that where there's not an overwhelming number of social workers within it. It was not that easy. So I had some great placements, but nothing kind of in that, what I was wanting to head towards. And I remember going to one of my, the kind of organizer of the field placements. And there might have been a few tears shed, but I kind of, you know, pushed that I really wanted to try and have something in the juvenile justice corrections,

probation parole, something like that. And so she kind of started cold calling for me and ended up finding someone that was willing to take me on, which was amazing. So, yeah, my first placement was in a juvenile justice facility. And that was really, felt really privileged to get that because they really don't have that many social workers in it. They mainly have psychologists and then they also had drug and alcohol counsellors who could be either a psychologist or a social worker. But my supervisor happened to be a social worker and was amazing. And from that I actually got my first kind of was like a short term

contract with them at the facility. And so that was kind of the start of the social work career. It was very short but loved it. And then after that, so then I kind of started looking into the, you know, the social work field. And I then got a position in a drug and alcohol rehab for women, which was a medium to long-term rehab. So they could be there, you know, between six to nine months, even, you know, you could be working with them up to, you know, 12 months with the outpatient, you know, or the community participation side of. it as well and I was there for a couple of years and I think that's where my skills really grew the most, the really steep learning curve and for both that kind of juvenile justice and the drug and

alcohol rehab. I did straight from, you know, the school to uni route and so I was, I think I wasn't even 21 for most of that. I think I, yeah, I think I had turned 21 halfway through that year of starting. And so that was really difficult and challenging, but also great in terms of my skills and being able to kind of, I guess, acknowledge that, yes, I was much younger and doing this kind of drug and alcohol work and therapy work with women who were much, much older than me and had much more kind of life experiences over their time. But, you know, with time and kind of being able to challenge them on that a bit, Like there was plenty of times where the women would come in and go,

not having her as my counsellor or my case manager. So kind of challenging them on that a little bit. And yeah, in the end, I actually had, you know, the full case load of clients of mine and felt like I was able to form quite good therapeutic relationships with them from there. And because that was on the Central Coast and then I was moving to Sydney. So unfortunately, I'd always wanted a hospital social. work placement, but there just wasn't that many, so I never got to have one. And so I remember

I was kind of coming to look at rentals in Sydney, and I remember just cold calling one of the hospitals that I'd seen on a TV show and kind of going, can I just be put through to social work and, you know, just doing the full on cold call and said, look, I've got no hospital experience, but, you know, really keen to learn, want to get into the field. I think it's really interesting. And I think they weren't that keen at first and kind of, you know, it was a bit of that. No, well, you haven't had a placement in hospital. It's not that easy to crack into it.

After a little bit of pushing, they ended up just letting me come and meet with them. And then I just, yeah, started on kind of contracts and that short term guest for them to trial it and see. and that was really great, loved working there. I started in renal, which was, you know, a big change from the drug and alcohol sector, but was still that working with people for longer term as well with the dialysis and things like that. And then a little bit into my work there, then switched into trauma orthopedics. And I think that suited me quite well. You know, I found the types of cases that were coming in quite interesting.

and yeah, really, really enjoyed that aspect of it. From there, I actually went a bit left to field and was offered a position to be the general manager of two services, which were a girls' refuge and a women's drug and alcohol rehab, kind of transition house, and that was very, very steep learning curve. And, you know, going from all clinical, pretty much, to not really any clinical, I think was my probably biggest struggle with that.

An amazing service and what they did really aligned with my values. And I love working with women, also love working in drug and alcohol with my kind of previous rehab experience. So that really, the kind of the service itself really fit with me. But I think that was probably where I realized that kind of top tier management, not having any kind of clinical is probably not the best fit for me. I think I need at least a mixture, a bit of both, if I was going to have that. And, yeah, it was lots and lots of kind of things that I had not done before in social work. It was very kind of managerial and, yeah, even, you know, rosters and profit loss margins and things

like that. So it was, yeah, a big change for my brain. but yeah, also feel really grateful that I've got to experience that for a little while. And then mainly the clinical wanting to get back into that was the main draw card back into health for me and probably as well an element of the structure, which can be good and bad, but, you know, the structure of health really appeals to me. You know, there's kind of pretty much, you know, a policy and a procedure in place for most things, which is, I guess, a bit of security.

in that sense as well. So ended up back, yeah, in a hospital and have been there ever since. I think I've been at this hospital for might be, I think it's maybe two, two and a half years now. And I work in the emergency and intensive care team, which I love. And yeah, so my actual role is split between three days of intensive care, two days of kind of, kind of mixture of emergency drug and alcohol, clinical pharmacology, and another role that we kind of call complex case, which is picking a case from any particular clinical area and kind of running with it because of its, you know, high level of complexity or whether it's, you know, needs a lot of kind of social work intervention. Yeah, so, and that's where I am now. Yeah. Oh, so much

incredible experience. I'm wondering if we go back to, your first experience moving from the Newcastle area to Sydney, that adjustment and moving from a smaller area to a hospital that's situated in a huge area. So you're moving from a small area to a huge facility. How did you find that process? Yeah, it was really different, but I think it probably maybe fit me even better. Well, I was born in Sydney, so I think it's kind of still in my blood a little bit. And yeah, I really like the fast pace of things. I think that's probably why, you know, keep getting drawn into the hospital world. Yeah.

