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Strategies for Avoiding Empathy Fatigue and Developing Emotional Resiliency During the Pandemic

by: SWHPN Board & Staff
Category: Education
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Aug
27
The Social Work Hospice and Palliative Care Network (SWHPN) applauds the recent decision by the FDA to approve the Pfizer vaccine, Comirnaty, for protection from COVID-19 for people aged 16 and older. The alarming rise in COVID-19 cases over the past several weeks due to the Delta variant is a stark reminder of the serious health threat the virus poses, particularly for the elderly, individuals with underlying medical conditions, and children that cannot yet be vaccinated.

SWHPN strongly encourages all social workers in hospice and palliative care settings to be vaccinated against COVID-19 to protect themselves, their coworkers, their patients, and their families. COVID-19 vaccines are safe and highly effective at mitigating the risk of infection, especially when paired with other scientifically-backed measures like frequent hand washing and mask-wearing. Vaccinated individuals are protecting themselves by reducing the spread of the virus. All SWHPN Staff members are fully vaccinated.

We also know that there are many reasons some people may have for their vaccine hesitancy, including historical health abuses due to race and gender, lack of paid time off, lack of childcare, and disinformation campaigns on television and social media. There are also people who are unable to take the vaccine due to pre-existing conditions, and yet will be safer as more people are vaccinated. We strongly encourage social workers to take steps to enhance vaccine access for everyone, to ensure we achieve the goal of herd immunity as quickly as possible. 

Finally, we know that navigating ERs and ICUs that are filling with patients that need critical medical support, tending to families that cannot visit in-person, and helping hospital colleagues that are fatigued and stressed can lead to empathy fatigue. We hope that you are finding ways to build up your own reservoir of emotional resilience and taking breaks when you can to recharge.
If you are looking for ideas, or have some tried-and-true tips to share, we invite you to join us for our next CE webinar, an interactive conversation on Tuesday, September 14 at 5 pm EST / 2 pm PST, “Strategies for Avoiding Empathy Fatigue and Developing Emotional Resiliency During the Pandemic.” Registration is here. Current SWHPN Members can attend free of charge. 
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Recent legislation includes hospice and palliative care social work as part of interdisciplinary survey team

by: Suzanne Marmo, PhD, LCSW
Category: Education
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Feb
05

On December 27, 2020, H.R. 133, the Consolidated Appropriations Act, 2021 became public law. This 5,593-page year-end legislative package included a policy provision which should be of interest to hospice and palliative care social workers. Part of the “Helping Our Senior Population in Comfort Environments Act”, also known as the HOSPICE Act H.R. 5821, is a requirement for survey and enforcement procedures to improve consistency and oversight for hospice programs. 

Federal oversight of hospice programs is not a new development. The Hospice Quality Reporting Program (HQRP), established in 2010 with the passage of the Affordable Care Act, mandated quality reporting requirements for hospice programs. Since that time, to provide transparency to consumers and improve care to hospice patients, hospices have been required to both measure and report quality care measures. The Hospice Act differs from the HQRP, in that it provides more detail about surveyor training, the survey process, and intermediate sanctions for hospices.  Surveys will continue to be required every 36 months and if there is more than one surveyor (required to be a nurse), it can be conducted by other members of the interdisciplinary team. The interdisciplinary surveyor team is an important opportunity for hospice social workers, in that it includes for the first time, the potential for professional social work oversight to be included in a Center for Medicare & Medicaid Services (CMS) hospice survey. 

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An Election Guide for Social Workers

by: Jessica Strong, Executive Director
Category: Education
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Oct
09

“The world has been abnormal for so long that we've forgotten what it's like to live in a peaceful and reasonable climate. If there is to be any peace or reason, we have to create it in our own hearts and homes.” ― Madeleine L'Engle, A Swiftly Tilting Planet

As of this writing, there are less than thirty days until the 2020 Election. This has been a year of tremendous uncertainty on so many fronts, and unlike in past years, it seems the uncertainty will continue through Election Night and possibly beyond.

As a 501(c)3 nonprofit, SWHPN is not permitted to endorse a specific candidate, nor are we allowed to oppose any candidate.

