by Robert J. Lanz, LCSW
The night shift social worker not only has to have the right stuff, but also the right friends on the local police force, because at night, the only social work help you get is the social work help you develop. Sometimes that’s easy, sometimes it’s not.
Historically, cops and social workers are not likely to hang out together. Cops tend to be more conservative on social issues and social workers tend to be more liberal. In the ER, what we always had in common were our attitudes toward victims of crime. Victims of child abuse. Victims of domestic violence. Victims of elder abuse. Victims of self abuse with drugs and alcohol. Victims of assault and victims of virtually anything that leads to death.
One of the first goals I had set when I started in the ER was to improve the relationship between us and law enforcement. My disadvantage in that task was that I was a social worker. My advantages, and I took full advantage of them, were that I was a guy and had carried a badge of my own in a previous life. I knew about guns and I knew about sports and I wasn’t going to let the fact that I was a social worker get in the way of any bonding I needed to do to make for a better relationship.
Using the Right Stuff, I made friends with the docs and sometimes played poker with them after hours. Taking advantage of that informal friendship, I convinced them that it should be the social worker who calls the police whenever there is a crime victim in the ER. That would save the doctors time, save the secretaries time, save the nurses time, and establish the social worker as the person most likely to help the cops when they came to the ER. It worked just the way I knew it would. Eventually, when everyone in the ER and everyone in the police department had a better idea of what a social worker did, they hired two for their department and assigned them to ride around and help the cops with those issues social workers can help with. It did take twenty years, but I’m proud to have been part of that whole macrocosmic arrangement.
But a macrocosm is made up of a lengthy list of microcosms, and this story is about one of those.
A lack of resources combined with huge problems leads to Right Stuff opportunities. One night, the Right Stuff moment had me calling for help from the police watch commander. The watch commander is usually at the police station, where he is the head problem solver for that shift. Generally that means if all goes well, he just sits at the desk reading. If things don’t go well, he has to get in his car and go solve some problem the other cops couldn’t. For that reason, he isn’t a big fan of phone calls, as they usually mean someone has screwed up and he has to go take care of it. So when a social worker without the necessary resources has to call for help, it sure improves the odds of getting help if the social worker with the Right Stuff connects with the cop with the Right Stuff with whom he has become friends over the years.
That night, the supervising nurse for the whole hospital, the equivalent of the police watch commander, came down to the ER to find the only social worker on the job at that time. This is always difficult because that nurse represents the whole hospital and is backed by the whole hospital administration when she makes a request of the only social worker. They had heard I had the Right Stuff, so they often came down to my zone with all sorts of difficult things they expected me to do, things on the “Everything Else” list. That long list of everything else is one that I wrote myself, so it was hard for me to get out of a request under those circumstances, even if I happened to be working alone with several patients to tend to.
A woman had admitted herself to the hospital earlier in the day for a serious surgical procedure, but she didn’t want her husband to know, so she told him she was coming in for some tests. Nothing to worry about. Unfortunately, she was too frail for the surgery and died on the operating table and the supervising nurse thought I should be the guy to inform the husband. He was an amputee stuck in a wheelchair, home alone. Old guy, major medical problems, home alone, and his wife of forty-six years unexpectedly died and I couldn’t leave the hospital. In the big picture of all the things that could now get worse, the big picture was getting bigger.
So I called the police station, got connected to the watch commander, who luckily, was my good friend Mike. There was no lengthy conversation, just “Hey Mike, can you come down to the ER, I need some help?”
All communication with the police station is done on a recorded line, so most likely, he thought one of his cops was in trouble and I didn’t want to spill the beans over the phone. Sometimes these things can be handled informally, and I’m sure he appreciated that I wasn’t going to make a big deal out of whatever the problem was.
Within ten minutes Mike showed up and asked what the cops did now, expecting the worst. Between fear and our long time friendship I had him at “Hi Mike”.
“Mike. I’m in trouble here.” I explained about the recently dead patient and her health compromised husband. Luckily they did live in our city.
Mike asked, “What do you want me to do, call him up?”
I said, ”I could do that myself. I want you to go over to his house, tell him what happened, see if you can contact a friend of his, and if you can’t, hang out until you’re sure he’ll be okay. Basic social work stuff.”
“But I’m a cop.”
“A good cop. Everyone likes you. You’re like a closet social work cop. It just sounds hard. I know you can do it. If you get really stuck, call me.”
Most cops hate to show fear, and they hate not knowing what to do, so Mike took the address and left in his squad car to go do some serious social work.
I called the night supervising nurse and told her I had taken care of the problem. Right Stuff. No questions. I’d just wait for Mike to come back, go upstairs and document what happened and that would be it.
Then it got busy, as always, and I got lost in crime and craziness and drugs and stress and the Everything Else of ER social work and forgot about the watch commander. A couple of hours later, the electronic paramedic door hissed open and he walked in. He looked all right. He didn’t appear angry. He approached me and smiled.
“How’d it go?” I asked.
“Awesome. I was a little uncomfortable at first but the guy was taking it pretty well. He cried a little then told me stories about their life together. When things slowed down and he didn’t talk anymore, I asked him about all the pictures of boats on the wall. Turns out he’s a sailor. I’m a sailor too, so we talked about boats for an hour and then he said he would call his son in the morning. He asked if I could come back and see him some time. We’re going out for breakfast next week.”
“So it went OK?”
“Yeah. But I have to go back to the station now.”
“Okay, Thanks Mike. I appreciate it.”
“Bob. Call me any time. Really.”
With enough of these micros, you get to a macro. Enough of the macros and the police have their own social worker and I can call her for help. Unless, of course, Mike is the watch commander and he wants to go do it himself.