FUTURE PROOFING OUR CLIENTS

Emma Hair and Samantha RennieSocial Workers

St George hospital, Sydney

…AND US!

Emma Hair and Samantha Rennie

Social Workers

St George hospital, Sydney

Aim of presentation

• Using our experience and yours to discuss cases

• How do we work with clients

• Looking at different cancer sites – what are similarities / differences

• Theories that help guide our practice

• We want discussion…please

• How do we keep going

• What we want people to get out of this presentation and discussion – ideas for your

own practice

What does future proofing mean to you?

How do we future proof our clients who die?

Is that even possible?

Emma

Case study

• Met breast cancer

• Background of case

• Sept 2011 - Referral came through Friday afternoon at 3:30pm – pt. having chemo

expressed suicidal ideation. Very teary+. Pt in her 40’s

- Important background information:

- Pt recently been diagnosed with metastatic disease. Initially diagnosed in 2000

- Also important – my daughters first sleepover party

SW input• Initial

- Assessment conducted. Spent some time with her – safety plan made over the weekend. Acute Care called and reviewed

• Follow up work

- GP link

- Psychiatry

- Discussed in supervision

- Saw approx. 8 times a year had phone calls etc

- Input Sept 2011 -2012

- June 2014 – Dec 2015

- Nov 2016- present

SW input continued

- SW supportive counselling – link to services

- ( carer support, son , Breast Cancer Charites, NDIS, Dreams 2 Live 4)

• Financial had to stop work. Massive implications ++ renting in private market ,living on DSP

• Carer role – was carer parents

• Parenting role

• Fatigue ++ implications on her mood.

• Significant impacts from treatment - could no longer taste food

* Themes discussed

- Idea that she feels like “ boy who cried wolf”- having met cancer over so many years. Friends / Family difficulty with

• What has helped you – “ think as peacefully as possible’

• What you need – good people in your corner, be able to be adaptable in your thinking – know what priorities are

Discussion

Sam

Case study

• Presented to the Emergency Department in January 2017 “just don’t feel right”.

Assessed by medical team and was discharged home. BIBA less than 24hrs later in

respiratory distress, confused and agitated.

• Transferred to ICU – diagnosed with AML. Background ex IVDU, hep C

• My first meeting and interaction – didn’t want SW input

• How to proceed from here

• Family situation

• Client self determination for our input – do they have choice?

SW input

• Supportive counselling around new diagnosis and throughout

• Housing – moved geographical area, left public housing accommodation

• Role as parent

• Son incarcerated

• Body image

• Ideas around death/memory making

• Family expectations

Discussion

Style of practice

• How do you build and maintain rapport?

• How to work with the MDT?

• Social Work Theories

• Other competing demands

Issues that arise in our practice

• What does SW bring to cases?

• Being able to sit with discomfort

• Working with other disciplines egpsychology, mental health, etc. Who takes the case?

• Dealing with competing demands

• Prioritising referrals

Self Care/Future proofing ourselves

• Competing pressures – how do you deal with this?

• Good supervision – what does this look like for you?

• Debriefing/peer supervision

• How do we prevent burnout?

Self care quotes

• “The time you enjoy wasting is not wasted time” ~ Bertrand Russell, British Philosopher

• “Weekends are a bit like rainbows; they look good from a distance but disappear

when you get close up to them” ~ John Shirley, American author

• “Let us be grateful to people who make us happy, they are the charming gardeners

who make our souls blossom” ~ Marcel Proust, French novelist

• “Every Friday I like to high five myself for getting through another week on little more

than caffeine, willpower and inappropriate humour” ~ Nanea Hoffman

Where to from here?• What can you take

away for your

practice

• With clients

• For self care

Thank you!