By Nina Miller, MSSW, OSW-C
AOSW Advocacy Director
 
It was March 2020 and I had just finished all preliminary testing – EKG, ECHO, pulmonary function studies and the like – and I headed to my final appointment with hematology to sign consent for transplant. “I’m sorry, but the hospital…COVID-19…your transplant has been postponed….Lockdown.” Somehow I was grateful that I was not the only one practicing isolation and forever grateful for online grocery shopping and our local Farm and Fleet for drive-through pick up for dog food and all things we needed to busy ourselves while maintaining our little five acre piece of serenity.
 
Fear—there was certainly fear of what might happen if the pandemic hit our home turf and anxiety about an unknown future of my disease course. I had finished Azacitidine injections and was in clinic at least weekly and now the unknown included how and when I would see my healthcare team and big questions about whether telemedicine would work when my internet connection was poor at best.
 
The preliminary testing happened again and in October 2020 I received an allogeneic transplant with donor cells from a young German woman for whom I am eternally grateful. I received chemotherapy outpatient and was admitted – alone and with no visitors allowed for my stay. Should I be relieved that the visitors that could not come would not be bringing me their germs? Should I look for the silver lining and enjoy each and every day dragging out the woman next door for walks in the hall and chats at the chairs by the windows to the world outside? Should I be thankful for living in an era with FaceTime?
 
Social workers, dietitians, pharmacists and others consulted via phone. Nurses spent time, always aware that they could do little to address social, emotional and psychological needs when there were meds to give and palliative care needs to attend to. The providers were great and I was fine but this time was not what we had planned for or how we envisioned it.
 
It’s no wonder that social workers are reporting that during this pandemic there is a need to provide more support to healthcare colleagues, that for some telehealth was a blessing and for others  telehealth was difficult and impersonal, and for many, reporting that lack of family attending appointments or hospital stays was impactful.
 
Advocating for services to address the psychosocial needs of patients and providers, advocating for adequate staffing and support for evolving practice, advocating for coverage for telehealth going forward, and maybe even for rural broadband, and advocating for resources for patients wholly impacted by their disease and/or their disease in a pandemic is the true work of our profession.
 
Advocating for patients is what you do. It is important to assess patient preference for phone or video visits vs. in-person visits, and make sure providers are aware and insurance covers. Build your skills to perfect the use of technology and how to provide service without the benefit of in-person contact. Contact payors and legislators to ensure adaptability to meeting patient needs. Contact local, state or federal legislators to tell patient stories that they need to know when public policy impacts patient choice. Finally advocate for yourself and the profession by making sure administrative persons know that social work services are critical to meeting the social and emotional and resource needs of patients and staff, especially in the midst of a pandemic.