Ep. 30 - Social Work and Vicarious Trauma: The Fear of it All Unraveling (w/ transcript)

Social workers are walking alongside people dealing with some of the hardest and most traumatic circumstances they've ever had to face. Sometimes these difficulties leave a mark.

Join Mim and Lis as they contemplate 'the fear of it all unraveling'.

Credits:

Hosts - Lis Murphy and Dr. Mim Fox.

Producers - Ben Joseph & Justin Stech

Contact us online at www.socialworkstories.com, follow our facebook page or use the handle @SOWKStoriesPod on twitter or instagram.

Do you have thoughts, want to contribute a story or question for the team, or just say hello? Send us an email on socialworkstoriespodcast@gmail.com - we'd love to hear from you!

Podcast Transcript - Episode 30: Social Work and Vicarious Trauma - The fear of it all unraveling (transcript).

To cite:

The Social Work Stories Podcast, 2020, ‘Episode 29: Social Work and Vicarious Trauma - The fear of it all unraveling’ (transcript), accessed online [insert date here], <www.socialworkstories.com>.

Date Published: 31/03/2020

With special thanks to Katie Wicks for transcription.

Photo by Lane Smith on Unsplash

Lis – Don’t you reckon it’s great to be back in the rhythm of life again. Like, these conversations I’ve missed so much and,

Mim - Yeah

Lis – But I thought about your point about sitting around the fire and,

Mim – The tribal fire.

Lis- We can’t even say that anymore.

Mim – Yeah, it’s a virtual fire now Lis.

Lis – Totally virtual, there are total fire bans going on and I just think so many people might be triggered by the whole fire thing now.

Mim – Ok so we’re no longer sitting around the fire at the camp site.

Lis – I liked your, sitting around with a cuppa though.

Mim – Yeah, yeah. Ok so now we’re sitting with a cuppa speaking with our, still our tribe.

Lis – Yeah

Mim – But definitely our colleagues are still out there roughing it at the moment actually, In Australia.

Lis - Yes still, But you and I get to just have these conversations again like we normally would and today’s is another one of those topics that you and I have talked about, cried about, shared our own experience of it, but it is another one of those ones that we’re really going to sink our teeth into.

Mim – I know

Lis – And it’s something we’ve also done some research about.

Mim – It is, but before we go straight in Lis, hey welcome to the Social work stories Podcast.

Lis – Woops, sorry.

Mim – Both to you and all of our listeners. The person over there speaking non-stop is Lis Murphy.

Lis – Thank you, thank you. I’m feeling frisky, I’m feeling very frisky.

Mim – She’s on a roll today everyone.

Lis – I love this topic.

Mm – It’s a great topic.

Lis – You know me.

Mim – I’m Mim Fox,

Lis- Hello Mim.

Mim – Hello Lis and hello everyone. We are talking about a topic today that Lis, we’ve been doing work in for about three years you and I.

Lis – We had started our research on vicarious trauma and compassion fatigue in hospital social workers coming up to nearly three years to the day.

Mim – Yeah, we’ve been working with a great group of social workers in a few different hospitals around this trying to really understand it and unpack it. Looking at the impact of compassion fatigue and vicarious trauma. And this story that we’re bringing you today is a colleague of ours, really really personal experience of the impact of compassion fatigue and vicarious trauma on him.

Lis – Absolutely, so that is what the focus is about.

Mim – Yeah

Lis- But he, in order to get to that focus, he tells us about a very poignant case, and I just let people know that it is about the death of a baby, um. But the focus is definitely on the impact that it had on this social worker. But I need to warn you, this is one of those social workers that can really tell a riveting story. The detail that he gives about the sights, the sounds, the things he was thinking.

Mim – Its evocative, it will draw you in.

Lis – It’s so evocative, and at times somewhat, I found it a little bit chilling.

Mim – Yeah, there’s a chilling aspect.

Lis – There is. But if this is something that you think, yep, I’m not interested in hearing about the story. Come back and listen to Mim and I talk about the impact on the social worker because that is going to be our focus.

Mim – All right, have and listen and we’ll speak to you again in a minute.

Music Plays.

