Monique Lalane, FCRH ’06, LCSW, a doctoral student at GSS, sits in her office at Bellevue Hospital on the other end of our Zoom interview. As the conversation gets underway, I see her eyes slowly shift to the right. Her gaze slides to an out-of-view computer and back as we speak. I hear the light, rapid clicks of a keyboard tap through my speaker.
Lalane is a social worker on the frontlines. Her responsibilities can’t pause. There are people who need her, and that need doesn’t stop for interviews. It doesn’t stop for anything.
“This is the epitome of chaos,” she says about what her life has been like working during the pandemic. “It’s been super stressful and hectic.”
Because for Lalane, there is no remote work – no ability to click mute or stop the video stream. She shows up every day to the hospital, whether it’s safe or not.
“That was a harsh reality myself and every other social worker [in the hospital setting]had to realize: that we were also considered essential workers,” she said. “We had many of the same expectations as doctors or nurses or other healthcare professionals, in that you were expected to come to work, and you had to make every effort possible.”
Lalane is a social work supervisor in the Department of Psychiatry at Bellevue, and also the clinical director of its addiction consult service. She adjunct teaches at both Fordham GSS and NYU Silver School of Social Work; is a group facilitator of the Living Well Program which, in collaboration with Fordham’s Beck Institute, provides trauma informed services to women who are survivors of domestic violence and homelessness; and is also focused on her dissertation.
So, when someone asked her to help doctors and nurses on staff at Bellevue cope with the mental anxieties and stressors brought by COVID-19, it might have been tempting to say, I have a full plate right now.
Helping Healers Heal
At Bellevue, a public hospital within N.Y.C. Health & Hospitals, staff provide service and care to patients regardless of their ability to pay, or their citizenship status. Patients come from all over N.Y.C. and beyond, many with complex needs and various psychosocial stressors. And during the height of COVID-19, staff felt overwhelmed with the influx of patients.
Helping Healers Heal (H3) is a comprehensive program at Bellevue that provides emotional support to its staff, implemented by N.Y.C. Health & Hospitals. The program relies on staff to volunteer, and Lalane is one of the trainers for the “peer champions.” And when COVID-19 came down like thunder on the hospital, H3 needed more healers to volunteer and more initiatives to help support the staff.
“The part of it that I’ve been really involved with is what we call ‘wellness rounds’ – that is something that just came out of the COVID response,” Lalane said. “I literally just walk around the units, such as inpatient medicine or ICU, introduce myself to staff, and I’m there to provide an in-moment check in, see how they’re doing, and remind them about the resources we do have available to support staff. It can be difficult for healthcare workers to step away from what they’re doing to focus on themselves.”
Despite what staff experience personally, Lalane said, their greatest concerns, worries, and focuses center on what patients go through. The devastation and loss experienced by so many is palpable. For some staff who may not feel like talking, Lalane may simply offer them a smile or a snack. She said the ability to be present, affirm the experience of struggles, and encourage what has been accomplished is significant.
“At times, it can feel like I’m a sponge for their unfiltered thoughts and emotions, all along the continuum from positive to negative,” she said. “My hope is that this interaction can be helpful for them to then return to their work a little bit lighter, and to know it’s OK to reach out for support.”
COVID-19 has spread everyone in the hospital thin, and the concept of volunteering when you’re already under immense pressure can be daunting. We must remember, Lalane endures the hardships of ‘regular’ work – then, she volunteers for H3 in an effort to support her peers. But the identified need and importance of these services seems to outweigh the challenges.
“Even though most staff acknowledged the importance of this and the need, it’s still something that you have to commit time to doing, and it is kind of draining work and challenging in a whole host of other ways,” she said. “But I think that speaks to people like myself and other H3 peer champions who just want to do this work to help our coworkers.”
In addition, Lalane said it’s not just the fear and anxiety of coming into work and getting sick that takes a toll on the staff – it’s the isolation afterward. The devastating impact of the virus on patients and their families brought with it an intensity many hadn’t faced before. Afraid to infect loved ones, some staff members choose to stay in a hotel or make other living arrangements over going home.
“Having to manage that on top of the stress of the day-to-day work was something most people hadn’t experienced,” she said. “What I still am marveled by is the staff still wanting to come to work and provide premiere patient care in the face of all of this!”
Added Societal Trauma
With the height of the virus’ impact behind America’s northeast (for now), you’d think H3 could come up for air. Sadly, you’d be wrong.
The country’s uproar over the senseless killing of George Floyd and the attention to systematic racism in America spurred a new wave of collective trauma for healthcare workers. Not only do staff like Lalane have to manage the effects of this trauma themselves, they come to work and provide services for patients who experience the same thing.
Lalane notes that these occurrences leave staff feeling incredibly drained and even burned out. She tries to see the positive, saying the situation also created a good opportunity to talk about coping strategies and mechanisms for taking action. Although this is a good first step, the future for total staff self-care, like so many things in the world right now, is uncertain.
“It starts with being able to recognize and have insight that you might be experiencing certain symptoms, or not being able to function like you usually are, and navigating that while working because we still want to be here for our patients,” she said. “But how do we best take care of ourselves? I don’t have a perfect answer for that.”
Social Work During COVID-19
Social work isn’t glamorous. It isn’t center stage. But it’s vital.
When modern media highlights frontline workers, social work often gets lost. We, as a society, are thankful for our doctors and nurses and grocery store workers and so many others – as we should be. But for social workers, whose job is often arduous and sometimes behind-the-scenes, the cameras don’t seem to flash as bright.
“It’s unfortunate that social workers are not being talked about enough in the response to COVID-19,” she said. “I can only speak for working in a hospital setting, but I’m sure this applies to every social service agency. Social workers are right there, and we’re not always getting that same recognition.”
But Lalane doesn’t supervise, teach, train, and work on her dissertation for attention. She wants to help people. That’s what keeps her showing up, despite the mounting challenges.
“It’s been a struggle. I’ve really seen how this has all impacted me, because I haven’t been able to stay as motivated or on top of things as I usually am. It’s hard to feel positive with all of the uncertainty,” she said. “What keeps me invigorated is learning, gaining a deeper understanding, and new experiences. Being exposed to new tasks and skills that I can work on to further help people enhance their well-being.”
Working during the pandemic has also added new meaning to hospital social work. Lalane speaks passionately about the immense value of hospital social work, a field she has worked in for 12 years.
“The point of contact with a hospital is often associated with complex issues and crisis, so social workers are critical in navigating these challenging moments for patients and their families,” she said. “The settings [medicine or behavioral health, inpatient, outpatient, emergency department, etc.], functions/role, and skillset for hospital social workers are incredibly diverse.”
And despite H3 responsibilities adding another heaping helping to her already-crowded plate, the program brought its own reward to Lalane’s life.
“I, like my coworkers, have a sense of, ‘we’re all in this together for better or for worse,’ and I think there is some relief provided by knowing you’re not alone,” she said. “Even now, as I go around, I feel as though I can even feel support from the people I’m going to support.”