I am writing to you all, one month after the Novel Coronavirus Precautions began to settle into my new routine of daily life as a Medical Social Worker, working for Hospice in Rural East Texas. (Nacogdoches, TX to be exact)
The past month has brought many changes into my life (and obviously that of so many others). I think it will be important to document the ever shifting rules and procedures that are dictating our lives at this time and how they may be affecting us as a whole, both negatively and positively. (Yes, there can be positive outcomes from this pandemic although the verdict for the specifics are still forming)
I will outline the week by week breakdown of my changing roles as a Medical Social Worker in another post, giving details and timestamps to help myself and others understand how quickly our lives have changed in the Medical Community as we adapt daily to a unprecedented way of living and interacting with our patients and families.
As a true extrovert, the Covid Pandemic has been terrible for my mental health. (I’ll discuss why self care is so important during this time in future posts, especially for those at risk of experienciing Secondary Traumatic Stress) Social Distancing is the new norm. Wearing a Mask in Public is standard. Avoiding people on purpose, denying handshakes and hugs, and general anxiety is the new way of interacting with others.
Professionally, my job has changed completely. It is no longer the job I was contracted to perform. Each email, conference call, and zoom meeting implements a new restriction, a new documentation method, and less physical contact, always. I am hypervigilantly checking emails and reviewing procedures to insure the health and safety of my patients and my self. Personal Protective Equipment (PPE) is both a curse and a blessing. Fortunately, my company is able to provide me with the PPE needed to preform the recently updated and restricted job duties expected of a Medical Social Worker. PPE does not help me engage with my patients, families, or community. It creates a communication barrier and reduces my ability to build a relationship with a family from the initial interaction in a Hospice Admission Visit. Personal Protective Equipment creates a Catch-22 situation for a Mental Health Therapist and Hospice Medical Social Worker. It’s a necessary evil.
My once large, engaging social world is now condensed to one other person, two dogs. and an insolent cat. (I am lucky and grateful to have them all in my life at this time, cat scratches and dog smells included) I am adjusting to my own personal and professional changes simultaneously while managing the mental health of 30+ patients and families. Some days I feel like I am successful in the transition and others I feel stressed and a weight of failure. Failure to be with my patients, failure to serve their needs as a therapist, failure to visit with their families due to Covid19 precautions, and the worst is failure to mind my own self care, letting the weight of it all turn my mood.
A month ago, my day to day job included close physical contact with my patients. I spent my day traveling between nursing homes and patient’s home providing in person emotional support by providing mental health interventions and community referrals to support my patients and family engaging them with therapeutic touch, calming massage, and musical intervention at the very least during my visits. My favorite part about my job was that I could hug and love on my patients and families, on purpose, because I know “hugs are drugs”. (It’s science, I promise. There are many studies that discuss the use of physical touch to reduce stress and cortisol and increase oxytocin, the feel good hormone. In my experience, patients who are nonverbal due to terminal illness can benefit from therapuetic touch and massage to increase calm and increase feelings of connection to the outside world. I have witnessed this personally and professionally and I am an advocate for physical touch as a treatment to those who are unable to interact with their world due to a cognitive or physical decline. More on this later. )
Fast Forward a month into the Covid19 Pandemic and my role as a Medical Social Worker no longer allows me to interact with my patient’s physically, completely restricting my access to many of my patients and severing all contact wih those in Nursing Homes. Patients who I have worked with and treated for over a year, are no longer able to interact with their therapist in person. Routine monthly, weekly, or PRN visits are non-existant with patients in Nursing Homes. My home patients decline my visits due to fear of Covid19 and within good reason, I support their choice and provide counseling on the phone when possible. I spend my time delivering supplies, food, and DNRs between doctors and facilities to keep myself employed. This is not the job I signed up for yet I try not to complain because atleast I am still employed unlike many others during the Pandemic.
We are only in the beginning of many changes to come and regardless of the outcome, we are all in this together. You are not alone. We are not alone. We are all isolated together, seperately as our new world begins to evolve.