Social Worker – So the case that I’m going to talk about today, is quite unique in that I wouldn’t frame it as being one of the more challenging trauma cases that I experienced across the grand scheme of things that I’ve been involved with over the course of my career. But it is one that has stuck with me across time. But also, one in which I very acutely became aware of trying to understand what my role is and feeling somewhat helpless or insignificant in being able to effect change for someone who was experiencing such acute grief and distress.

So, it was a case where I was on call. It was a Sunday morning. At about three or four in the morning I got a call to come into the hospital because a baby had become unresponsive and passed away overnight and had been bought into the emergency department. So, I was asked to come in to provide support to the mother who was there with the child. So, I made my way into the hospital, as you tend to do with that kind of work, kind of hypothesising what that might be like when you get there and try to frame how I might approach a situation such as that, and what would I do. That in itself is challenging, because you don’t really have a reference point yet. Or you are out of the context. So, I think often receiving that call can be very daunting because your trying to place yourself in the workplace when you’re not at work. But also, then trying to work out what you might do to support a person in that situation. So, I was going through all of that when I was going into the hospital. I arrived and I was in the emergency department. So, I got there, spoke to the medical staff, doctors and nurses that were involved in that situation. There was an immense heaviness in the emergency department just about this particular case. Just because clearly it was incredibly sad, and staff were quite distraught about trying to support the mother of this baby that had passed away.

So, this real kind of almost jarring contrast of the emergency department with sounds and fluorescent lights but this real kind of deep heaviness in the emergency area. I made my way into, in most emergency departments have like a family room where people go, and conversations happen about things that are happening in emergency with families. So, the mother of this baby was in there with the baby and there was also this two-year-old child there as well, looking completely lost and not really clear about what was going on. And there was a nurse kneeling beside the mother who was holding the baby, I’ll call her Chloe. And the nurse was stroking the back of the mother who was cradling the baby that had passed away. And the nurse was also crying. So, I walked into this family room we refer to it as, very dimly lit, there was no windows, it was the middle of the night anyway. But it’s a very dim room with furniture that was just really really well worn. And into an emotionally intense and heavy environment. So, coming I guess from home really into the emergency department that was full of fluorescent lighting and then moving back into this really visually dark, visually and emotionally dark area really. So, the mum was very understandably incredibly distressed. She was clearly grieving the death of her baby that had just occurred. There were moments where she also had lucidity, where she was able to come out of that for a minute and have a conversation, but then would just go back into that acute distress. So, the nurse left that room and so metaphorically handed over the baton of responsibility for that situation to me. So, I was then left to try and work out what was I going to do in this situation. I remember at that time feeling incredibly ill equipped to be able to affect any kind of meaningful change or support in this situation. I mean what could I possibly do in this situation to make anything better. That in itself is very jarring, around I had this responsibility to manage the situation and to support this person through what I assume may well be the most traumatic thing they have been through or will go though in their life, yet so ill prepared and unable to do anything meaningful in this situation.

I was talking to the mother or trying to talk to the mum about what had happened and not really knowing what I was trying to ask her, and not really knowing what I would say to her in those moments where she was incredibly distressed. She kept repeating the same lines over and over. It was “ooh Chloe, wake up Chloe”. And that was a repeated phrase, almost as though Chloe was playing a game with her and by saying that Chloe would wake up and things would go back to normal. And she kept repeating that same kind of phrase, she was stuck in that loop for a period of time where she would say, “Chloe, come on Chloe, wake up Chloe” And that for me was laid down as the soundtrack to that experience, of being in that room at that time And again I recall this feeling of being incredibly insignificant to do anything meaningful to change the situation for this person. But so, incredibly, I would say, overwhelmed by the sense of responsibility for that situation. The doctor came in at one point and did speak to the mother, Chloe’s mother, to talk through the medical aspect of what had occurred and what would happen next. I remember the doctor looking to me, with this look on her face of, trying to get reassurance and kind of checking if what she was saying was ok. I remember nonverbally giving her this reassurance in that moment. But again, it just reinforced to me, that this is all sitting with me, they are also relying on me to be the person who’s holding this together. I spoke to that doctor afterwards, I had taken myself out of the room, and the doctor said was that ok, was what I said ok. And it was, she was very empathic, and it was fine, it was good. But it just again hit me that I was the one that people were turning to, to be front and centre in this situation. And it also struck me that the team collectively were supporting the mother of this baby, and I was supporting the team in supporting this mother. But who was supporting me? I was left as the last person standing, trying to you know hold everything together, but who was my person to sort of go to if I was needing to support the other people in the room. It was a really surreal moment I think to have, that revelation of questioning I think when I understood that I felt very ill equipped to be in this situation that I was finding so incredibly confronting. I remember questioning the profession in the sense that, how did the profession that I know and love and trusted get me to a situation where I am so out of my depth and so uncomfortable really in dealing with what I needed to deal with. So, the organisation was asking me to do this, but I personally felt like I was so ill equipped to be the person dealing with it.