But yeah, it was really different. And, you know, in the rehab, it was a team of, I think the whole team. There was three case managers slash counselors, myself and two others. There was a clinical lead, a CEO, and then the kind of overnight staff and the weekend staff. And it was an isolated area on the Central Coast. It wasn't, you know, somewhere where you could just duck down and, grab your lunch. It was, you know, on this kind of isolated street, just like a house that the women lived in. So it was really different. And I guess everyone was kind of had that therapeutic basis.

And it was very much focused on recovery and drug and alcohol and trauma. And I guess everyone kind of really aligned pretty much in, you know, their values and things like that. Then going into a hospital where there's so many competing, you know, I still think everyone's probably, or most people's overarching values of, you know, wanting to make a difference or, you know, improve people's health and things like that are still there. But I think, yeah, around that kind of, I guess, yeah, everyone's got competing demands and things they have to get done in the day and things that, I guess, are priorities for them or pressures for them.

and I'd never really had any experience in that in the healthcare setting. And I guess social work being a very small, cold in a really big system. Whereas, yeah, in the rehab it was kind of, you know, I guess everything was situated around us. We were running the groups. We were doing the morning meetings. We were having the counselling sessions. It was all kind of focused around, I guess, our views and opinions and decision-making. whereas very different in the hospital system.

So I think, yeah, it was a bit of a culture shock, but I think probably more in a positive way. Like I think it fit with me really well. And how do you negotiate that work that you need to do with other disciplines in the field, on the wards, in the intensive care unit? Because everyone, as you said, has their own roles and their own competing priorities sometimes.

How do you push forward the social work agenda in that space? I think it takes time and I don't think I've definitely got it perfect by any means and there's definitely days where you go, oh, just, you know, working into work in an NGO where it's all social workers and everyone's kind of got the same agenda. But yeah, I think there's probably a combination of different things, building good relationships with your teams. You know, it sounds kind of basic, I guess, but it is pretty important. And like I think them starting to value your role and seeing the difference it makes. For example, sometimes, you know, on the rare occasion, someone might come in very quickly and die within the space of a few hours on a weekend and social work might not be contacted

at all. And I think you do tend to notice the difference in the way we can just maybe de-stress a situation a little bit and also how the families are as well. having our input sometimes. So I think once teams and professionals and all the different multidisciplines start to see that, they do start to value it. I'm especially lucky because in emergency and intensive care,

I think they really value social work. And, you know, if there's something happening, they'll want us down there. You know, as soon as the kind of major trauma page goes off, we're down there. And, you know, you'll see them like, okay, have we got, yep, we've got doctor, we've got so and so,

where social work. So yeah, I think we are really valued. Of course, there's still going to be some, the hospital system naturally comes with pressures around discharge and beds. I think, again, emergency and intensive care probably have that pressure a bit less than some of the ward-based clinical areas. But I think it's probably still there on occasion, but I do think we've actually, and it's definitely not, you know, just me. It's been many that have come before me in terms of, I guess, building the trust and the profile of social work within the hospital. So they do kind of know if we say we really think this person needs to be parked somewhere for the night

or, you know, we won't be able to sort this out until tomorrow. They tend to really listen to that. Yeah, so I think we're pretty privileged that we've got really good teams around us. And, yeah, it does feel like a hospital, but very much values our work. That's really good to year. Can you describe, you've told us about the area that you work, but on a typical day, obviously it's always changing,

it's always dynamic, but what might your day entail? What sort of things are you responsible for? Well, look, I guess I'm probably even lucky again that I do have a kind of split caseload, and I tend to do intensive care the most. That's where I sit most of the time. and I am lucky though that we, I think for some other areas, they have the sole intensive care worker day in, day out.

So it's actually nice to have a bit of a split and have lots of variety, but I'll go off, you know, just an intensive care day. It starts off as kind of, I guess, getting a bit of the lay of the land. So I usually kind of find out who's still in from yesterday, who's new in for the day, and then I'll head up and get a handover. or, you know, I guess a bit of an update from the team in ICU. And then I think, like, you know, lots of social work areas,

it's about, okay, prioritising. You know, you'll kind of get a sense from the team and the nursing staff around whose priority for the day. It's nice in intensive care that it's fast-paced in that there's, you know, there's always lots to be done, but it's different to emergency in that, you know, you usually not always, but you usually have some time to work with the family. Sometimes the patient, but mostly it's just work with the family.

