Becoming Anti Oppressive in Hospital Social Work
by Andrea Johnson
I reflect with irony on how, after years spent in school working
toward my BSW, it was while visiting a colleague in the hospital
a few weeks after my coursework was complete, that I discovered
what being a good social worker is really all about. Minutes after
her surgery, this fellow social worker started a conversation
with the three women who shared her room. As she listens and speaks
to make inter-subjective meaning, a deep sense of healing occurs.
It is an ‘ah-hah’ moment for me. In it, I see her
years of professional training and life experience fused, giving
her the ability to give voice to these patients who, it seems
to me, are oppressed by our health care system. But then, that
is just what she does. That is just what we do. We are anti-oppressive
social workers. We don’t just listen. We hear. We don’t
just talk. We engage, make meaning together and challenge oppression.
We are more than just cogs in the machine. We are healers.
As a new graduate just starting my first job in a hospital,
I am only starting to glimpse the contradictions between this
ideal and the realities of day-to-day practice. I start to wonder
why, if what we do is so central to the healing process, I often
find myself feeling like I am on the edge of it? It is not long
before I realize the barely-spoken, whispered reality: that within
the health care system, we are the ‘Other.’ We are
oppressed by the system much in the same way that our clients
are oppressed by the racism, sexism, classism,
heterosexism, ageism and ableism of the larger social system.
We are outnumbered by nursing staff by at least 15:1, and what
we do is considered by many to be the ‘touchy feely’
stuff, not essential to the ‘real medicine’ practiced
by those around us.
To transform the construct of social worker as ‘Other’
in the health care setting, we must work toward making not only
our clients’ but our own voices heard as well. On the individual
level, we need to name our oppression, deconstruct, re-define
and reclaim what the role means to us. This means eliminating
gossip and telling the truth to one another. It means building
the kind of relationships based on trust and respect that will
bring us toward the centre and away from the periphery. It means
taking the work of the Partnership
Councils being piloted throughout the FHA seriously.
Finally, we must look toward making changes structurally, with
the goal being to increase the number of full-time, permanent
social work positions. We can do this by demonstrating the measurable
outcomes of our practice during health care service provision
reviews. We can also do this by getting political, which means
not thinking about politics as a four letter word, and helping
to elect a government that values the health of its citizens.
When this happens, the rule rather than the exception will be
that permanent social work staff will consist of more full-time
than part-timers, and that supervisors will not feel too busy
managing their own caseloads to support front-line staff.
As my friend reminded me on the day of her surgery, social workers
are truly as valuable as the other medical professionals with
whom we work. While the landscapes we travel may not be visible
to the naked eye, that doesn’t mean they aren’t real.
To social workers like us, health care is about much more than
just healing the broken body. It is about healing the mind and
the spirit through social justice. We companion those in pain
and challenge oppression by advocating for a space within the
system for their voices to
be heard. In an era of government cutbacks, where flow-through
has become the focus of care, social workers should be thought
of as being at least on par with our colleagues, since this feat
is, in itself, nothing short of a miracle.
