Photo by Todd McNaught
Patients come to the Seattle Cancer Care Alliance knowing they will receive world-class medical care. What may surprise them is how much support is available to help them with their nonmedical needs.
The Social Work Department's six-member team assists patients with both practical and emotional concerns before and after their inpatient treatment. "When patients first get diagnosed with a life-threatening disease, it's a crisis point," said social worker Amy Delay. "Everybody is different, but some people need a lot of support to figure out how to deal with cancer in their lives."
Led by department director Moreen Dudley, different members of the team focus on different categories of patients. Delay works with general and medical oncology patients. Jennifer Denson works with autologous-transplant patients and gastrointestinal-oncology patients. Christy Aplin and Amelia Johnson work with allogenic-transplant, radiation-oncology, hematology-oncology and gynecology-oncology patients. Anna Bakke is the pediatric social worker.
While their focuses vary, their skills and training (all hold clinical master's degrees in social work) are the same. "The thing about social workers is we have basic skills that can be transferred to any setting," Delay said.
Social workers possess the flexibility to deal with diverse populations, the empathy to develop rapport quickly, the knowledge to refer people to appropriate community resources and the experience to make accurate assessments of patient and family needs. "One of our main jobs is to just pull it together for the families," Denson said. Whatever other personal issues they come with are all exacerbated at a time like this."
Indeed, the ripples from a cancer diagnosis touch virtually every aspect of a patient's life from their careers to finances to personal relationships. Few are fully prepared for everything that lies ahead. "A lot of what social workers do is educate patients and families about the treatment process and the emotional changes that occur during this time," Dudley said.
Helping patients and families know how to ask their doctors and nurses questions about their medical care and condition—including whether to continue, change or stop treatment—is one of their most sensitive tasks. "We never try to make a choice for patients," she said. "We try to help them come to their decision on their own."
As much as patients and families appreciate the Social Work Department, so does the Alliance medical staff. "The doctors and nurses are very relieved to be able to refer people to us," Delay said. "Otherwise, they would be dealing with many of these issues."
How closely social workers work with patients and families varies. Their involvement can start as early as the moment a doctor tells a patient he or she has cancer and can continue through years of follow-up visits. Many patients come from out of town and lack a local support system. That's where the social workers step in. "Patients and families appreciate that there's someone here they can call on for anything," Delay said.
Often, helping patients and families resolve practical concerns such as insurance and housing creates a sense of trust that leads to dealing with more emotional issues. "It's a foot in the door to building a deeper relationship," Aplin said.
Besides one-on-one counseling, social workers also lead patient-only and patient-family support groups. They don't, however, provide long-term therapy. In those cases, they make referrals.
The clinic's social workers appreciate the value the Alliance places on their clinical skills and training "It's important to feel supported as an employee," Aplin said. "The patients and families get a sense of that and they comment on it all the time."
Recently, social workers conducted a quality-improvement project that collected information from patients about their experiences with the informed-consent process. Based on preliminary results, the department may conduct a second, more in-depth assessment, Dudley said.
As emotionally draining as their jobs can be, the social workers gain inspiration from the courage of patients. "It's very rewarding to be helpful to someone in a stressful time," Delay said. "It's incredible to watch how people learn to come to terms with cancer and realize there is a lot of value in their lives in spite of having to deal with a life-threatening disease."