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Scholarships available for Fall 2020 SWHPN Summits

by: SWHPN
Category: Education
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Aug
13

Thanks to a generous grant from the American Nurses Foundation, SWHPN is able to offer a limited number of scholarships for our August, September, and October SWHPN Summits. These scholarships are for both members and non-members, and will cover the costs associated with one Summit.

We are hoping to help social workers that have been negatively impacted by COVID, so that you may continue to learn and get CE hours during this difficult time. In the event that demand exceeds the available supply of funds, we will use a random lottery to determine the scholarships. Applications will be accepted on a rolling basis until September 14, 2020.

APPLY HERE

Social Justice and Palliative Care Policy

by: Suzanne Marmo, PhD, LCSW
Category: Education
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Jul
18
In an effort to engage in social action to address racial inequity, SWHPN’s Statement on Racism and Structural Inequities in Hospice and Palliative Social Work is suggesting the bold and necessary step of asking us to critically question how we, as hospice and palliative care social workers, are contributing to maintaining systems of inequity in the work that we do.
These are hard conversations to have, but needed to do the work necessary to correct racial and ethnic disparities inherent in end-of-life care. In the book, Anti-Racist Social Work, Lena Dominelli writes that racism is not just a matter that can be “educated away,” but rather requires the “eradication and the transformation of our socio-economic and political structures.”

To begin to be anti-racist palliative care and hospice social workers, we need to examine our own personal biases and the systems of care that pay our salaries and contribute to poorer care provision for people who are not white. Using a lens of intersectionality to examine the market based economy of health care in the United States, having a life-threatening illness and being black or Hispanic unfortunately, leads to poorer end-of-life care outcomes. As our healthcare system struggles to care for those impacted by COVID-19, we have seen that higher rates of infection and death have occurred in nonwhite communities. Palliative care research also tells us that racial and ethnic minorities experience a higher likelihood of difficulties in managing symptoms from all illnesses, including higher rates of experiences with pain, a higher likelihood of hospitalization in final stages of life, and a higher likelihood of discharge from hospice. According to the National Hospice and Palliative Care Organization (NHPCO), hospice utilization rates for blacks and Hispanics/Latinx persons are still vastly disproportionate when compared to the general population, with 82.5% Caucasian, 8.2% African-American, and 6.4% Hispanic/Latinx patients enrolled in hospice compared with the overall U.S. population percentages of 60% Caucasian, 12% African-American, and 18% Hispanic/Latinx. 
In a recent article I co-authored in The Journal of Policy, Practice and Research I attempted to examine these disparities using a social justice informed policy analysis to examine two of the primary payors for end-of-life care, the Hospice Medicare Benefit and Medicare coverage for Palliative Care. In practice, these federal policies have substantially socially unjust effects by providing disproportionate advantages for those who are white, have family caregiving support systems, and higher socioeconomic status.

We need to ask ourselves, what role do we play in maintaining this hospice and palliative care system of structural inequity that favors and maintains a norm of whiteness and socioeconomic stability?  We also need to recognize how the hospice and palliative care workforce continues to not only serve more whites than other ethnic minorities, but also maintains a majority of whites employees in professional and leadership roles, while at the same time maintaining a low paid workforce of direct care workers who are more likely to be black and brown women.  

Social workers are trained to be integrated practitioners, meaning that we can, and should, be considering multiple levels of practice when working with client systems. However, often, social workers tend to focus primarily on roles that are more reflective of micro level of practice. A recent job analysis of 482 hospice and palliative care social workers published in the Journal of Social Work in End-of-Life and Palliative Care showed that social workers consider macro practice or “engaging in social policy and community development” to be of lower importance in job tasks when compared with other more traditional micro practice roles. This moment in history should be recognized as a call to action for social workers to engage in policy analysis and examine policy outcomes to better develop skills in policy action and political organization.