Again, throughout all of those conversations the mother was repeatedly saying oh Chloe, wake up Chloe. I just want to say it again to reinforce that this was a common theme across the conversations that I was having with her. At some point the father arrived in the hospital, in the emergency department. So, he had been out celebrating the birth of Chloe. So, he arrived, and he was intoxicated when he arrived. It seemed to me there was great difficulty for him in trying to land himself in that room. So, understanding that his capacity to comprehend what was going on was impaired because he was drunk. But he was trying so hard just to wrap his head around the fact that he was in an emergency department and needing to try and comprehend the fact that his daughter had just died, and the irony of this is devastating, while he was out celebrating her birth. Some tension arose between the mother and the father, understandably in such an emotionally intense situation. There was some questioning around what had happened overnight and how Chloe had become unresponsive. The father then, he left, he left the emergency department. It seemed to me it was more than he was able to comprehend, he just needed to flee. He just couldn’t be there and try and wrap his head around what was going on.

Again, in that moment, after he left and I was with mum again on her own with the two-year-old, who was still looking lost and had this uncertain role in this situation. There was no one else we could call to look after this two-year-old. But there was this situation of trying to manage this mum and the other child at the same time. And I was very aware of the impact that this situation would be having on that two-year-old. And was kind of not really able to grasp what was going on, but clearly felt something was happening and it was bad. The heaviness was unmistakable. I think that impacted on the child as well. But I still felt like a stranger imposing in this deeply personal life experience for this family and a deeply devastating experience, but still a deeply personal one. And who am I, little old me, like walking up to ED being so front and centre in trying to address and resolve and support them through the situation. It was just so a disconnection for me around what I was needing to do in this situation and what I felt like I could do. The question then came up for around, what is my role here? What am I supposed to be doing here? Is my primary purpose being a support for the mum, am I meant to be a babysitter for the two-year-old? Am I supposed to be the hospital representative in terms of facilitating the processes that happen when someone passes away in hospital? Or was my role to be a support for the staff who were here dealing with it as well. And I realised that I was all of those things at once, but I felt ill equipped to be any of those things in their own right. There was a real, and again I use the word disconnection, between what I was needing to do and what I felt I was able to do in that situation.

Interestingly to me, the part where, the part after the father left the emergency department, is the part where I stop being able to recall, or visually recall what happened in that situation. I either can’t recall it or I’ve blocked it out, I’m not sure which. But that is interesting to me that where my ability to retain information hit its capacity or the situation was overwhelming to the point where I couldn’t absorb any more, or lay anymore of that memory down, I’m not sure. I don’t remember what happened after that situation, after that part of the situation. Knowing what I know about processes in the hospital when the death of a child, there are things that would have occurred following up from that. But I just don’t have any recollection of what those things were.

My next recollection of that situation would then be on Monday morning when I was back at work. So, this all happened in the wee hours on Sunday morning, while I was on call. So, the next working day, the Monday I was back at my computer just going about my business and trying to organise my day. And one of the senior social workers came up to me and said that she’d heard about the on-call situation that I had had and asked if I was ok. And I absolutely vividly remember feeling this innate and intense need to shut that conversation right down. I remember having palpitations and getting, it made me just so anxious that I was being asked. I just knew that I needed to just not have that conversation. So of course, I said, no I’m fine, it was fine, it was pretty intense but I’m ok. Knowing, well physically knowing but, I wasn’t able to articulate or recognise that for myself at that time. That I wasn’t ok with it. That I felt this need just to not engage with the conversation. And I think the fear of having that all unravel. I think if I kind of said actually no I’m not ok with that situation, it would have spiralled into a whole conversation around why am I not ok with that.

