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Guilt, grief and loneliness from Covid-19: Medical social worker at NCID lends ‘soft touch’ in women-dominated field

SINGAPORE — A migrant worker so lonely, he looked forward to medical personnel entering his isolation room to take his temperature as the highlight of his day.

Guilt, grief and loneliness from Covid-19: Medical social worker at NCID lends ‘soft touch’ in women-dominated field

Mr Daniel Chee (pictured), 27, is one of only three men working as a medical social worker out of the 12 at the National Centre for Infectious Diseases.

  • At NCID, only one in four medical social workers are men
  • A 27-year-old talks about his work there comforting patients who have infectious diseases such as HIV
  • He is also among a team of medical social workers there tasked to support Covid-19 patients and their families
  • Those who are hit by Covid-19 commonly exhibit grief, self-blame, guilt and loneliness, he said

 

SINGAPORE — A migrant worker so lonely, he looked forward to medical personnel entering his isolation room to take his temperature as the highlight of his day.

Family members getting highly emotional when they are unable to see their loved ones who are infected by Covid-19 because of strict safety orders.

Mr Daniel Chee has seen these and more while working as a medical social worker at the National Centre for Infectious Diseases (NCID) in these gritty times.

The 27-year-old is just one of three men working as a medical social worker out of the 12 at NCID.

He has spent a large part of his three-year work stint at the centre tackling the pandemic.

At the height of the Covid-19 outbreak last year, Mr Chee was among a team of four medical social workers at NCID tasked to support Covid-19 patients and their families, particularly those experiencing emotional and psychological distress.

On the smaller number of men doing what he does, Mr Chee said: “I think there are fewer men in the field of social work because the assumption is that social work requires soft skills, which women are stereotypically seen to be more suitable for.

“This notion has been reinforced over the years and it may be tougher for men to exhibit qualities that are perceived as ‘feminine’.”

He has no qualms, however, showing the softer side of himself while supporting patients afflicted by infectious diseases.

“It has been both physically and mentally tiring as the ever-changing nature of the pandemic meant that we had to also keep pace and be adaptable (to changes in workflow, for example). Nonetheless, it is meaningful work.”

With a large part of his work centred on social interactions, a challenge Mr Chee faced at first was picking up facial expressions and conveying empathy from behind a mask.

Medical social workers such as himself can only speak to patients via the phone through a glass window and enter the room only when absolutely necessary.

“It was difficult to pick up the nuances in non-verbal communication such as facial expressions, posture, eye contact and gestures that would have normally played an important role in assessing how the patient is coping,” he said.

Mr Chee also sensed that some patients felt that talking through the phone was impersonal, which might have affected their willingness to open up more.

To make up for it, he and the team learnt to express emotions more intentionally through the tone of their voice and making it a point to let patients see them through the glass window while talking on the phone.

Another challenge the team faced was to convey to patients’ families that they could not visit their loved ones in the ward. Mr Chee has been on receiving end of frayed tempers but said that he has a high tolerance level for such situations. 

“Perhaps my training has helped me understand that when people are frustrated, they are not frustrated with you but by the situation they cannot control. I think it’s important to acknowledge to them that it is a frustrating and painful situation and not push their emotions under the rug or play it down,” he said.

“It was truly a tough situation to navigate, and I truly appreciate the nurses, administrative staff and visitor registration staff who have had the toughest time fronting this aspect for the hospital.”

PROCESSING GUILT AND GRIEF

Among his interactions with Covid-19 patients are migrant workers, some of whom had difficulty coping with loneliness while in isolation.

Mr Chee recalled providing emotional support to a migrant worker who was particularly distressed during his isolation period, although he maintained contact with his family through video calls.

“He told me that the parts of the day he looked forward to the most were when healthcare workers went into his room to take his vital signs, bring meals and water and administer medications.

“It made me reflect that those of us who could still move around relatively freely often take these seemingly insignificant face-to-face interactions for granted.”

Mr Chee was touched by such migrant workers’ personal experiences and the families they left behind in search of better opportunities.

