SWHPN Guidance for Talking About Masks

As some social workers who have been working remotely are now returning to work and going into people’s homes wearing masks, we are hearing reports that some are getting pushback from both patients and coworkers about wearing masks. Some have shared that patients have expressed a worry that this is an indication that they may be sick with COVID-19, while coworkers have expressed that they do not feel they need to wear masks for various reasons. Below we offer some suggestions for responses that you could give to both of these groups. These responses were provided to us from various social workers we have spoken with, while others come from a variety of resources you can click on to learn more.

Some suggested prompts:
I wear a mask in every patient’s home and in all public spaces while I am working.
One of the first responses you might choose to give to patients can be to normalize that this is standard procedure, something that has been recommended by the Centers for Disease Control for all people to wear a cloth covering their nose and mouth in public spaces or in situations when they cannot be physically distanced (6 feet apart). The primary reason for healthcare workers to mask is to protect patients. In this way, we keep any germs that we may have from transmitting from ourselves to them and we are following recommended practices that are based on scientific evidence. While we do not suspect that we have the virus at this time (if we did, we would be at home and not at work), research has shown that people can be infected with COVID-19 and not showing any symptoms for up to 2 weeks before they begin to feel ill.

Wearing a mask is not a political or cultural statement for me.
While I understand some people believe that by wearing a mask, they are stating that they have a certain belief, my personal beliefs have nothing to do with the choices I make at work. Rather, I make choices based on the policies of my employer and what is recommended as in the best interest of the patients and families that I work with.

Frequently Asked Questions:
What if a patient or family refuses to allow you in the home if you are wearing a mask but your agency has asked you to wear one or you feel it is what is recommended for patient care?
SWHPN recommends that you do not visit patients and families in person without wearing a mask until general masking recommendations have been lifted by the CDC, and especially if masking is recommended by your employer. If a patient or family member feels that a mask is an obstacle to a visit, we recommend that you do not remove the mask for a visit, but change this particular patient’s care plan to be one that is virtual when possible, unless the family member that objects to masking is not present or changes their objection.

What if a co-worker refuses to wear a mask?
We have heard reports from some hospice social workers that some coworkers do not want to wear masks for various reasons (I live alone, I know I am not sick, etc.). Because we as social workers know that we cannot control another person’s behavior, and masks are intended to keep other people healthy, rather than the wearer, we know that this can potentially impact your health. If a co-worker refuses to wear a mask, you have 3 options: talk to them and provide education, speak to your leader about the issue, or stay at least 6 feet away from this co-worker, something you can control.

Another talking point you can try is sending them articles about masks, like the one above from the CDC, or one of these from NPR: https://www.npr.org/sections/health-shots/2020/06/21/880832213/yes-wearing-masks-helps-heres-whyhttps://www.npr.org/2020/06/17/879682816/a-growing-body-of-research-highlights-the-importance-of-wearing-face-masks, and https://www.npr.org/2020/06/11/875311079/how-the-widespread-mask-use-could-slow-the-coronavirus-pandemic.

Of course, there are many different people in the world and they may have their own reasons for not wanting to wear masks. As one author writes about here in The New York Times, many black men are afraid to wear masks for fear of racial profiling. In the Atlantic, another author posits that a public health approach for people who feel asking them to mask is infringing on their rights, taking an empathetic approach, as outlined here, will be more successful than badgering, shaming, or pushing. 

One final thing to consider when providing patient education: utilize tools that are culturally competent and meet the health literacy needs of the patient and family. There are a number of healthcare inequities which are being highlighted during this pandemic and as a social worker, it's important to address and discuss these issues with your clients so that you can assess and hopefully address what barriers may exist within their medical services. Providing linguistically and culturally appropriate education is a start. Talking openly about racial and ethnic inequalities with your patients and families is a step. We will be posting more about racial and ethnic disparity and the COVID-19 pandemic on this site, but here are some tools you can use when educating about masks and COVID health literacy:
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