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Saturday, April 1, 2017

Stand Up! For Each Other as the Year Marches on

By Vickie Leff

Stand Up! was 2017’s theme for Social Work Month. As many of us know, social workers are excellent advocates; advocacy it is a core skill that is integral to our teaching, profession, and interventions. In celebration of that theme, as March concludes, I want to challenge you to spread that enthusiasm and charter across the palliative care universe this year. After all, palliative care is a team sport, defining itself not whole until a physician, nurse and social worker (at a minimum, with ideally many more disciplines involved) are members. This is not a random collection of professionals, but a calculated necessity based on evidence of how the best care can be provided.

But the world of medicine, where most of our patients live, has many silos and doesn’t often work as an interprofessional team. The administrators we work with, who are responsible for the growth of our programs, may not be accustomed to such an interprofessional collaboration and often have to account for more factors than just best evidence based care. All the more reason for all members of the team to Stand Up! for each other. It is not enough for the physician to lobby for more physician positions without the unwavering support of their nurse and social work colleagues; or a nurse practitioner without the other professionals bringing their voice to the discussion.

https://www.socialworkers.org/pressroom/swmonth/2017/logos/JPG-2017SWM-LogoWeb.jpg
I worry that the long history of hierarchy in medicine may lull us into forgetting we must stand and fall as a team. I have been at the table, filled with palliative care providers including physicians and NP’s, when news has come down that an additional social work position would need to be put on hold, and everyone immediately looked at me for my reaction. I was disappointed with the news, but surprised that everyone only looked at me. I said, “this should concern everyone, not just me as the social worker”. After all, it isn’t about one professional but all of us together providing the best care, with our distinct scopes of practice and shared goals.  Our programs are only as good as each member of the team and the care each can uniquely and synergistically provide.

This is hard work we all do in the field of palliative care; it takes its toll on us emotionally. Some days we feel we make no difference at all and other days can be full of meaning and reward. Doing the work by ourselves, however, is dangerous and although necessary to get the work done, is never palliative care at its best. We must be vigilant about reminding ourselves and colleagues about this as we struggle through the day to see 11 new consults on top of the 25 already on the list. Standing up for each other is one way to remind ourselves that we are equally important, each have something vital to bring to our patients and families.

It is exhausting work, but we mustn’t let that tire us from voicing the support we all need to be the best team possible. I will stand up for our NP’s, our physicians and social workers. Without one of them, we all fail. Our patients need all of us, not just one. This is what makes palliative care so impactful to individuals and families; we tend to the whole of patient and their family. Just as we tend to our patients, we must stand up for all of us.

Vickie Leff, LCSW, ACHP-SW, BCD is the clinical social worker for Palliative Care at Duke University Hospital. She uses running and humor (not at the same time!) as her primary coping mechanisms. You can find her on Twitter at @VickieLeff.


Image Courtesy National Association of Social Workers, https://www.socialworkers.org/pressroom/swmonth/2017/logos/JPG-2017SWM-LogoWeb.jpg 

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