“Some of the migrant workers continue to reach out to us till today, and ask how we are doing.”

Guilt is another common emotion that Mr Chee has seen in Covid-19 patients, who fret over how they might have contracted the virus and potentially affected people around them.

One patient, a mother with a young child, told him about her feelings of immense guilt, of having brought the coronavirus home unknowingly after being infected at her workplace.

“At the time, there was not enough data to show how the virus could affect younger people so, naturally, there was a lot of anxiety on her end as a mother infecting her child.

“In my sessions with the patient, I helped her process the events that happened and understand that she could not have known who around her was infected, so as to assuage the guilt she felt,” he said.

While most Covid-19 patients under his care recovered, there were a few who did not survive their infections. In those heartrending cases, families would often require more in-depth emotional and psychological support.

While supporting them through grief and bereavement, Mr Chee emphasised the importance of providing a safe space for them to express their emotions.

“Often, the gut reaction towards a grieving person is to offer sympathy, avoid bringing up the person who has passed on and encourage them to ‘move on’ when, really, they would probably feel better when given the space to express their emotions.

“I remember speaking to the family of a patient who was critically ill and asking them to talk about the patient’s life — his relationships, hobbies, career. It was the first time I saw the family smile, albeit through tears, in a while.” 

HIV PATIENTS, VICTIMS OF ASSAULT

At the NCID, Mr Chee’s work also revolves around providing psychosocial support for patients diagnosed with other infectious diseases such as the human immunodeficiency virus (HIV).

He facilitates their applications for financial assistance and plans for their discharge care among other tasks.

“We provide counselling as they come to terms with their diagnosis, facilitate access to affordable treatment, provide support for their families and in some cases, advocate against stigma and discrimination they may face in workplaces.”  

Some of his colleagues also provide educational talks to organisations as part of their efforts to combat stigma and foster a more inclusive society for patients. 

While Mr Chee does not think his gender affects his role as a medical social worker, he acknowledged that there are certain instances when his gender could be an issue for some patients.

For instance, with survivors of sexual assault who are prescribed medications to reduce their risk of contracting HIV.

“As social workers, we have to be mindful about providing trauma-informed care and sometimes, that means acknowledging that just my gender alone could affect the patient.

“Thankfully, I have colleagues that are conscious of such issues and are amenable to taking on such cases when we do see that it is a concern,” he said.

INTERNSHIP AT TAN TOCK SENG HOSPITAL

Initially keen to go into sociology, Mr Chee developed an interest in medical social work after a three-month internship at Tan Tock Seng Hospital in 2015.

One of the cases that remained deeply etched in his memory involved an old couple living in a rental flat. They had to declutter their home to make space for the husband’s wheelchair.

“During the decluttering process, the wife repeatedly expressed her anger about being ‘forced’ to declutter and even threw her belongings at us,” he said.

“From her point of view, those items represented what she had gone through in life and she felt like she was made to throw away her life memories.”

The incident made Mr Chee reflect on how interventions prescribed by the medical team, though well-intentioned, can be misconstrued by patients and families.

He also realised the importance of a medical social worker’s role in bridging these communication gaps.

Inspired by those working with patients diagnosed with infectious diseases, he expressed interest in working at NCID upon graduating from the National University of Singapore with a degree in social work.

He, too, wanted to make a difference to patients marginalised in society as a result of their medical condition.

However, Mr Chee admitted that there were times over the course of his work when he had felt particularly drained.

“I think any job that is emotionally or psychologically intensive could potentially result in a higher likelihood of burnout.

“For myself, I find that being able to continuously find meaning in the work I do makes it easier for me to manage the burnout — in the same (way) that we help our patients and families (find meaning in the process as they) go through challenges in their lives.”

Mr Chee added that a supportive team and colleagues help to make the journey less lonely.

Away from work, he looks forward to simple activities to recharge.

“I practise self-care by listening to music, watching movies, going outdoors to experience nature, playing badminton and tennis and making time to meet up with loved ones — essentially, all the activities that keep my soul nourished.” 

Related topics

mental health NCID Covid-19 coronavirus HIV social worker

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