So some time after that situation, I would say a couple of months , maybe three or four months, within that period, I didn’t actively do anything to resolve or address or talk through the experience of that on call situation with the death of Chloe, and my involvement in that. I probably didn’t feel like I needed to, but in hindsight I recognise that I actually did need to. I started to develop auditory intrusions, so I kept, at various times, and at times when I was unprepared for it to happen, I kept hearing the mother saying, Oh Chloe, wake up Chloe, it would just come back to me, at various times along the way. And of course, that would then connect the dots for me to straight back into that dark room with that emotional intensity and the heaviness of that particular on call case. So that happened quite a few times over the course of a couple of months, where just out of the blue, I would just be going about my business with no kind of real identifiable trigger that I could see, that would come up. And then I would just be taken straight back into that situation. So, I kind of look back at that and realise that was an indication that there was something happening for me with that situation that has been left unaddressed.

So, I’ve got to say, that so those auditory intrusions did go away over time. But I will make the point that I didn’t actively try and do that because I wasn’t in a position where I could acknowledge that I needed to. That I needed to address it. I also at that time lived near the hospital that I worked at. So, I would hear the helicopters coming in, and the ambulances coming along to go to hospital. So, if I was at home, I would hear the ambulances or the helicopters and I would just have this sense of anxiety, just the sound of that was a trigger for me that provoked anxiety. Even if I wasn’t on call, the sounds of those helicopters or those ambulances would take me back into that situation as well. Again, that resolved over time and morphed more into a, something is going on I feel sorry for whoever is on call. But I didn’t actively try and resolve that situation and accepted that was a part of the aftermath of the work that I was doing at the time. I think that also manifested into a bit into my next role, so I moved then into a position in an intensive care unit for a couple of years. And although I would never have articulated it this way at the time, looking back at that time and that experience it’s clear to me that over a period of time in ICU and being repeatedly exposed to situations of trauma and supporting people who are experiencing trauma. I became avoidant of ICU and the clinical work in ICU. So that work still got done, still needing to do the work we are being asked to do, however what I became aware of is that it was becoming more and more difficult for me to take myself from my desk when I get in in the morning and down into the ICU unit and I started to favour parts of my role that were not the clinical components. So, kind of would have this dread around having to go down and confront these situations and the administrative parts of my role at that time were just so much less confronting for me. The tricky thing I think is if you’d asked me at the time, do I need to have a break from that environment, I would have said no, because I loved it, and I still do love it. But I wasn’t at a point where I could recognise that something needed to be different or that it was having that impact on me. I knew it was taking me longer to get down into the ICU and there was an issue there, I knew there was something going on for me. But I couldn’t allow myself to acknowledge that or address that, because again there was that fear of it all unravelling. Because I framed myself as someone who really loves working in this space, so if I can’t do this, what do I do?

