As we all know, the landscape of healthcare in the U.S. today is extremely complicated. It seems like there are weekly shifts in healthcare that one day support and the next threaten the Affordable Care Act and have the potential to throw our system into perpetual chaos.

In the news we have seen the distress of young people facing cancer who have died by their own choice or as a result of the disease progression. These political and societal stressors have an impact on our patients clinically and emotionally, and result in their own stress for both patients and their caregivers. An increasing number of people are struggling for resources—both human and material—to help with the demands of cancer treatment.
    
When oncology social workers intervene and assist patients and families, they are met with a greater acuity in the hospitals and now increasingly in the outpatient settings where more of the treatment has shifted. The caregiver burden is increasing and will continue to do so as the follow-up care around treatment increases. Accompanying the additional burden to both the caregiver and the patient is the increase of psychosocial needs and fiscal constraints. More patients are presenting with their own past trauma histories unrelated to the cancer diagnosis, which add an overlay of both social and psychological complexities that can impact their adherence to treatment and ability to receive care.

In short, there are many factors that oncology social workers help patients and their families with during the course of their day. So our challenge is how do we continue to make an impact and continue to meet the client where they are in the face of all these challenges? Here are a couple of suggestions that might be useful.
 
Apply the principles we use in the clinical setting to this wider context; whenever possible divide up the issues to make them more manageable for the patients and their families. Using the crisis intervention model, help people to prioritize and not get ahead of themselves nor sidetracked. This will help them to stay present and to minimize feeling overwhelmed by the many factors that are complicating their lives today.

Foster collaboration with one another and with our colleagues. These are tough times and we need one another now more than ever. If we find points of collaboration where we can work together we will form a strong, cohesive front that will contribute to our relevance, sustainability, and effectiveness.

Conduct research and gather data on the many facets of our work. This could be as simple as doing a needs assessment for program development. It can be the development of a short assessment form that can be distributed after a program or group. The more data we have to explain what we do and demonstrate the impact we have across a large spectrum of issues, the better it will be for our patients. Demonstrating consistent leadership in the clinical arena will help us to not only provide excellent patient care but also relevant programming to assist patients and families in spite of the ever-challenging, changing landscape of healthcare.

Finally, I suggest we need to pay consistent attention to recognizing the impact the work has on us with its potential for compassion fatigue and burnout. The more attention we pay to this both on and off the clock, the more we will be able to not just survive in this ever-changing healthcare environment, but also thrive.

In these complicated times perhaps the best approach is to formulate a combination of simple responses comprised of self-care, collaboration across disciplines, and a plan to demonstrate how we assist people undergoing treatment for cancer and survivorship.