So, yeah, you know, you definitely have pressures around, you know, getting certain things done, but it also feels like you can take your time with some families and build a bit of a relationship with them. And the doctors who are, yeah, fantastic up there are usually pretty good at, even if they think somethings, you know, they're a bit concerned potentially about, you know, a situation or a healthcare status for one of the patients, they'll usually, where they can try to meet with the family before they're getting to those really difficult conversations. They want to build rapport. They want to know who's who. So yeah, I guess it's up to us. Yeah, so I'd kind of be

finding out who the main priorities are for the day and starting to make contact with the family, probably first off, you know, as well as reading the notes and getting all the background and things like that. Most patients in intensive care are intubated and ventilated, so you're not able to kind of communicate with them. So, you know, just going off that consent, where we can't get it off them, you know, that implied consent. So finding out who's who in the family. So they'll usually have someone listed as their main family member. And making contact with them, it's, I guess, a very different scenario at the moment. And I don't know whether we'll go into that separately later,

but in terms of the COVID climate at the moment, so how we do things normally is very different to how we're doing them at the moment. But going off in, you know, a normal day where we can have people coming to visit, I'd probably be wanting to meet with them in person. And, you know, having a really good conversation with them, we have a couple of nice family rooms.

so sitting down with the family, finding out the dynamics, who's who, who are the key players in the family. Is there anyone that needs to be here that isn't here? And then it's nice that we do have a bit of that facility to do some therapeutic work with them around whether it's impending grief or anticipatory grief or even just the traumatic nature of having a loved one in intensive care. I spend a lot of my time demystifying the setting a bit. Thank goodness, but a lot of these families haven't experienced ICU before. So just explaining how things work and even just keeping it really simple that, you know, you're probably not going to get a call from a doctor every single day necessarily. And sometimes that can actually be a good thing. It means that nothing's really changing. yeah, helping to be, I guess, that middle person between the family and the team and the doctors.

And most of the time, I think they're really grateful to be able to speak with us. But, you know, their main thing is they want to know what's happening medically, where are we at with things. So, yeah, often that will be their main question, which I can, you know, really help them with. I'm always saying, I don't come from the medical side, but I think just knowing that, there's someone that can potentially, if they really need it, help them link up with the doctors if they've got a particular question, if they feel like they haven't had enough of an update, or if they're a bit confused about something. Yeah, so a lot of it is kind of, like, whether it's practical or demystifying, but helping to make their current situation

slightly less difficult or traumatic or stressful, and that can be done in a number of ways. And so, yeah, we do have the capacity to actually grab family members for a one-on-one kind of session ongoing, which is really lovely. A big part of the role is family meetings. And I don't think I really realized the art of doing a family meeting and doing it well. There's so many different elements to it. And, again, very different how we're doing them at the moment. but on a normal day, the doctors are usually pretty good at, you know, they want to have a little chat before the meeting and, you know, a bit of a tee up and they really take on board,

you know, if we say, look, this is mum and she's told me that she's hesitant about this, this and this, just letting you know that's probably going to come up. Mother and brother haven't spoken in years, but they're really making it work at the moment. Just those kind of family dynamics that I think helps. the doctors to kind of get a sense of what's happening and maybe feel a little bit less caught off guard in a family meeting around what might come up. I also love, I guess, that we're not really part of, we don't have that medical knowledge necessarily so we can really take away some of the kind of really high level medical stuff and there'll be times

where I'll say in a meeting, oh, so sorry, what does that mean again? And even I can layman on myself not knowing rather than, and then you can kind of see the family go, oh yeah, like I, sometimes they're a bit, I guess, you know, scared or nervous to kind of say, you really need to bring it right down, you know, layman's terms. And I think sometimes it helps the team to jog with them. Oh, yeah, you know, we've got to speak, you know, as if the person isn't a doctor. Yeah. It sounds like there are some really amazing opportunities to do some great work with families and people who are close to that person who's medically unwell. But what is your approach? What do you do if someone comes in and they don't have anybody to support them?

Yeah, so this is such an interesting part of the job as well. And this kind of, yeah, is both in, happens in emergency and in intensive care. And we get really detectivey. And it's, yeah, again, part of the social work role that I wouldn't have necessarily known was part of it. So you get really creative, doing a deep dive into all of their old notes, as many volumes as there are. And yeah, I can't tell you how many times we've kind of thought there was no one. And I've, you know, found this random letter from a doctor 20 years ago that, you know, was actually, oh, mentioned mom and mom's name. And, you know, it is about then starting to liaise with some of the community, whether there's community,

services that have ever been involved. Their GP, police, my health record, yeah, really kind of getting creative, the embassy, the consulate. A few times we've gone through them and been able to find family members. Sometimes it can be, I guess, a bit difficult or a bit of a ethical dilemma around that you know there is family or they have said there is family but are estranged or you know they've said in the past they didn't really want them contacted. That's probably even more tricky sometimes. And where do we sit in terms of letting that family member know? And especially a lot of the time when the person isn't awake or able to give us their thoughts on would they want them contacted or not. Yeah. So that can be quite difficult to navigate, should we, shouldn't we? And,

you know, that takes a lot of different conversing with the team. and working out, you know, really just how sick they are sometimes, you know, even talking, if they've had some previous healthcare admissions or anything like that, talking to the social worker and going to remember how do they speak with their family members and sometimes I'll go, no, they've always said they just do not want that person ever contacted, they don't talk. And then other times they go, oh, no, actually, you know, they said that they're estranged, but I remember they called last week or something. So it does actually feel a bit like detective work sometimes.

