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Social Workers and Chaplains at the Front Lines During COVID-19

By Adriana Krasniansky

Like doctors and nurses, chaplains and social workers are critical members of hospital care teams who are adapting their workflow and adopting telehealth platforms during the COVID-19 pandemic. 

However, much of their work requires navigating difficult and vulnerable conversions not well-suited for a video screen. This article investigates the unique approaches chaplains and social workers are taking to serve patients digitally in their times of need.

Social Workers and Chaplains’ Roles and Responsibilities During the COVID-19 Pandemic

With countless regions under stay-at-home orders, social workers and chaplains have been identified as essential workers by many, but not all, hospital networks and healthcare organizations. 

Both groups are involved in the treatment and support of COVID-19 patients. Chaplains provide emotional and spiritual support to patients and their families during and after treatment, and offer valuable assistance coordinating end-of-life and funerary services, particularly in situations where families are remote. Social workers assist patients and families navigating healthcare and welfare decisions in these confusing and critical moments; they also coordinate or provide therapeutic services to the affected and their loved ones. 

Beyond COVID-19 cases, social workers and chaplains must also attend to patients facing other health circumstances and challenges. Alongside physicians, nurses, and ethicists, chaplains and social workers are core members of palliative care teams for those with chronic or end-of-life conditions. Social workers support individuals and families facing dangerous environments during stay-at-home orders. Both parties acknowledge that difficult and traumatic diagnoses, circumstances, and health outcomes continue amid the pandemic — and many of these cases are receiving less support than usual, given the reallocation of attention and resources. 

Telehealth when Possible

While many chaplains and social workers continue to report to hospitals or field calls, others are testing and implementing telehealth approaches.

For social workers, telehealth check-ins can be especially difficult given that 1) cases are often managed by care teams (composed of multiple professionals), 2) clients may not have access to reliable internet, and 3) clients might not provide an accurate account of what is happening inside the home — something more difficult for the social worker to pick up on in a digital conversation.

In an article on the UK social work website Community Care, social work organization Birmingham Children’s Services Trust shares that its social workers are using tools such as Microsoft Teams and Skype to stay in communication with teams and professional contacts. The organization must also work with partner agencies — such as housing shelters, rehabilitation facilities, nursing homes, and other welfare providers — to address constantly changing plans and regulations. Given social distancing measures, many agencies and facilities have had to reduce their operating capabilities, further exacerbating circumstances. 

“Times of crisis can bring the best in people but can also lead some of us to make decisions we wouldn’t usually make. It is important we get the right balance… in order to protect those of us that need it most.”

James Bullion, Vice President, Association of Directors of Adults Social Services (U.K.)

Like social workers, chaplains must significantly change their operating procedures when making the shift to telechaplaincy. In an interview with the Times of Israel, Rabbi Benjamin Lanckton, a chaplain at Massachusetts General Hospital, said, “Our job is to be a non-anxious presence, and without face-to-face interaction that’s hard. But what I’ve learned over the past week is that virtual visits are not nothing.” 

Many chaplains have taken to completing their check-in rounds over the phone to reach patients in and outside the hospital who may be quarantined or under stay-at-home orders. Other hospital networks, such as the NCH Healthcare System in Naples, FL, are offering telehealth chaplaincy visits via facility iPads, specifically for patients facing emotional and spiritual emergencies in isolation. iPads and other video chat tools make it slightly easier for chaplains to push conversations beyond surface-level topics; but, as experts have noted, patients might keep conversations high level about the COVID-19 pandemic, and chaplains will need to ask deeper questions to connect with patients’ personal thoughts, concerns, and/or distress. 

Healthcare leaders also acknowledge that the physical, emotional, social, and spiritual effects of the COVID-19 pandemic mean that an increasing number of people will require social work and chaplaincy support. The Association for Clinical Pastoral Education, the certification board for chaplains in the United States, has issued a request for volunteers to offer telechaplaincy services (telephone or video conference) to understaffed healthcare networks. Organizations such as the American Chaplaincy Network are organizing digital roundtables and forums for professionals to share their learning and experiences with one another as the pandemic moves across regions. 

For social workers and chaplains looking to take initiative with telehealth services or to transfer their practice to a digital capacity for the time being, it is vital to review national, state, and employer privacy guidelines and technology standards. In the United States, social workers and chaplains must abide by HIPAA telehealth guidelines, which have been adjusted for the COVID-19 response.

Comfort Beyond the Screen

Sometimes, social workers and chaplains face situations where telehealth simply is not a viable alternative. Social workers must conduct necessary site visits or connect with hard-to-reach patients. During COVID-19 specifically, chaplains must consider how to support and comfort patients, such as those who are on ventilators and unable to verbally communicate. 

Like physicians and nurses in the hospital, in these cases, chaplains and social workers can consult with their managers and teams and visit patients at a distance with additional equipment and precautions. At this unprecedented time of social distancing and health-related isolation, social workers and chaplains are among the front-line workers who assume risks and sacrifices to ensure patients feel less alone.

Adriana Krasniansky

Adriana Krasniansky is a graduate student at the Harvard Divinity School studying the ethical implications of new technologies in healthcare, and her research focuses on personal and societal relationships to devices and algorithms. More specifically, Adriana is interested in how technology can support and scale care for aging and disability populations. Adriana previously worked as a writer and consultant in the technology field, managing projects involving artificial intelligence and robotics. Her work has been featured in publications including The Atlantic, Quartz, and PSFK.

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