There's a First Time for Everything...

I've been a Hospice Social Worker for two months now and I've taken a very strange attitude towards death. Basically, it's part of my job and the quicker people die, the less I have to see dying patients. This may sounds really wrong, but I'm really looking forward to my new project and I can't focus on my new project if I'm constantly seeing Hospice patients. I began with 16 patients, then lost 6 and got a few more, then went back down to 10. Last week I was given two more. My boss decided that I wasn't going to be given any more new patients so that I could begin to focus on the new project. Well, she obviously didn't tell the powers that be. I saw a new patient yesterday (that I shouldn't have gotten) and then checked my voice mail last night and was given yet another patient. With the addition of the newest patient, my caseload is back up to 13! I was so happy when it was down to 9. I guess I should take this as a compliment. There are 3 other new social workers that can take patients yet all of the new ones are going to me. Either they really like me and think I can handle it, or they really don't like me and are trying to punish me. My plan is to have a sit-down with the powers that be next week to request that my patient load stays steady at 13 and that no new patients are added after these people die. I think that's fair!

However, as I get new patients, especially recently, I form a bond with the patients and families. When I first started this, I was the second social worker to be assigned to a case and I never had enough time to form a bond with the family before the patient died. Last week (I guess it's actually the week before last) I visited a patient. Prior to this visit, I had spent most of my time in the home speaking with the daughter and granddaughter, doing pre-bereavement. I decided that I had neglected the patient and really wanted to get to know her. I visited her on Thursday, February 2nd and spent 45-minutes learning about her childhood, her adulthood and what she hoped for in the remaining time that she had. I really enjoyed her and felt an even closer bond to this family. You can imagine my complete shock when I got a call from one of my supervisors on Friday, letting me know that I should try to get ahold of the patient's daughter, because my patient was possibly already dead. She had stopped breathing and refused her medication that day. They were waiting on the nurse to visit to pronounce her as dead. I was in complete shock - I had just talked to that patient! I did some brief counseling on the phone with the daughter and made a plan to call her on Monday.



Monday came around and I was still a little distraught. I couldn't believe that she had died. Even though I know that death is the outcome of Hospice, I wasn't prepared and I didn't feel like I had done a good job of preparing the family. I went to the wake (viewing) on Monday afternoon. I walked in and was amazed at all of the flower arrangements and all of the people. As I signed the guestbook, I overheard the daughter telling some family member, "Oh, the Social Worker is here, I'll introduce you". I hugged the daughter and grandchildren and went and paid my respects to my patient, who was now laying in a casket covered in flowers. Very weird. I made arrangements to meet with the family in the next week to start some grief counseling. I couldn't imagine that I would ever get this attached to a family.

But that's not the weirdest part. As a social worker, I have to document everything that I do with my patients in progress notes. I wasn't sure whether or not I had to document that I went to the wake. Turns out that I do. What the hell was I going to say? "Well, patient is still dead although I thought I saw her neck move. Her make-up looked good and the flowers were real pretty. Looked like a pretty good turnout, guess she knew a lot of people." It just seemed strange, although I was supposed to write about the fact that I will continue to be available for the family as a source of support, blah, blah, blah. It's so much easier NOT to see the dead people afterwards. I kept willing her to get up (hence the neck movement) and all I could say to the daughter (aside from "I'm sorry") was, wow, she really looks good, they did a good job (horrible, I know). And I told her that her mother was a neat lady (I actually think I used the word "neat") and that I was glad I got to meet her. So awkward...

So, my first wake. Next up - my first funeral. This working with dying people is just getting weirder and weirder!