So looking back to these situations it makes me question what was happening for me at the time, both when I was directly asked I needed to talk through that particular case in ED with Chloe or when I was unable to acknowledge the fact that I was struggling to attend the work in ICU because of the nature of the content of that work, it’s a really curious thing to me that I just wasn’t in the position to acknowledge that for myself. I think it’s amazing and great that someone had asked me after that incident with Chloe if I was ok, it makes me realise that the timing is so crucial because we can ask lots of questions around, are people ok, do people need support and to debrief. But if they’re not in a position or able to have that conversation there’s that disconnection again. I think part of the issue is also around the culture, there certainly was a culture at that time that we didn’t really talk about this stuff so overtly. There’s almost a sense of in relaying a challenging case that you may have had on call or on the ward or where ever you might work, it can be at times be a sense of one up man ship where if I was to say I had this awful motor vehicle accident where someone passed away and the person I’m saying that to might say” ooh yes that reminds me of a case where there was two vehicles and three people died and it was horrendous. And what that says to that person is, you can’t be struggling with this because I’ve had something worse and I’m standing here in front of you. But what it also says to the person who is doing that is, this persons can’t be worse than mine cause mine must surely be worse than theirs. It’s a really interesting problem I would say, in that we need to think about the way that we talk about the aftermath or the vicarious trauma associated with being exposed to trauma. And making sure there is a conversation in our departments or in our work teams or where ever we might work that allows that to happen in a supported way. I think there’s a real cultural element to making sure that conversations about this are happening and that it’s a normal part of everyday conversations in social work practice. I think there’s a lot of barriers to that happening. I think one of them is around being seen as not coping. I think one of them is around questioning professional identity, if I can’t do this what do I do? And if I can’t do this but everyone else is what’s wrong with me? I think one of the challenges is that trauma cases often seem to be worn like battle scars. So I think we all, I’m assuming social workers who are practicing have cases or stories that they can draw upon that were kind of the worst story that you’ve been involved with and we just accept that that’s a part of our work, or like social work history. And so, we with those situations, I think there’s an issue in there around needing to have had one of those experiences to have a place in that conversation. And I think there’s an issue in that around by virtue of our work period we have a place in that conversation. However just inadvertently through the work that people have been doing they may find themselves having cases or experiences where they have experienced some intensity, or some trauma based or vicarious trauma.

One of the challenges I think is also around trying to seek support from managers or supervisors. So, I work in public health and the general structure of support is that you would go to your supervisor who is also usually your team leader or your direct line manager. Which I think is fraught with difficulty if we’re trying to talk freely about some of the challenges we’re having in our work and get support for that by the people who are assessing our performance its fundamentally flawed in my opinion. So there’s a challenge or a barrier to people being able to talk freely if the sense is that we’re not able to talk about this or there is a fear of repercussions if people do talk freely about their struggles dealing with the content of what they are exposed to at work. And I think the important thing is understanding that we need to frame this as a work health and safety issue in its simplest form. By virtue of being at work in this environment we are exposed to trauma therefore it becomes a work health and safety issue in its simplest form

Music Plays

Mim – Oh Lis that haunting refrain, Chloe, wake up Chloe oh my god that kills me.

Lis – That is chilling. I mean we’ll talk a little bit more about some of the symptomology that he talks about. But, that one’s really interesting that auditory intrusion.

Mim – Isn’t it.

Lis – That was his and now has become mine.

Mim – It’s become mine as well. I know, but it is such a feature of vicarious trauma.

Lis – But I have not heard of auditory intrusions described like that. He just described it so beautifully and now it all makes sense.

Mim – The other auditory intrusions though were the ambulance sirens and the helicopters.

Lis – So I get that even to this day and I haven’t done on call, like I do some back up. But the helicopters can still trigger me because where the hospital where I first did on call helicopters coming in that’s social worker call out and never the nice call outs.

Mim – Yeah, I mean we’ve talked about this on the podcast before, about the experience of being on call and having to get up in the middle of the night, you don’t really know exactly what you’re going into and you have to pack your stuff. The way he describes it as going from the outside world and then into the fluorescent lights of the hospital and these dark spaces in the hospital that are so dark.

Lis – That are normally lite up during the day.

Mim – Right, and that’s where the family was. So that’s really very visually accurate I think, I felt like frighteningly I became here with him in that space.

Lis – And the other thing about being on call is that your alone. And he talked about that a lot. And can we talk now about that sense of responsibility that he felt.

Mim – Yeah let’s talk about that.

Lis – And we’ve talked about this on the podcast before not only does the social worker have to deal with the traumatic crisis that they’ve been called in for and supporting the family. But then also that sense of responsibility for the team.

Mim – Yeah

Lis – And so there was that young doctor that was asking the social worker is this ok, like what I said was that ok. And that overwhelming sense of responsibility that he talked about. Like, I’m not only responsible for the mother, and trying to provide support and hold the space for her, now I’ve got the whole team.