Yeah. And sometimes it is a confidentiality issue, not just an ethical issue. I remember one time someone came in and they didn't actually know who the patient was. And I found an opal card and it was thankfully registered and I called Opal and they said, no, we can't give you those details because, you know, for confidentiality reasons. So I guess it's reassuring to know that. if you want something to be confidential for the most part, especially government agencies are willing to uphold that.

But it does make your role a little bit more difficult if you're trying to figure out who someone is in the first place. Yes, I'm totally right. And families, I think, you know, helping them navigate. That is another part of the role, you know, if they've got a loved one who's ventilated and in a coma and intensive care. And they go, well, I tried to call their bank and they just won't give me their details or they won't let me get this money out or they won't let me

do this. And I absolutely empathize and kind of understand how difficult it is for them, but I usually will say as well, but, you know, I guess that's a good thing that they really are respecting that person's confidentiality. And, you know, even if someone says, oh, I'm so-and-so, you know, they're not just going to okay, hand over whatever it is or give that information out. But, yeah, I, see both sides. I see the frustration for families as well. Yeah. And the caseload mix is really interesting to me. I'm curious how you kind of coordinate or navigate that because there must be times when you feel like you need to provide support to someone almost full time if it's a really intensive or complex case. But being able to either communicate to someone that you're only there

part-time or hand over to someone else who might be sort of job sharing, how does that all work? Yeah, and I think at the start I was a bit like, how am I going to do this? And I think at the very start there was a few cases where I was just like, I just need to hang on to all of these and keep going because I've, you know, built this relationship and this rapport with family and we're this far in and all of those different things. And that was definitely, I think, part of the difficulty I was finding at the start. I'm lucky to have the person I job share with is just amazing.

And now I think, yeah, definitely that we've had some time. We've gotten into a really, really good rhythm with it. And we're both quite good at when we're meeting with families. Most of the time it'll come up really early that we'll say, you know, I'm a Monday to Wednesday and so-and-so is Thursday Friday. Yeah, so they're not kind of blindsided when it gets to Thursday and I'm not there. it's taken, oh yeah, I guess it took a little while for me to get used to that, but yeah, it actually works really well surprisingly. And I think both ourselves and the team have gotten really used to that.

It's quite good as well because I think, you know, you don't want the team to be too reliant on that one person and feeling as though, no, this social worker is the only person that can do this role well or no, we need them here for any family meeting. Because the reality is we can't be there all the time and there's people on call and they have to be okay with that person coming in who's not their regular social worker that they know. We have weekend social workers well. So I think the fact that it's not just the one person the whole time, it actually does help everyone to kind of get used to that it is fluid and it's a team approach. It's not just going to be that one person. There's sickness.

There's leave. There's all those things. I think there's a few. cases that you and over the time that, you know, it's really felt necessary to hang on to. And surprisingly, not very many. And I think that's probably because we do set it up quite well, but they're prepped and ready for that person to come in on Thursday. I guess there's also the benefit of me still being in the building is nice.

And so sometimes I can do a bit of a warm referral if I think it's needed in terms of going up there as well and saying, okay, the family, this is so-and-so. But yeah, surprisingly, people are really fine with it. And if we think that they are not going to be, or if there's, you know, if it's, for example, it's, you know, I've done Monday to Wednesday and then I had the capacity on the Thursday. And that's the other thing as well, because I still have got that other case load. But if I had capacity and I knew there was a meeting happening and it was maybe the final meeting in an end-of-life situation, then maybe we'd negotiate that I would go to that final one and vice versa.

But yeah, surprisingly, it actually works really well. And I think probably and hopefully for my longevity in intensive care, because I've had colleagues and friends work in intensive care and definitely said that they feel as though they've had a bit of a shelf life with that in terms of their own burnout or compassion fatigue or whatever it might be. So I think probably having that split is actually really helpful to have a mixture in the week, especially if you have a really heavy week with lots of end of life or some really difficult cases. And then you completely switch gears for the Thursday and be doing drug and alcohol or complex case.

And what's your experience of participating in the encore? roster because for anyone else in the hospital, they're coming into an area that they're unfamiliar with and then handing back over to someone who they know is familiar and can take over and run with it. For you, some days it must feel like, and literally you're finishing work, you're getting called back into work in the middle of the night, then you're going back to work, you're seeing the same people for most of your time. How is that for you in that role? I think I actually, and I do do on call a fair bit, and I have always done throughout my whole social work career, but I think usually when I get a case that is something that, you know, is seeming like it's going to be, you know, mine the next day. I actually really like that. It just works really well, especially if it's one that I knew was happening throughout the day or was involved throughout the day and then I happened to be on call on the night and it all. happens. So it's actually, it feels nice and it feels sometimes a bit like serendipitous, like,

oh, you know, that's really nice. And, you know, I'm glad I was able to be on call for that. And maybe that was part of the journey that it was actually nice for me to be able to be there for that situation or whatever it may be. And yeah, not having to do a big long handover. It's nice because it's just for myself. But yeah, so no, I actually think it's, you're pretty exhausted for sure. I think because it is my bread and butter throughout the day, getting a call in for a case like that actually feels pretty nice. Yeah. Not the time of the call, but just being able to, you know,

okay, yep, this is my domain. I know what I'm doing. I know, you know, it's not unfamiliar territory. Yeah, you just kind of snap into gear. But I imagine for those families, it would be quite comforting knowing that you're finishing up your shift for the day, but you can say to them, I am on call overnight. If something happens, I'm going to be here.

