Social Workers Are Essential Workers

by Lana Lipe, LCSW

     I recently heard about the neat new initiative that a big name, franchised grocery store was offering to give healthcare professionals the opportunity to “skip the line” at their stores if they show their badges. I thought this was a great idea and headed to the store after work with another hospital social worker and a nurse case manager. We were all in uniform and had our badges in hand. Upon showing up at the door, both of us social workers were questioned heavily about what our roles are in the hospital. The staff member asked us, “If you are not a nurse, what makes you essential?” We felt as if we were having to provide a job description and plead our worth to get in the door. Our case manager colleague was let in the door without an issue after the staff member saw that his badge said “Certified RN.” A similar situation happened to a colleague at a different store from the franchise, where she was informed, “I have been turning away a lot of social workers.”

     It was really distressing to be told that my job as an Intensive Care Unit (ICU) social worker was not considered "essential" or "front line" because I am not a doctor or nurse. I was upset when the situation occurred, but after sitting with my emotions, I realized that my frustration was not with the employee or the store. Where my frustration was really coming from rests on the fact that this experience is not new. Across the globe, social workers are often left out of important discussions, disregarded as important members of our teams, and our roles are generally misunderstood. Usually, we take it in stride and keep it moving for the sake of those we are helping. We are so good at being the voices for those who have had theirs silenced, but we can sometimes forget to do that for ourselves. Given the current state of the world and this encounter, it seems there is no better time to take the opportunity to shine some light on how essential social workers are to the communities we are so eager to help.

     To do this work, social workers have master's or bachelor's degrees in the field, and many go on to get licensed, requiring a lot of time, energy, money, and devotion. We are working in hospitals, community clinics, nursing homes, hospice, schools, homeless outreach, legislation, addictions, the legal system, family services, nonprofits, grassroots operations, public health, gerontology, palliative medicine, as community mental health counselors, on disaster and crisis response teams, in corporations, private practice, research, with refugees, in immigration, with veterans, and in countless other settings to help improve the lives of vulnerable and oppressed populations.

     Pandemic aside, social workers walk alongside those who are experiencing a range of challenging situations, such as illness, disability, poverty, abuse, and discrimination. We help sharpen their natural strengths and do our best to work with our resources to remove barriers and produce environments that enhance their functioning. According to the National Association of Social Workers (n.d),

[…] professional social workers are the nation’s largest group of mental health services providers. There are more clinically trained social workers—over 200,000—than psychiatrists, psychologists, and psychiatric nurses combined. Federal law and the National Institutes of Health recognize social work as one of five core mental health professions. (NASW, n.d.)

     In these agencies and with our clients, we have also been using our skill sets on the front lines helping patients, families, and our communities navigate the COVID-19 pandemic.

     Right now, people are dying alone without being able to hold their loved one’s hand or say their good-byes. Hospitals everywhere have appropriately implemented “No Visitor” policies, so families are unable to visit their loved ones—regardless of their infection status. Hospital staff are afraid that they will contract the coronavirus and expose their families to it. This means they are sleeping in hotels, tents, and in their cars to avoid this possibility. Families are afraid that they will not be able to afford their bills, as they have been laid off. Rites of passage, such as births, graduations, weddings, and funerals, have been changed and postponed. This shows that even for those who have not tested positive for COVID-19, this disease is having an impact on every single person on this planet. Each of these situations has corresponding expressions of grief that are very likely to have long-lasting impacts on physical and mental health, social relationships, spirituality, and finances.

     The psychological, emotional, fiscal, and other components of this pandemic require clinicians who can not only sit with the grief and fear, but can activate support despite the challenges. We, social workers, are the people the team calls when they do not know how to handle the emotional complexity that inevitably coincides with illness and hospitalization. We are the professionals who help people address the concerns they may have about affording treatment and understanding what their treatment options are. We are rallying their social support systems to help them after they leave the hospital, comforting those who cannot leave the hospital, sitting with their loved ones after the doctor tells them that they will not survive this hospitalization, having the difficult discussions about what their medical wishes would be in an end-of-life situation, connecting them with community resources, addressing concerns of domestic violence, engaging patients in substance abuse counseling and referrals, assessing for suicidality and other mental health concerns that are affecting their safety and well-being, and providing crisis intervention, among many other things. This accounts for only a very small percentage of how we help others each day.

     In addition to the work we do with the patients, staff, and community, my colleagues and I are continually checking in with the medical team and providing emotional support, Critical Incident Stress Management debriefings, and resources to help get them through the devastating work that they are being asked to do. We greatly value the work our medical teams do day in and day out, and we do our part to help them with distress, so they can show up every day to save lives. It is a lot of emotional heavy lifting to be there for others who are risking their lives and the lives of their loved ones so they can be there for their patients. This work requires a level of expertise that social workers have and readily want to share with our teams.

     Recognizing that the field of social work is broad and expansive, it is understandable that our profession can be confusing. As a social worker, I will continue to do my due diligence to try to shine the light on the work we do every day. Going forward, it is my hope that our colleagues, community partners, clients, and their families will feel more comfortable in asking us how we can help, because that is really all we want to do. It is also my hope that social workers will become more included in important discussions.

     To our communities, please consider this as an opportunity to include career fields such as social work in discussions about being essential providers—even after the pandemic is behind us. Being essential is not about getting to the front of a line or receiving any other special privileges. We are often overlooked for praise or recognition, which is generally fine with us, because we know the value of our work. It's about being given the opportunity to have a seat at the table and be included in discussions about what is best for our patients and their families. Like, really, really included. To our colleagues, patients, and families—it is perfectly okay if you are sometimes unsure or confused about the role we play. We will be more than happy to talk about it with you.

     As social worker and writer Lindy Alexander has so beautifully said, “It’s a privilege to be able to bear witness to someone’s story when they may not have had the chance to tell it before.” This is the foundation and culmination of our work. We have been doing this work long before the pandemic and will remain advocates who provide social medicine long after.

Reference

National Association of Social Workers (NASW). (n.d.). About social workers. https://www.socialworkers.org/news/facts/social-workers

Lana Lipe, LCSW, works in two Intensive Care Units (ICUs) in Honolulu, Hawaii. Lana earned her master's degree at the University of Maryland School of Social Work in Baltimore, Maryland in 2017.