Interested in learning more concrete ways to influence and address macro level changes that are needed?
  • See SWHPN's List of Resources for Health & Race Equity
  • Participate in SWHPN's next TweetChat, which are announced on the SWHPN Events Calendar
  • Send us your resources or suggestions for what we can share with the field or how we can improve as an organization of social workers

How Will SWHPN Change in Response to the Killings of Breonna Taylor, George Floyd, Riah Milton, Dominique Fells, and Innumerable Others?

by: Allie Shukraft, SWHPN Board Chair
Category: Education
Tags
Jul
17

As social workers in this pivotal moment, there are key lessons from the field of social work, and particularly the field of palliative and hospice social work, that we at SWHPN can apply to help some of us become better both in our work and our day-to-day lives.

1: listen more than you speak. 
It is very easy for those of us who have any privilege to think that we can speak on an issue, but this is often where we misstep. The opportunity for people in positions of privilege to speak and write with words that contain microaggressions is frequent, especially if those of us who have privilege do not acknowledge that privilege. Acknowledging out own biases can be difficult, but doing so without a defensive response is one way to help in this moment.

2: do not expect those who would be hurt by your questions to respond to them.
Just as you would not ask extremely vulnerable patients such as those who are in extreme pain, those experiencing extreme existential suffering, or those who are vulnerable in other ways to participate in a research study, do not expect black, indigenous, and people of color to teach you about diversity, equity, and inclusion if you are a white person. As one person put it: “That is the oppressed teaching the oppressor." While there may be opportunities to learn in webinars and other formal settings, for white social workers, it’s important to remember that some of our friends and acquaintances may be emotionally exhausted right now, beyond what you are feeling, and you will need to respect that when reaching out to them.

3 (this one’s a challenge from our Vice Chair, Karen Bullock): think outside the box.
During the last SWHPN Summit we had an open networking session where Karen made an excellent point about language and how she does not like to be put in a box. She didn’t suggest that anyone else follow her lead particularly, she just suggested that we all think critically about the language that we use for ourselves and for others. As we know in this field, language can be fraught. A “difficult family” can be code for many things, particularly when race or ethnicity are applied. When we’re talking about language such as "cultural competency", "white fragility", "anti-racist", it is important for us to explore what these terms mean to us, as well as to unpack what they may mean to others and to examine why we may want to use them, if at all. Before the last SWHPN Summit, a SWHPN member reached out to ask if “Cultural Competence” was the name we wanted to use for the Summit right now and my honest answer was, “I don’t know." Being open to discussion without defensiveness and without taking things personally but recognizing that there are deeply emotional issues around these issues is an important part of how we face up to making changes in our organization.

4: keep your ethics in check
I have seen several posts now on NASW discussion boards, Twitter, and various listservs where social workers have harkened back to our professional ethics and values. Recently, social workers Lauren Schmidt, MSW, LICSW, APHSW-C, Daphne Lindsey, LICSW, Elizabeth Julian, LICSW from Seattle Children's reached out to express their disappointment that SWHPN had not posted any resources exploring the intersection of racial inequity and COVID-19. This was after their colleague Arika Patneaude, MSW, LICSW, APHSW-C, EMMHS had reached out to express a similar disappointment a few weeks back. All of this is to say that we should be doing better, and they are right: this is in our bones as social workers. Here are just two of our core values that we should be turning to right now (and really, always) as we engage in conversations about inequities across all intersections:
  • Value: Social Justice
  • Ethical Principle: Social workers challenge social injustice.
  • Social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people. Social workers' social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice. 
  • Value: Dignity and Worth of the Person
  • Ethical Principle: Social workers respect the inherent dignity and worth of the person.
  • Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity (National Association of Social Workers [NASW], 2008).
SWHPN is ethically obligated to educate about social justice and to speak on the dignity and worth of each and every one of our members, as well as each and every one of the patients and families that we serve, as well as those who we do not yet serve but who are eligible for our service. In truth, we recognize the dignity and worth of all persons, and we would like to work together with our members to highlight the work we are doing to improve our work in showing that we do care about these ethics, as well as in highlighting the incredible resources that are out in the world.