And you can say the same on the other end. If you get called in, you can say, I'm going home now, but I will be back to check on you in the morning. So it's nice for the patients and the families, but I can imagine it can be difficult for you in terms of holding on to all of that and knowing that things are happening back at work. Yeah, I always throw that out to the families, you know, if I am on. but I also, I think even just, not even necessarily me being there,

but I think just sometimes comforted by just knowing that there's someone if they need it and often they don't and sometimes they do, but even just being able to say that I'll be there on Monday, but if there's something that happens on the weekend, you know, there is a social worker around, if it's on call, there is a social worker around. And I'm usually pretty, obviously, obviously you can't predict the ones that come in as new after hours into intensive care, but the ones who I guess I'm concerned about or, you know, they're looking like they maybe are deteriorating or something's happening. I'm usually pretty good at just flagging with the on-call social worker. And I know that I'm someone that likes to be

prepped for something if there's a potential that something might come up. So I usually just, you know, give them a bit of a brief outline of what's happening and who's who. And sometimes if they're getting called in the middle of the night. They're not going to have time to read through all my notes necessarily. So, yeah, I think that helps. You know, when that person calls after hours and they go, yeah, oh, yep, no, I know about that one. I think that's probably a bit reassuring for both parties. Yeah. You hinted earlier at some of the difficulties that COVID has posed in your setting. How is that developed and how does that change the way that you need to work? Yeah. So that's been pretty huge.

huge, I think for a number of different reasons. And I think it's been a mixture of, you know, some good learning as well about how we can stay connected and how we can do things a bit better in that space. And I think, yeah, no touching is, you know, it's bizarre that you think that's part of your role, but, you know, having to be distanced and not touch someone, just feel. a bit bizarre and obviously it's not like you go around touching people but you know if yeah if the situation you know it feels natural it feels right to do you know a pat on the back or even just to be proximally close to a family when they're going through something and when you've really

built a long relationship and rapport with them i found that really difficult that it's actually you know you cannot get close to these people you have to be very far away and not be able to do any kind of, yeah, supportive pat on the back when they are going through something is a little bit bizarre and takes them getting used to, you know, even just not, you know, shaking their hand or being close when you're meeting them for the first time, just things like that. But you, you know, naturally I think we as social workers really do, we understand that kind of nonverbal communication stuff and that it does play a role and it does change how you work with someone and make an impact. So that's been a weird part of the change. I think, I guess a few

other things, the main one, especially at the moment, not being able to have any visitors at all for families has been, you know, really difficult. And I just feel so much for the families and a phone call, not being able to see them, not being able to be here. Naturally, even just, I feel like you pick up so much when you're in or when the family's in, you know, they'll, yeah, the doctor might walk past or the, you know, one of the consulting teams might happen to walk past and give a bit of an update or the nursing staffs there to kind of explain what the machines are and what they're doing for their loved one, even just putting faces to names, seeing us, knowing who we are. Yeah, it's just, I think that's by far the most difficult part. And yeah, I just really

empathise with the families for that, but they just cannot visit it all at the moment. We have had over the time a few situations where we've had to get a bit creative and, you know, there has been someone who's died with the family on the iPad in front of them. And that's, yeah, so hard and really difficult for families. And that's been going for the whole time, really, because, you know, lots of families live overseas and haven't been able to get here or get here in time. So, yeah, that's, I think that's really hard. And as much as we can, doing what we can to alleviate families,

stress and distress around that. But also, it's just, they just want to see them. They just want to visit. So, you know, nothing we do is going to totally help their situation. But, you know, we have been trying to do what we can in terms of being creative. So definitely trying to reach out. with phone calls. We've been doing iPad video calls and people have fed back even, yeah, a few days ago

that that was extremely helpful for them when they couldn't be here just to be able to see it and make it real and also just to be able to say what they want to say to their loved one with a video behind, you know, that they can actually see each other. Yeah. With, you know, other things like when I've had loved ones who haven't been able to be here. here doing handprints or something like that with their consent and getting them sent off to the family, locks of hair, things like that, that I guess memory making in some sense when they can't be here. So that's probably been the hardest thing. I think it's very high anxiety for everyone

and that probably includes, you know, everyone that's staff, that's visitors, that's patients. and I think sometimes we do naturally jump into that role of trying to alleviate their anxiety in some way. So yeah, even just helping to manage people as a nurse or a doctor and they were, you know, really, they just felt really anxious about a certain situation with a family or something. I feel like we've had to step in a bit with that as well and just help to alleviate some of that. And then I guess as well, just we kind of knew what we knew in terms of, you know, that hospital setting and especially, you know, working with that kind of discharge planning or case management. Like I feel like most of us are pretty across things like contacting the consulate if we needed to or how to do guardianship or how to do NDIS or something like that. Whereas the COVID climate brought about this whole new, I guess, field of information that we needed to be across.

