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Chris Coutts, Social Worker

25th September 2019
This diary was written in March 2020

08:55 Arriving at Sobell House on time and relatively stress-free is often a reminder that we did well to decide to live within 15 minutes’ walk from work so there are no commuter headaches! When participating in resilience training, I make this an important point in the work/home balance discussion. So self-care has been addressed before work commences!

09:00 In preparation for our ward handover meeting, I check my emails and voicemail which provide me with valuable information to share with the team. I then set up the day’s schedule.

09:15 Ward handover with our multidisciplinary team where we share a summary of overnight and weekend events of a clinical and psychosocial nature. This can help us to adjust any planning required for the day. The role of a Social Worker is closely connected to Occupational Therapy and Physiotherapy in terms of a patient’s care needs when discharge planning. Chaplaincy collaboration is also common when spiritual care and family support is required, which may also involve funeral planning.

09:30 Following information from the handover, I contact a Solicitor well known to Sobell House to arrange a will writing appointment as soon as possible, and advise the charity team that a witness may be required later in the day to assist the Solicitor to finalise the will. I also discuss a patient, Trevor*, and his daughter, Sarah*, with our Benefits Advisor who will visit them today to assess entitlements and advise on action she can take.

10:00 In order to arrange a discharge for a patient, Rose*, who is medically fit to leave Sobell House, but unable to return home because her care needs are too high for a package of care, I’ve invited a Nursing Home Manager to assess her situation. Following discussions with Rose and her husband, Ron, and three sons, we locate a nursing home which has a vacancy and is also geographically and financially viable. This meeting is just the first step in Rose’s discharge. I will then need to make a referral to secure eligibility for funding from NHS Continuing Care and assess Rose’s care needs with other members of the Sobell House multidisciplinary team, so that the nursing home has a complete picture of what’s required. If a room is offered, I then work alongside our Discharge Coordinator to agree on a discharge date when the funding – based on final costs – is authorised.

12:15 Head to our weekly multidisciplinary team meeting on the ward, where over a dozen health care professionals discuss the details of all patients on the ward. Today there are 17 patients to discuss. I contribute to this meeting regarding psychological and social support, and discharge planning.

13:30 Lunch is a very important part of a busy stressful day! I find a break essential – either to eat in peace and rest and reflect, or share with others in chat and have a laugh.

14:00 I collaborate with Graham, our Chaplain, and Tom, our Music Therapist, to teach medical students communication skills when caring for patients receiving palliative care and their family. The Medical Education programme with 5th year Oxford University students requires Senior Doctors at Sobell House to address psychosocial topics such as spiritual care and cultural diversity, therefore the wider multidisciplinary team are very valuable when teaching skills such as communication.

15:00 Drive to the other side of Woodstock to visit a patient, Arthur*, at home. Arthur was an inpatient on our ward and was discharged with a package of care funded by the NHS, whereby a care agency visits to provide care and support. Arthur has his daughter with him for my visit. He is over 80 years old, a farmer who lives alone in a cottage independently before admission to Sobell House. He resists the thought of having carers look after him at all but continues to agree for the sake of his daughter who worries about him. Like many patients, the loss of physical and social independence is as painful an experience as the diagnosis of serious disease and end of life care.

17:00 Unlike the morning walk, I now face a drive back to Headington, however the traffic is kind to me in this direction. It is useful to use this time to reflect on the day and practise some stress management strategies such as playing music and avoiding the news at all costs!

*Patient names have been changed for anonymity.