Mim – And that sense of, I’m taking care of all these other people who’s taking care of me? And I really felt so much for this social worker when he said, that he felt betrayed by his profession. That actually he had been built up and trained to be here in this moment, but without a safety net. And I would push that Lis and I would say not only is he betrayed by his profession but at that moment he is also betrayed by his employing organisation. Because that is not fair, for someone to feel in that moment in the middle of the night that they are that alone with no one to call for back up.

Lis – Yeah, and the reality is there is, well certainly the hospital where I work with and the other one’s that I know of, there is a backup system where you can call a senior social worker to provide support, workshop ideas about how you approach that particular case. So, you are never alone, however, everyone feels reluctant to ring at 3am the person on back up.

Mim – Do you know what though, there are a lot of smaller hospitals where the person on back up is the manager of the department, so you don’t want to call them.

Lis – Yes, and the other thing that’s really interesting Mim, about the whole back up system, is that no one gets paid to be on that.

Mim – Yeah that’s right.

Lis – So that’s another example of the good will of social work a lot of the time in relation to how our services are run.

Mim- Do you know, the good will of social work is an episode all and of its own. But I really do want to stress the risk that we have when we think about the coping of our social workers in an individual manner. So when we forget about the responsibility of the organisation we only focus on our individual social workers, what comes from that is what this social worker eluded to at the end of the interview, or spoke about in the interview which was a culture of are you tough enough right. That one up man ship, ok. And when we have a culture like that, are you tough enough to do this work what that means is, the responsibility for compassion fatigue and vicarious trauma falls squarely on your shoulders. No one else is going to jump in and support you because you’re now labelled as weak.

Lis – That and also, I think there is probably a whole bunch of wounded healers in that department who their way of coping with a fellow social worker who might be struggling, as I would imagine this social worker was, is to self-reference. Like, you think that was bad, gosh I got a trauma last Wednesday where there were 13 members of the family.

Mim – You saw the one family I saw 5.

Lis – That’s right there wasn’t just one baby that passed away, I’m telling you there was an entire village.

Mim- That’s it

Lis – So, I have a feeling that they can be, it’s a defence mechanism. I can’t go there with you because I am up to here, and people I’m gesticulating above my head, with my own experience of vicarious trauma. And you and I both know from the preliminary research results that we have, is that the on-call system can tip some social workers over the edge.

Mim – Absolutely.

Lis – That unpredictability that isolation, but also, you’ve also just been working a full day.

Mim – You’re exhausted already.

Lis – You’re exhausted already, and we know there is an accumulative nature to vicarious trauma. But the other thing that you and I have talked lots about is that when you’re in the setting of ED for instance with an on call, I don’t think there’s anything vicarious about that at all. You’re in the trauma.

Mim – That’s right you become a part of that trauma.

Lis – You’re sitting in a room with a mother with a dead baby.

Mim – Yeah.

Lis – There’s your trauma. I mean visually and now this auditory experience of it.

Mim – So actually the social worker is traumatised as well.

Lis – Yeah

Mim – It’s another layer of trauma.

Lis – Yeah

Mim – And this social worker really talked very acutely about his symptoms, right. He spoke about the fact that he lost his memory and there was a whole period that he simply just cannot remember. He talked about the auditory intrusions, the haunting refrain. He talked about how he became avoidant of the ICU intensive care work and he started favouring the non-clinical work. So, he started favouring the administrative managerial work. Got to tell you that’s a familiar concept Lis.

Lis - And I , it absolutely is Mim and I thought the way in which, he’s a perfect case study in some regards to you know, people who are saying, I’d really like to know how I can gauge if people in my department maybe struggling.

Mim – Yeah

Lis - Some of those behaviours that he was demonstrating are classic but they’re not the ones that are articulated. Because you can bury yourself in good admin work or a QI project or putting your hand up to take on more students. But what if the underlying driver there is because your traumatised or experiencing vicarious trauma and compassion fatigue.

Mim - Yeah

Lis - And so I want us now Mim to be able to talk about that whole scenario where he’s sitting in his room right, I don’t know if it was a supervisor or a manager, that comes in and says “are you ok, are you ok?” And remember he said “yeah, yeah, yeah I’m fine because I was so frightened of unravelling at that moment”.

Mim – That’s right, he brushed it off.