in terms of families, can they come? How do they get exemptions to travel? How do they get visas approved? What pathways do they need to go down? How can they get an exemption to visit the hospital? And what would that look like and come out of quarantine? All those different things, which we had no skill or knowledge base of before, but had to learn pretty much on the fly when it was all happening.

Yeah, so that was probably another aspect as well. Yeah, sure. When you were talking about that comforting touch, you reminded me of a situation where, I mean, you're not supposed to sit on someone's bed, but if someone pat's the bed, you sit on the edge of the bed, right? And she was relaying a story and kind of got around to talking about some really heavy stuff and was just so incredibly distraught by what was happening. And I just put my hand on her knee just as a sort of gesture, right? And I didn't think anything of it. It was just an automatic, I feel like this is the right thing to do. And she put her hand.

hand on my hand and said, thank you. That is the first time that anyone has touched me since I've been in hospital that hasn't been taking my temperature, changing my catheter, giving me an injection. And you just really, I guess you forget that in these environments that are so sterile and so dehumanizing in so many ways, there's so much that's just really simple that we can do in terms of being close to someone that is comforting for them and helps them get through a really difficult situation. Exactly. And I think that, you know, it sums it up so perfectly.

And I think, you know, the hospital is so, you know, it's a place really of saving lives and, you know, getting people better. And then when we shift, especially in that kind of end of life phase, when we do shift gears and it's not about that anymore, it's actually, it's still a hospital at the end of the day, but how can we take away that clinical side within the constraints that we have? And I think a lot of that is about trying to bring in the humanness, you know,

rather than it being about, yeah, saving lives and health care and bloods and all those kind of things and shifting focus to actually just the human life and the human person. And yeah, it's not easy to do in that setting. So I think, yeah, we do try hard to bring in element. of that wherever we can. And yeah, I think that touch is part of it as well. And it's just still have to work within that sterile environment of the hospital.

But as well, bringing in our human side. And that's, I think, the nice part of working, you know, in the end-of-life space that you actually can sit with them. And, you know, your whole intervention might be just reminiscing on stories. about the person and weirdly having a laugh in the most sad of times or you know showing your emotion when you have it as well if it is a tear or whatever it might be so yeah it's a really lucky space to be in actually are you comfortable talking about a case that you've found most challenging while you've been in that setting oh yes I think there's probably two that stand out for me in my time

and I think there's something about, and I don't know whether this is for everyone, but I definitely feel like, you know, even when the nurses, you know, will ask for a debrief about a particular case, or even when anyone, you know, one of the nurses will just talk about one that particularly was difficult for them, it sometimes around the connection to self, I guess, which maybe is a bit selfish, but it's just naturally how it happens. and, you know, I think both of those were my age, and even some of them had some more weird similarities as well.

And I think, yeah, a combination of, you know, it does get you to reflect on yourself and that you're not in that position, but you very much could be, you know, in any circumstance and, you know, it does definitely put things into perspective, but also just the connection. you make with the family and both those particular families, I think it was quite emotional for me because the families were just so beautiful. And, you know, actually it happens more than just those ones where they'll be in their absolute, you know, worst moment of their life and have just been told that their loved one is about to die or going to die or whatever it might be. And then they'll often say, like, I don't know how you do this job or like, you're just amazing for being here. and how do you hear this and how do you cope with this? And it's like just so humbling, humanising and just, yeah, humbling and just, you know,

these families that they're still thinking about others and kind of making sure you're okay with this news and how do you cope with this news? And you're like, that's, you know. Yeah, that's not the focus. Yeah, yeah. It's like it does. I guess it just shows, yeah, the resilience of people as well. that, you know, even in those worst, worst moments, they can still think about others.

And, yeah, like I said before, you know, even have a laugh or have a joke or, yeah, those two in particular was probably around a combination of just building quite a lovely rapport with the family and just probably something around them being similar age or circumstances or whatever it might be. I'm curious how, if we kind of step back a little bit in time, you mentioned that sometimes in your drug and alcohol work, you'd have people that were a similar age and then you'd also have people that were quite a bit older than you. In terms of positionality and power dynamic and, I guess, respectful challenging of what someone's saying to you, how did you negotiate that process? It took time. At first, I was quite hurt by it.

or took it personally or got a bit upset by it. And I had some really good, especially when it was kind of those very early days in the kind of drug and alcohol rehab and had some really good colleague and supervisors. And because, you know, especially I'm thinking in one case in particular where it was just like, no, I'm not working with you. I need someone mature. I need someone with life experience. It's just not clicking.

