Loss

Loss – Personal and Professional

It has been a while since I’ve posted anything. My summer has mostly consisted of getting back into jogging (I’d like to say running but frankly it’s a slow jog that gives the other patrons of the park plenty of time to notice my sweaty, tomato-red face. It may look like I ran a marathon but I didn’t come close), building up my vegetable garden, procrastinating studying for my preliminary exams in August, and work. Things were going along with relatively few hiccups until about 3 weeks ago when my work world crashed and burned.

Three weeks ago today, I received a call from a fireman calling from my employee’s cell phone. One of my clients had passed away overnight (natural causes) and the employee who found the client was too distraught to speak to me on the phone. Naturally I called my supervisor and we all rushed to the program. As you can imagine that morning was a chaotic rush of communication with coroners, family members, employees, staffing agencies to cover staff time off for recovery, etc. After everyone left the program I cleaned the client’s room so that none of my staff would have to do it while they were grieving. Times like this are difficult in work settings because my reactions have to come last. First I have to support my clients with managing their emotions and then I have to support my staff with managing their emotions. Only once I was alone in the client’s room did I finally get to experience my emotions and have a nice cry.

I have lost clients before (my population dies, on average, 25 years earlier than the general population) and the loss of this client did not count as my most traumatic experience with client death. Nonetheless, I was very fond of the client we lost and had always felt a special connection with her. She was a client of mine in the job that I had before my current one. When she entered our program I met her family and realized that we were neighbors when I was a child. Due to the age difference between me and the client we didn’t know each other back then. However, it was very likely she saw me riding my bike or playing in the front yard at some point. The client had gone through some major struggles but had been doing wonderfully in the past several months. The family said the client was acting the way she did years ago when she was healthier. That made her death particularly poignant. To struggle for so long and work so hard to be healthy, only to pass away before getting the opportunity to fully enjoy your health is tragic. She had so much more to give the world.

Three weeks later my staff is still grieving her loss. The other client in the home has many questions and is struggling with being without roommates. The employee who found the client is having difficulty processing everything and has taken time off to cope with the experience. The program is just trying to stay above water. I’m struggling to reconcile two sides of myself: the social worker side who wants to be infinitely patient and understanding vs the administrative side of me who has to make sure that the remaining client is taken care of and the program continues to run as smoothly as possible. The temptation to treat your employees as clients is strong at times like this. The therapist in me wants to provide counseling and treatment but a good supervisor has to realize where the boundaries are. I can’t be their therapist – that is not my role in their lives. I can be supportive and understanding but the needs of the program also have to be kept in mind and balanced.

The loss of a client is never easy. I don’t know if our clients ever realize how much we care about them. I still think about some of my clients from my first social work job and worry about how they are doing. When a client passes away you always wonder – could I have done anything different that would have changed this outcome? The first client I lost nearly broke me – the circumstances surrounding the finding of that client’s body were horrible. I had trouble with flashbacks and intrusive thoughts for several months. I blamed myself for the death and was convinced I could have changed the outcome somehow if I had just been a better social worker, a stronger clinician, checked on the client more often, etc. Each time I lose a client, a part of me flashes back to the loss of that first client. It took me a long time, and help from some amazing supervisors, to heal from that experience.

Now I want to be the amazing supervisor who helps their employee through a traumatic experience. I’m worried I don’t have what it takes. I’m worried the program will continue to spiral down and I won’t be able to save it. I’m worried about a lot right now.

(Did I mention I have a massive 4 hour examination about statistics and research in 14 days and if I don’t pass it that I can’t continue with my doctoral program? No pressure)

Oh, and I’m making the featured image for this post my (still growing) puppy because he is silly and make me laugh. He is super long when he stretches out!