Lis – I’m really curious, I think in some regards it’s like, who hasn’t experienced burn out in the social work profession. So, I know that when I burnt out people outside of me saw it more clearly than what I did. But I’m really curious about what that person could have said or acknowledged to him to let him know that it was ok to be able to talk about what was going on for him.

Mim – So the way he said it, was that he was sitting at his desk just kind of starting his day, getting his head back into things and someone came over stopped in quickly and said ‘hey I heard about that call out , how are you?’

Lis – Right

Mim – Yeah, so what are we thinking that actually, because I would say that is a very well meaning, well intentioned person, who is probably also starting their day at that point. And probably thinking about the million things that they also have on their agenda for the day. So like, when we’re trying to really articulate what it is that that person could have done are we thinking some of the more classic social work relationship building techniques, taking the person aside, sitting in a more quiet space, having a more in depth discussion, making it less flippant. What are you thinking Lis?

Lis – Yes, I think you’re right in a number of those points in that it’s about choosing the right time, the right place, and I guess having the right relationship with that person that they can talk about the impact that it’s had. And you’re probably right Mim, as I’m listening to you it possibly was too soon at that moment.

Mim – I do think it was too soon.

Lis – Yeah

Mim – And that’s what I’m trying to get at. That there’s a limit to what managers, team leaders, senior social workers, whatever the role is in your organisation, there is a limit at that very close point in time to what can be done effectively. What my instinct and coming out of the research as well from what people have talked about was helpful, it seems to me is actually is the ongoing relationship with the person. So, it’s not a quick check in, it’s actually a quick check in plus a follow up in formal supervision. Plus, another quick check in, plus a come and have lunch with me, do you know what I mean?

Lis – Yes

Mim – That it’s more than just that.

Lis – And is that the supervisor or is that the manager, or the colleague or friend or is it a combination of all of the above. That the culture is around how we regularly check in with each other and that it’s not just the onus on the social worker saying I’m struggling here, but an acknowledgement of what we do in our work is hard and that we do need to create an environment in which people can be held in the work that they do. And I think that’s the other thing that you and I have often talked about how often the emphasis is on the self-care, but how much responsibility is it of the organisation to create a safe workplace for our social workers. And how do we know that there is a safe place. When we go to apply for a job.

Mim – Yeah

Lis – How do we check that stuff out? You know, is it enough to go what’s your supervision like here? Is that enough? What’s your work health and safety policies around vicarious trauma?

Mim – But also all it takes is one manager to change and the culture will change, right. So, we know how tricky and fickle a culture can be. That’s the reality for people. You go to somewhere and think, wow I’ve landed somewhere amazing and then something shifts and when you think back to what it was that shifted, it was a crucial staff change usually that did it. And so my feeling is that, rather than continuously trying to build armour for ourselves as a profession, around making ourselves tougher in many ways, My feeling is that we actually need to just get a bit real in this profession about the impact that our jobs have on us. And being able to create a culture in the profession that says, it’s ok to be vulnerable.

Lis – We go Brunei on this one.

Mim – Absolutely go Brunei, we always do. But absolutely that actually to be able to say it’s not that it takes strength to be able to do this job, it’s that it many ways it takes vulnerability. And if you’re going to be sitting with other people in times of vulnerability then you need to be ok with your own vulnerability. And that means being able to put your hand up and say , I’ve had a really hard call out, I’ve had a really hard week, I’m really tired, and I need my colleagues, and I need my friends and I need my family and I need to get outside at lunch time and see the blue sky and do something a bit different for a minute. Because what struck me with that conversation when the social worker was saying that he was getting in on that admin, I mean that happened to me Lis, it happened to you, right.

Lis – We wouldn’t be sitting here right now, would we, if we hadn’t burnt out.

Mim – That’s one of the things that we connected on was that we both burnt out. And when I burnt out, I then sunk myself into education. When you burnt out.

Lis – Same

Mim – It was education as well. Like this is the most common thing that happens, right. And one of the things that’s come out of our research is actually that having a variety in your workload helps to ward off compassion fatigue and vicarious trauma. So, one of the things that we need to look out for each other is, is it time to do something a little bit different. And if it is, that’s not about betraying your colleagues, it’s actually about taking care of yourself.

