Social work in a colorectal unit

Pierre Matthee informs us of how social work in healthcare operates and the role of a social worker in a colorectal unit.

Social work in healthcare

Several myths exist in the field of social work. One is that social workers only work with abuse, the removal of children from their homes, and/or handing out food parcels. It may be surprising to know that there are numerous areas that one can specialise within the field of social work, such as the specialty of social work in healthcare.

Like many of the areas of specialty, the South African government is formalising it as an area of specialisation. Social work in healthcare, or medical social work, as it is known in other countries, is still unknown amongst professionals and patients in SA.  

Dealing with emotional responses

A misconception amongst patients is that they don’t want to talk to someone about their emotions, as they feel they aren’t crazy. What needs to be kept in mind is that admission into hospital, receiving a diagnosis and/or undergoing treatment can be extremely stressful. This can be accompanied with several emotional responses, such as anxiety, anger or worry about what the future might bring.

For some, it’s the first time they are confronted with illness and don’t know what to expect or what to do. Like the patient, the family also experiences a sense of being overwhelmed and are concerned about their loved one. Patients and family members are often scared to talk about their emotions, because of the fear of upsetting each other. Research has shown that there is a direct correlation between our physical, psychological, and social well-being. By neglecting one, it will have a direct impact on the others. The role of the social worker is thus to create a link between the three spheres, to empower both patient and family to achieve a level of cohesion.   

Within the field of medicine, patients are never in isolation; they are always part of a bigger world. Theoretically, the role of a social worker is to look at the patient by looking at the bigger world he/she is part of, taking into consideration specific elements. For example, the patient’s family, friends and work. 

No patient is the same, as their social, cultural, and spiritual backgrounds make them unique. 

Social work in a colorectal unit

Within a colorectal unit, the social worker will conduct a specific psychosocial assessment. This is to evaluate the patients psychological and social functioning related to their health situation and to determine the direct impact it has on their behaviour and indirectly on their health. Problems and areas of growth are identified, and together with the patient, the aim is to constructively work towards finding solutions. The overall goal is to achieve optimum quality of life.  

Colorectal cancer patients’ quality of life is often uniquely compromised. This may be because they need to visit the bathroom more frequently than other people, or because they use a long-term stoma bag.

Patients may question their identity, as they may see themselves anatomically different than others. This not only impacts on the way they look at themselves, but it also brings emotions, such as what will people think of me when they know I ‘poo’ into a bag. This may lead to patient’s isolating themselves, which can have several consequences, such as financial pressures due to physical disability or trying to deal with everything on their own.  

Benefits of seeing a social worker 

There are several benefits for you, as a patient, to see a social worker. Not only do you get an opportunity to speak to a professional about your experience, but you also get a chance to better understand your own situation. Patients learn to separate their problems from themselves, thus understanding that the problem is the problem and not themselves. Everyone has strengths to assist them on this journey. You might just need some help identifying them. 

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