Self-Care

Keeping It Together – Even When You Don’t Want To

I received some sad news this morning. A former client passed away over the weekend and the funeral is tomorrow. They left the agency several months ago because they needed a higher level of care. This is the second former client who has died in the last 30 days. Losing clients (even if they’re former, you will always think of them as your client) is never easy. As a social worker I’m privileged to be involved in intimate details of people’s lives. I wouldn’t be in this line of work if I didn’t care deeply about those I work with. A professional hazard is that you will inevitably lose each client – many will recover and move on (YAY), some will drop out and you’ll never hear from them again, and some will die before their time.

I work with individuals diagnosed with serious mental illness. They are vulnerable to homelessness, abuse, poverty, lack of access to nutritious food, unhealthy lifestyle habits (smoking, lack of exercise due to illness or because of fatigue from medications), etc. People with these diagnoses tend to die about 25 years sooner than the general population. This means that the death of a client in their 40s or 50s is not unusual.

One of the things that has made the deaths of the two clients this month so difficult is that I needed to support my staff and other clients with the grieving process while I also grieve. Today was a difficult day. First stop this morning was to tell the other clients and answer their questions to help them start to process their grief. The next job was notifying all the staff who worked with this person and supporting any of them who needed to talk. In addition, there was my regular workload. All of this had to happen while I was feeling quite sad and somewhat guilty that I hadn’t followed up with the former resident and visited them in the nursing home the way I intended.

I think that all of us, at some point in our daily lives, have needed to keep our own reactions in check in order to make sure thing get taken care of. Sometimes this must be done daily. So how do we keep it together when all we want to do is fall apart? Here are my suggestions:

  • Acknowledge your feelings – To the best of your ability in your situation acknowledge that you’re not feeling 100%. Depending on what’s been going on, a simple “I’m not at my best today” may be helpful. If you don’t feel comfortable saying this in your work environment then at least acknowledge it to yourself. Give yourself a break if you find that you’re not working as quickly or as accurately as usual. We all have off days. You are human, you’re allowed to not be perfect.

 

  • Talk it out – If you have someone you trust at work then go to them and ask if you can share some of your thoughts. Be mindful when choosing who to help you process thoughts or feeling. For example, I wouldn’t go to one of the staff I supervised to talk about feeling sad at the loss of this client because I’m supposed to be the one supporting them. I’m honest with staff about my feelings – I can tell them that I feel sad about the death of the former client but for a deeper exploration of my feelings I seek out either a supervisor or someone else in the company that I don’t supervise.

 

  • Set aside time to fully experience your emotions – I learned this from a former supervisor who specialized in treating other therapists. It is very useful when sitting with a client who is sharing tragic or horrifying personal details. If you’re in a situation where you can’t react the way you really want to (cry, scream, curse), then make yourself a promise. Identify a time later that day when you can react the way you want to and tell yourself that you can put those thoughts and feelings on hold until that time. The trick to this is that when the identified time comes, you MUST keep the promise you made to yourself and allow yourself to think whatever sad, negative, irrational thoughts that you ignored earlier. If you promise yourself a time to react, put your feelings on hold, and later don’t give yourself what you promised then you stifle your emotions which will impede healing or coping with whatever is going on. I find this one helpful when I have intrusive sad or anxious thoughts that are keeping me from doing my work. Once I tell myself I’m going to deal with those thoughts later in the day I’m able to refocus on what I need to do.

 

  • Take care of yourself – When you are struggling it is crucial to take good physical care of yourself. Your mind is already going through a lot, don’t make it also have to deal with a body that feels unhealthy. You may have the urge to eat ¾ of the birthday cake in the break room left over from yesterday’s celebration (been there, done that), but try to keep yourself to a regular-sized piece. Drink lots of water and minimize your caffeine intake. If possible, take a short walk during a lunch break. Eat whole fruits and vegetables. Try doing some gentle stretching.

As always, some (or none!) of my suggestions may be helpful or effective in your situation. I can only share the things that help me. I would love to hear ways other people make it through their day when it’s an extra struggle?