Lis – Because I think if everyone was doing that then there’s not a sense of shirking.

Mim – That’s right

Lis – I’ve got to carry the load, and probably, I can hear you, I can hear you the people listening in the podcast going, that’s all well and good when your fully staffed.

Mim – (laughs) Yeah that’s a lot of you out there.

Lis – Flu season hasn’t hit, or you know half of the department have been seconded over to elsewhere. I do hear that. I do hear that. But despite all that how do we create a culture that moves beyond just self-caring and the yoga class and creating something at departmental level as well. Like I absolutely agree with you about the management issue, you know a great manager makes a hell of a difference, like a principal of a school.

Mim -Absolutely

Lis – But Mim, I think that wouldn’t have been the case, yes that would have been the case with our miners, using the metaphor of a mine and all the work health and safety stuff that went on to create mines as a safer work place, or building sites. They have worked long and hard and the unions have been involved in creating work health and safety guidelines. And somewhere in there I think we can learn from it. What constitutes a safe workload, and it will look different in different clinical areas, but why aren’t we having those conversations?

Mim - Yeah

Lis – We know that there are always going to be beds that need to be, you know people have to be discharged, they’ll always exists. But when do we come to a point where we go, and that’s all I can do today people, I have reached my limit. And I think there needs to be more discussion around safe workloads for our social workers.

Mim - I would agree completely with that Lis, and we get a bit side-tracked about thinking through the impact on our patients and our families and our clients in non-health settings. And what happens when the social worker walks away and they’re the only one holding this case. We need to think smarter about being more collaboratively responsible for the vulnerable people that we work with so that we can take care of ourselves as well as providing continuity of care for them.

Lis – Yes

Mim – So, Lis this is one of those topics that you and I have been speaking about for the last minimum three years if not longer. From the day we met and could continue to do so.

Lis – I think we should Mim and I think closer to when the results of the research comes out.

Mim – We’ll talk about them.

Lis – And there will be articles that you’ll be publishing on it, and I think it needs to be a constant theme. One of the things I’m really interested in is sometimes when we do those interviews with social workers, they do talk a little bit about some of the things that they find really useful in their work around caring for self or what makes their work safer. And I think maybe every so often we include a bit more of that in their story.

Mim – Yeah. I think that’s really valid. I think this is a really pertinent issue for all of our listeners. Whether you’re a social work student thinking about how you can survive in this profession. Or whether you’re an experienced practitioner who’s made it this far and is needing more inspiration and more strength behind you to keep going. Like I think really there is a collective responsibility that we have.

Lis – Or whether you are the social worker that went off and opened that coffee shop or florist.

Mim – Yeah

Lis – Like you’d always thought you would, whether you’ve actually done that. Because that was my barometer. I needed a bit of a break when I’m fantasising about running my own coffee shop or bookstore.

Mim – Yeah. One of the moments when I realised that I was exhausted was when I went to visit my cousin years ago who was a jeweller, and I went and stood in her store and looked at all these beautiful gem stones, I thought how is it that you are surrounded by all this beauty all day every day and I do the work that I do? That was one of the key moments when I realised how tired I was. And I think that’s the stuff we need to start clueing into.

Lis – Mmmm

Mim – And then taking those moments of revelation and going to our colleagues, going to our managers, going to our friends and family and saying I need to be proactive now.

Lis – Right, you know lets Segway again, and encourage our listeners to talk to us about those very issues.

Mim – Yeah, that’s exactly right.

Lis – And Mim, how do our listeners do that?

Mim – Everyone hit us up on twitter or Instagram @SOWKStoriesPod or send us an email, we’d love to hear from you directly on socialworkstoriespodcast@gmail.com Thank you so much to Ben Joseph and Justin Stech our producers, Katie our social work student who has been out there doing interviews for us. And we’re about to welcome a journalism student as well onto our podcast series Lis. So, it’s an exciting time. Stay tuned listeners speak to you next time.

Lis – I’d just like to add a big take care, you’re doing great work. Look after yourselves.

Mim – Yeah, you really are. See you later Lis.

Lis – Bye

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