I need another counsellor. I was pretty quick at first to go, yep, okay. and went to my other colleagues and went, okay, one of you is going to have to take her on, she doesn't want me anymore, you know, we need to find someone else. And they encouraged me to kind of meet with her again and do a bit of gentle challenging around that. And I found that was actually really helpful because we got to this totally different place where she actually acknowledged that we were the same age and that she had always wanted to go into counselling. and so there was this feeling of, I guess, and probably, now I'm thinking about it,'s that kind of

the reverse of me thinking of those people, you know, the young people that are in intensive care or gotten cancer and ended up in intensive care or something like that. And it's kind of the reverse that she was, you know, I guess I was reminding her of where she could have been or felt like so-and-so hadn't happened where she would have been rather than anything particularly personal. And so once we kind of acknowledged that and that that was a struggle for her, and I guess named it a bit,

it was actually, yeah, completely different dynamic, literally from then on, were able to work together really well. Yeah. So I think probably most people would say that naming it or putting it out there is usually better, being transparent about it and saying, this is how I feel,

this is where we're at, this is the situation that we're in. But yeah, I'm glad that we didn't just say, okay, let's shift you over now because I think that was even kind of some good learning for her as well. And, you know, really it was her reflecting on her own loss, I guess, the loss of experiences where she felt like she should have been career, all those different losses that Arna's recognised. Yeah. And given that your work is so challenging and you're dealing with such a huge amount of grief and anxiety and stress every day, how do you maximize your shelf life as you put it? How do you look after yourself in that space?

Yeah, I think I'm probably lucky in that, you know, I do have the benefit of having that, probably that split is really helpful. And even now, there's been a few times where my person I share with has been off and I've kind of taken on that for a month or so. And by the end of that month, doing it full time, I think, I'm sure you get used to it when you're in it, but I think I just, for my longevity, it probably works really well. I also have the most fantastic team.

So, you know, I guess in those couple of situations where I've been more impacted than usual with some cases, you know, they're very happy to sub in and take on ICU for the day or do a split or, you know, maybe help me out with some of the cases or whatever it might be to kind of support me. Yeah, so I'm really lucky that they're so flexible with that. think as well probably that we've gotten the team so used to not having that one person all the time. I think it makes it really easy that someone else can just jump in. I think doing some other things as well, I think that's definitely really helpful.

So last year put my hand up to go to the bushfires and do some support there, which was just, you know, totally reinvigorating again and yeah, doing a different mix of different EOIs or participating in, you know, some other things that aren't just purely death and dying. And then I guess the out of work stuff as well is just really, you know, trashy TV and having a good cry. I'm a big cry on. The trashy TV probably helps with that. Yeah, exactly.

Oh, this is so bad. I'm going to cry. What would you say you love most about the work you're doing at the moment? I think probably it feels like a perfect fit for me, like even my friends who aren't social workers laugh that it's like the career that was made for me because I just love hearing people's stories from start to finish. And I think we've got such a privilege in social work that people will tell us things that they've never told another soul. And we get to be the kind of holders and the listeners and the responders to that information. So that's pretty amazing. And yeah, I think just seeing the resilience of people and, you know,

they'll talk about their life experience and the things they've gone through. And you just, you know, you can't believe that someone has gone through that much and is still standing and keeps pushing on and still, you know, still engaging with social work, engaging with professionals and opening up. And so, yeah, getting to see people's resilience in their absolute worst times and worst experiences and, you know, you're not, whether you're a patient or a family member coming to hospital, you know, you're not on your best, you know, you're not having your best day. So it's just, yeah, really nice to see people's resilience, I think.

You know, even in death and dying, being there for those final moments with someone. And I think people will probably say that word of privilege a lot, but it is. It's an honour to kind of, you know, these families let you in and let you be there and let you hear them reminisce about all the good times and talk about the person that's not that person we just see in hospital, in the hospital bed. It's like, no, they've had all this other life that we get to kind of be exposed to, which is really nice. Yeah, you've had such amazing experience and really diverse experience so far. Is there any other type of social work that you can see yourself being interested in. I know you've tried some management and it was just too far removed from the

clinical, but what else interests you? Well, the list is long, but I think probably like disaster work, especially after doing that, you know, small stint during the bushfires. I think, yeah, some sort of disaster work is probably high up on the list. But yeah, really, I'm so open to so many different things. I, you know, mental health, I really still have a passion for drug and alcohol, forensics, corrections, juvenile justice, sexual assault, TV. There's a huge list of different things I'd want to get into. I think probably for me, whatever I did, I think I work best when it's diverse, when I've got maybe a mixture of different things. That's probably where I'm sitting at the moment and, you know, even some of that management stuff definitely interests me,

but not when it's just that. And I think that's, again, that not just wanting one thing. It's having, wanting a mixture of different things. Yeah. And within that then to break things up, do you get much of an opportunity to work on any projects or research? Yes, there is. I think probably the main thing that's happening for me on the side at the moment is part of a community of practice group that's running this year and it's basically looking at how we can best service adults who have experienced childhood sexual assault and coming up with a kind of integrated service model service delivery in the local health district so been working on that and you know there's a number of different people in different areas of social work and health within the

