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A Day in the Life: The Palliative Care Social Worker

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“Every workday morning, I get up and prepare my three-year old son for the day, take my prenatal vitamin, give my husband a kiss, then settle in at my computer for a day of talking to people who are facing the end of their life, or those who have lost their loved ones.”

Since 2018, Bev Nolan has worked as a social worker supporting end-of-life care in Vancouver. She spends her time caring for patients and their closest family and friends who are dealing with the fact that they or someone they know is entering into palliative or hospice care.

“For me, it’s all about building connections with people,” says Bev. “As people transition into the hospital or hospice, I go in for a visit and make sure they are comfortable and settled and ensure I have done a thorough handover to the staff at the site. It’s really a wonderful thing to be in a position where I get to enter into people’s lives and help them during an often very difficult and trying time.”

On Tuesdays and Thursday afternoons, Bev works out of the Nancy Chan Ambulatory Palliative Care Clinic, a donor-envisioned program that provides specialist consultation to help with the physical, emotional, and spiritual needs of individuals and their families in palliative care.

Otherwise, she is providing support either in the cardiac palliative clinic, or doing at-home visits to clients in the Pender Health Unit catchment area for individuals who choose to remain in their homes.

“Before Covid-19, my day would include bereavement visits, taking phone calls to offer support to front line staff, and an afternoon of full clinic sessions with people living with life-limiting illnesses and their loved ones. Normally, if someone were hospitalized or admitted to hospice, I would take some time to go check in. But nowadays I haven’t been able to go into the hospital or hospice,” says Bev, her voice softly trailing. “That’s been a really hard piece for me. I’ve lost many clients since March, and I wasn’t able to physically be present for them. I miss seeing clients in person, being at the clinic, and being able to run over to VGH if someone was sent to the hospital.”

After the coronavirus came to BC and we began to see spikes in March, Bev’s work shifted dramatically. Instead of attending in-person appointments to help people during these private and intimate life moments, her personal care system moved into virtual care. Family discussions about end-of-life care were now on video calls.

And yet, while she says there has been a form of connection lost relying purely on this format, Bev has also seen the benefits virtual care has had to offer: providing service to patients with multiple co-morbidities who find it difficult to travel or are afraid to leave their homes during this time, and loved ones who live far away become more intimately involved with the patient’s care plan.

“This has broadened the ways we can offer care,” says Bev. “When people were referred to the clinic before, they had to come to the clinic. Now, we’ve been able to provide great care to people in the comfort of their homes who otherwise may have felt fearful to venture out during the pandemic.”

She has seen this crossover into the team as well. Typically, the palliative care network is spread across several sites. But as staff members have adjusted to the technology together, it has brought with it a feeling of connection.

“Now that we’ve gotten a routine and we’re comfortable using this technology, it feels more connected,” says Bev. “It is amazing how everyone has adapted and continued to offer really great care for people.”

At the end of the day, when Bev closes her laptop and puts down the phone, she feels drained – but happy. She knows she has made a difference in someone’s life at a time when they needed someone like Bev to be there for them. To offer empathy, a safe space to grieve, and the knowledge they need to get through one of the most painful times in life.

“It is a mentally draining job, and certain days are harder than others. You are navigating through people’s stresses, worries, anxieties, and there isn’t a day that goes by where somebody isn’t in tears,” says Bev, breathing out a sigh. “But it’s such rewarding work. I get so much back from it. I learn so much from the people I support and I am honoured and grateful to be able to play a role in their lives.”

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