With that in mind, below are the steps we have taken so far to change the organization and the steps we plan to make in the coming months:

  1. At the July board meeting, we are discussing our strategic Equity, Diversity, and Inclusion (EDI) plan. This will include embedding EDI strategic plans within each committee (rather than creating a new committee specifically for EDI). 
  2. We will be asking all educational presenters to include EDI materials in their presentations. 
  3. We will start an Equity, Diversity, and Inclusion Special Interest Group (SIG) within the next few months, while also asking all SIGs to embed EDI within their goals and action planning.
  4. We will share new crowdsourced resources every Friday about 3 topics: Grief and Bereavement, COVID-19, and EDI. If you have read a great article, listened to a thought-provoking podcast, or watched an illuminating webinar on one of these topics, we want to hear about it! You can submit these on this form until 5:00 p.m. EST to include it in that week’s SWHPN Shares post.
Here are a few recent resources we're drawing some learning from; we know there are many more and hope you'll submit those here.

  • Code Switch: Why Now White People: in this episode, hosts Gene Demby and Shereen Marisol Meraji discuss theories for why the country, and specifically white people, appear to have responded to George Floyd’s killing when so many others have gone unanswered.
  • Income emerges as major indicator of coronavirus infection, along with race: this Washington Post article describes who is getting sick in the pandemic. This won't be surprising information to medical social workers, as poverty is a social determinant of health and a lever of power, but it will be important to note, especially for our patients who live in places of intersectionality.
  • Suggested by social workers Lauren Schmidt, MSW, LICSW, APHSW-C, Daphne Lindsey, LICSW, and Elizabeth Julian, LICSW at Seattle Children's:

To our members, we ask that you make a commitment to equity, diversity, and inclusion both with your colleagues and with your patients. If you’re white, commit to listening to colleagues and patients who are hurting. Tell us when we make a misstep (and when it doesn’t take too much energy). This is going to be a difficult period of change and I can’t promise we will be perfect; but I can promise we will try as hard as we can, and that we will try to apply the above principles.

Allie Shukraft, MSW, MAT, APHSW-C | SWHPN Board Chair

A Way to Respond: Learn and Share Your Voice

by: Jessica Strong and Allie Shukraft
Category: Education
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Jul
17

We know there is a lot going on. In just the past twelve weeks, we’ve seen the COVID-19 pandemic blaze through our communities, resulting in more than 100,000 deaths. We’re seeing the related economic downturn affect workers, businesses, housing, food security, and more interrelated systems. We’re sharing the righteous anger from thousands of people across the country as they protest the impunity with which racial, ethnic, and xenophobic hatred and violence has been allowed to flourish. We echo the statement cried out on the streets and emblazoned across social media that Black Lives Matter.

Through it all, hospice and palliative care social workers have faced changing norms and practices head-on. We’ve grappled with determining who is considered an “essential” worker eligible for PPE. We’ve learned how to conduct family meetings in our living rooms and parking garages via videoconferencing and new apps. We’ve figured out how to show a smile behind a mask, how to show concern without being able to hug, and how to record memories and share presence for loved ones who couldn’t be physically present. 

AND we’ve done all of that while also grappling with the social justice issues that, due to hundreds of years building up layers upon layers of structural racism and inequities, are suddenly split open for all to see. Of the COVID deaths, we see the disproportionate impact it has had on Black people, Native Americans, Latinos, LGBTQ+ people, incarcerated people, and other marginalized communities, due directly to historical factors including redlining, unequal access to  to jobs, healthcare, and insurance, and stigma from healthcare providers. In the economic downturn, we see the same factors at play again, affecting those already struggling; and again in the police and judicial systems that overwhelmingly harm communities of color. It has been a lot to take in and process, even more for our social workers who are living it as a reality.

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It Starts With Us: SWHPN Statement on Racism and Structural Inequities in Hospice and Palliative Social Work

by: SWHPN Board & Staff
Category: Education
Tags
Jun
02

The Social Work Hospice and Palliative Care Network (SWHPN) wholeheartedly rejects the killings of black and brown people by police. As social workers helping ease suffering at end-of-life, we cannot let racism and disparities in care go unchecked. We are here to support a more just, equitable system for all.

Our organization is comprised of nearly 1,000 hospice and palliative care social workers throughout the country. Our core work focuses on providing professional development, amplifying evidence-informed best practices, and advocating for improved policies and increased funding, so that all patients and families experiencing serious illness receive expert psychosocial care which alleviates their suffering, improves their quality of life, and facilitates their dying in accordance with their wishes.

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