local area and yeah, we've kind of been all coming together once a month and, you know, just talking about some of, I guess, what we would see is really necessary for that kind of integrated service. And I think that's hopefully where social work is heading for the future in terms of that, not that siloed effect as much anymore. I think people are realizing that having an adverse childhood experience really then can impact you. as an adult in many different aspects of life. So rather than, oh, no, I've had a sexual assault to the child. So I, you know, there's only this one service that can kind of assist me and then know, okay, but drug and alcohol, I need to go to just the drug and alcohol service. So having that

more integrated response. And I think we're heading that way, even just in terms of, you know, I think it's maybe statewide or definitely within our service, you know, we have a bereavement specific social worker on site who actually can help do that transition between kind of hospital and community and can do that ongoing work and even you know we've got the domestic violence counseling service on site that's again that follow on rather than okay no we're going to refer you to this completely separate service yeah so that's i think probably the main thing that's going on for me at the side at the moment yeah and if anyone wanted to read or know more about social work in this area, where would you direct them? Is there any good

information out there, good resources? Yeah, so the Australian Institute for grief and bereavement is quite a good one. They've got lots and lots of different, you know, every week, a couple of weeks, they've got a new webinar on training. You don't have to be a member. Anyone can listen in, kind of in their prices for those are really reasonable. They've got lots of resources. and things. I think even just looking at some of those grief and loss theories or crisis intervention theory can just help to get a sense of the way we do things and why we do them the way that we do. I think it's New South Wales Health to the Australian, it's called the End of Life Essentials newsletter. Anyone can sign up for that as well. And that's got lots of

different articles that they send to you that is kind of the intersection. between end of life within health. So that can be a good place to kind of start looking for some articles or research or papers because it is a niche. It is, yeah. Is there anything else before we finish up that you wanted to talk about in relation to your work? I just think that what you're doing is awesome.

And I think, you know, even that where we're heading with social work and that change for technology-based things and being able to connect with social work, without necessarily, you know, when just the reality is we can't all just kind of sit in a room and share stories or experiences at the moment. So I think even things like this is amazing just to be able to feel connected to social work still and the profession and hear about other people's experiences and get inspired. Go you. Thank you.

It's such an interesting area of work to me and especially things like end of life. No one wants to think about it. No one wants to talk about it, especially in a lot of culture. cultural situations, it's considered bad luck to talk about it. So it comes all of a sudden, people are unprepared. And I think what you're doing in terms of these short-term interventions for people who are acutely unwell and supporting their families and their friends to understand this process and what their entitlements are in that setting, asking the right questions and being a source of support and comfort is so important for people who are thrust into this environment. And

I love what you were saying about your interest areas while you were studying because so many people might not have the confidence to really push for that and say, I really want to have a placement in that area. So you might get to a situation where you've graduated and all of a sudden you go and find jobs in that area that you thought you wanted to work in and then you realize that it's not actually what you thought it was going to be and it's not where your skills and learning could be maximised. So again, just reinforcing how important it is if you can negotiate a placement in an area that you're interested in. I think it's setting you up to have firstly experience in the area and means that hopefully when you go for work in that specific space that would put you

sort of ahead of the other new grads. And yeah, I just love coming back to those tangible outcomes that you see for families when a social worker has been present in that space. So developing relationships with them, helping them to develop relationships with the team, can sometimes make a really horrible situation, just a little bit more palatable, a little bit more easy for that family, that person to manage. So you've really highlighted the role of social work in this area. I think it's wonderful. Thank you.

Yeah, I think the amount of times I've kind of put the embarrassment or pride aside and just going, I'm just going to put the question out there. I'm just going to call that random service and see if there's the job going or, you know, if I haven't gotten a job calling up and saying, can I try again? It's tended to work out in my favour most of the time. Well, I'm glad you've landed where you have because you're obviously an asset to the company, to the hospital, and I'm sure your colleagues enjoy working with you. So keep doing what you're doing.

It's wonderful. Thank you so much. Thank you for sharing your experience. It's been wonderful chatting. Yes, you too. Thank you. Thanks for joining me this week. If you would like to continue this discussion or ask anything of either myself or Scarlet, please visit my anchor page at anchor.fm slash social work spotlight. You can find me on Facebook, Instagram and Twitter, or you can email SW Spotlight Podcast at gmail.com. I'd love to hear from you. Please also let me know if there is a particular. topic you'd like discussed or if you or another person you know would like to be featured

on the show. Next episode's guest is Tony, an accredited mental health social worker and the founder of the Child Protection Party, which came about due to his commitment to working with families who have had their children removed. Tony has worked in generalist family and gambling rehabilitation counselling services and was a founding member of a group facilitation program working with men who have been violent and abusive. I release a new episode every two weeks. Please subscribe to my podcast so you're notified when this next episode is available. See you next time.