By Jeanice Hansen, LCSW, OSW-C

I have been working with individuals in the healthcare arena for 34 years now and, like many of you, I’ve been through and witnessed a lot of changes. I think it is reasonable to say that my formal social work training did not prepare me for most of it. And, how could it? Understanding and navigating the complex system of healthcare delivery was not a core part of my education. And, who could have ever predicted the evolution and changes we would see. Trained as a “generalist” in the mid-’80s, I had one class called Social Work Practice in Health Care. (Ironically, I still have that 1984 textbook.) It was at a time when the SW profession had begun to move beyond focusing on the theoretical approaches of the helping profession to examining specific fields of practice, from emphasizing the information common to all areas of SW practice to defining the knowledge and skills needed for a specific field practice.  

The impact of that class launched my professional journey into the field of medical social work and ultimately specializing in oncology social work 10 years later, including excursions through patient navigation and hospice and palliative care. Like many of you, most of my professional training and further specialization occurred on the job. Experience teaches so much more. After all, the academic environment can only help us gain the confidence to get into the water and, hopefully, give us enough tools to swim and not drown. But the current of the social work profession can take us anywhere. Mine immersed me in the field of oncology social work and I have never regretted it. 

The early years of working in healthcare occurred while I was a single parent of two young boys. All those years shaped my personal and professional life and included many elements of “survivorship.” We were all trying to find ways to thrive in the midst of competing stakeholders that both held a vision of what was best for us and had difficulty delivering what was needed. I learned that survivorship, in any sense of the word, is complex, challenging, and ever-changing. 

So, in preparation for writing this article, I began to think about how my evolution as an oncology social work professional and the evolution of quality cancer care seemed to have in common with the concept of survivorship overall.  

Setting a course and constantly making mid-course corrections. Learning from our mistakes, repeating some of them, and making new ones. The recent article published 10-2-24 in the Journal of Clinical Oncology titled, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis: One Decade Later (https://ascopubs.org/doi/10.1200/JCO-24-01243) offers an analysis of strategies proposed in 2013, their status now and recommendations for “interprofessional team-based practice.” OSW practice has also benefited from a similar review of our past progress in delivering quality supportive care in this system and continues to recommend others that enhance interprofessional communication, collaborative practice, and survivorship support for individuals with advanced cancer. Challenges remain for the policy and practice of cancer care delivery, OSW biopsychosocial supportive care, and our individual survivorship experiences. Many of us find ourselves striving to meet multiple and complex survivorship goals in all three systems. According to the article, “The number of cancer survivors has grown to an estimated 19 million and care is more complex.” We and the system we work in have several challenges that persist within cancer survivorship – as a system, a professional practice and individuals.  Our attention, time, and talents are required in all of these areas. It is so fortunate that we have AOSW colleagues to share and learn from this experience together. We are all evolving with them.