As a social worker I’m a witness to so many different kinds of pain and while I’m mostly prepared for what that entails, I have to say that at this early point in my career, being a social worker to someone who’s dying of a terminal illness is one of the toughest things ever. Likewise, but perhaps to a lesser degree, it’s also one of the toughest things ever to try to work as usual after a close coworker gives their two-week notice. It takes an emotional toll knowing that an inevitable farewell will have to occur soon.
This week I’m dealing with the aftermath of both of those kinds of farewells.
Last Thursday a social worker who has been a part of our team for almost two years and who has been my dear friend and colleague all this time shared her farewells to the rest of the staff, and will be moving on to work in a different agency. She had discussed her future career plans a number of times with me so I knew this day was coming and I knew this day was inevitable. It was an inevitable farewell that I had prepared for, and as I wished her the best in her future endeavors, I tried my best to mask my sadness and loneliness.
Then last Saturday a tenant assigned to my caseload passed away. As I was hired since the startup of the agency site, I was this tenant’s primary social worker since they moved into the site about two years ago. For many months the tenant struggled with a terminal illness and I ended up visiting the tenant in the hospital many times. The two most recent times I had visited the patient, the patient was in a critical condition and sedated, and then sleeping peacefully but breathing very heavily. The site’s program director and my direct supervisor reassured me that I went above and beyond in providing services to the tenant and in developing a therapeutic relationship with the tenant. I think I was a bit too overwhelmed with the twenty-five other tenants on my caseload and I would have liked to have been more available for this tenant, but knowing the tenant’s conditions, I knew this day was inevitable. I’m left remembering their fighting spirit and their daily struggles.
When I went into work on Monday, many people asked me if I was okay. If I answered honestly, I would have replied that I was surprised that I felt okay. I was surprised because while I found myself grappling with a deep sense of loss, I actually also felt relieved. I mean, sure, I felt sad and such relationship terminations feel so strange that I don’t think anyone would categorize it as an “okay feeling,” but there is definitely closure in no longer having an inevitable farewell always looming in the back of my mind. My empathy muscles got stretched quite a bit witnessing my coworker try their best to endure their final days at work and also in witnessing the patient fight so hard everyday to stay alive. I felt a bit guilty about it, but it’s true; finally being able to say my farewell was a relief. I don’t think this is the answer people would expect in asking me if I was okay.
In any case, whether I was actually okay or not, I had come to work, and so, well, I had to be. I wasn’t going to allow myself to come into work unable to deliver quality services to the other tenants on my caseload and to be a team player to my coworkers. If I couldn’t I would have called out sick. My caseload and my team needed me to carry on and do meaningful social work as usual.
The work day did have very emotionally challenging moments though. About three tenants on my caseload sought me in distress about having learned that their neighbor in the building had passed away. There was a common theme in their distress, mainly that they weren’t able to visit their dying neighbor and say goodbye. The tenants demanded to know why they couldn’t be informed which hospital their friend was in. Even though this is something I explained many times before, this time it felt especially important to be very clear in explaining how all staff had to abide strictly with confidentiality laws. The tenants expressed their grief and sense of loss with me and though it was very emotionally challenging for myself as well, I was present with them, and provided counseling to ease their emotional suffering. The agency was going to host a memorial next week and I reflected to them this could be an opportunity to commemorate the person together and to say farewell together.
There are other tenants on my caseload currently who are diagnosed with terminal illnesses. To them, this news was especially dreadful. One tenant told me they were so glad I was the one to inform them first because with the way some other tenants relayed the news, the tenant felt like they were next in line to die. I maintained confidentiality of specific details but clarified that the terminal illness and the conditions of the person who passed away were very different. I also reflected how this tenant had cause for optimism because of how the tenant was following up with treatment plans and with medical service providers. I said to the tenant that though our site was understaffed and so I was overwhelmed with a caseload that was larger than it was supposed to be still I’ll try my best to be available as possible to the tenant every step of the way on their treatment process. I felt I was being very legalese in trying to reassure the tenant in this manner but my approach has always been to refrain from giving potentially false promises and to provide support only with tenant’s full consent and rapport. Honestly it took a lot out of me to have this conversation with this tenant, knowing that this tenant was someone I may be inevitably saying farewell to in the near future.
The most draining conversations were the phone conversations I had with the family members of the tenant. They were all aware of the passing away before I was aware so fortunately I didn’t have to break the news to them. Still, the sense of grief and sadness in our conversation was palpable. We expressed appreciation of each other. I especially felt sad that the family was struggling to come up with enough money to have a funeral service and to afford cremation. They were at least excited that the agency site will be holding a memorial commemoration and said they will be glad to come and join.
I almost broke down crying immediately after this series of phone conversations with the person’s older brother, and the person’s two daughters. But alas, I blinked twice, took a deep breath, and focused my energy on remaining data entry work and having sessions with tenants on my caseload.
The program director at the site was telling me of her experiences of when she was a social worker to people diagnosed with HIV back in the 80’s. She had witnessed so many of her clients struggle to stay alive and she had unfortunately become too used to planning and attending funerals and memorial services. We talked about how we as social workers continue the work we do when we have cases that are inevitable farewells. They’re like the toughest things ever.
I’ve worked at this site for almost two years now (it’ll officially have been two years on June 22, 2017), and I’ve witnessed eight social work coworkers say farewell to the agency, and this most recent final farewell with someone assigned to my caseload is my second one. I do think I’m somehow becoming better adjusted to these kinds of inevitable farewells. It is a lonely depressing feeling at times. But I’m seeing that I’m capable – like so many other social workers are – of commemorating the past achievements and challenges, of appreciating the lessons learned, and of moving onward and staying focused on the tasks at hand.