“Water Ice” & Jeny From the Block

Somehow I’ve completed my second week of the 13 I have here in Philadelphia and there is so much that I have learned and that I am still learning here.

One of the things unique to being a traveling healthcare worker is how fast we are expected to pick things up and learn a new electronic medical record (EMR) system, and resources. We are usually expected to be fully trained and flying solo within the first week or two, if we are even given that long. Whereas in North Dakota I did not need as much training because I was working in dialysis which I had done several times before, this experience has been a steep learning curve. I have to say that the hospital I work at (Lankenau Medical Center) is amazing. My experience has been SO great here so far. It started from the moment I met my supervisor (Jeny – yes, one “n”) in person. She literally introduces herself to patients as “Jeny from the block” 😂 She is also hilarious and so fun to work with. Also, I love how much she knows about medical terms and meanings, and the field of social work. I am learning so much from her. Also, fun fact: I am now “Katie from the Bay” when I introduce myself to patients LOL.

Also, side note: I love the food combinations here: sweet and salty aka my fave. My first week here I was introduced to what Philadelphians call “water ice” (pronounced ‘woo-der’ ice) 😂 California’s equivalent would be Italian ice or sorbet. Here they sell it in huge gallons though! One of the agencies we often work with donated two gallon containers of cherry & mango flavors. As if that was not enough, they also donated a bunch of soft baked pretzels. Pretzels are also huge here which I am not mad about…at all 🥨 Here in Philly people combine the two for a sweet & salty snack. I won’t lie, it was actually pretty delicious! I got my sweet AND salty fix. I think it would also be delish with some ice cream in there too. It would probably resemble one of my favorite treats from Sacramento at Gunther’s ice cream: the fruit freeze! I will have to try it at some point! I also still need to get a cheesesteak. I was recommended to go to South Street by my previous manager and my current supervisor reinforced that! Some day soon.

I am also gaining so much knowledge to add to my travel social work repertoire. This assignment in particular has presented a brand new challenge which is learning, and I mean REALLY learning about discharge planning especially as it pertains to traumas. It is already week two and I have seen everything from gun shot wounds (GSW) to motor vehicle crashes / motorcycle crashes (MVC/MCC), suicide attempts, and falls. Each trauma case presents its own challenges. Some people go home, some people go home with hospice or comfort care, some people don’t make it. Some people go to skilled nursing facilities. Some can tolerate home health. Some don’t have any needs.

I worked at a level 2 trauma hospital like Lankenau before in San Jose (Regional Medical Center) but there social workers were not nearly as involved in discharge planning as I am now. There was also a difference in the level of involvement social work had with the trauma team. It is no fault of RMC’s of course, I just think social work did not have the proper introduction to the trauma team that would have been helpful in bridging some of the communication gaps. I applaud Lankenau for the amount of respect and involvement the physicians and trauma team display for social work. Social Workers are a core part of the team and our presence is needed during rounds and in general.

The cases here remind me more of those from East San Jose than North Dakota did. There is a lot of gun violence, many of the cases severe. I will do a separate post on this another time because it has been weighing heavily on my mind and I am still trying to process it.

As a trauma social worker my role is to follow these cases from admission to discharge. I do respond to some trauma activation codes in the Emergency Room as needed, but usually I start following the patients on the floors (especially in the surgical ICU). Whatever they need from a psychosocial perspective and referrals they need is taken care of by the social worker.

EXAMPLES:

• Female who attempted suicide by jumping off an overpass and ended up having multiple broken bones requiring acute skilled rehabilitation prior to going to inpatient psychiatry. I would be responsible for sending a rehab referral based on insurance, coordinating with psychiatry to follow her as well, providing emotional support to the patient & family and arranging for transportation via ambulance at discharge.
• Young male shot 30 times walking out of his house and is now in the hospital on life support but parents do not want to pull the plug. I would have to provide emotional support to his parents who never expected their child would die before them. If they are hesitant, a goals of care meeting would need to happen and if they chose to take him off life support, I would delicately provide information about burials, cremation, and various death/dying resources with the assistance of palliative care.
• Older male with limited support who was independent prior to the hospitalization who fell, broke his hip and femur (non-operative) and is now unable to walk or drive or anything he used to do. Physical therapy recommends he goes to a skilled nursing facility (SNF). I have to check his insurance, apply him to SNFs, but also provide emotional support to the Patient due to this life changing event. He may be grieving. He may feel despair. He might refuse the SNF. If he does that, are there family that can help and will he accept it?

Again, none of those cases were real… all of them have been changed for confidentiality. But those are just some examples of the kinds of cases I see in the trauma unit. As many areas of medical social work do, trauma social work definitely gives me so much appreciation for life today. We never know what day is our last, and this is totally my reminder. Let this be your reminder too: live your life and enjoy it this weekend!