Providing Soul Care in the COVID-19 Era

• ICU nurse, Chris*, isn’t struggling to manage his own fear around his work with COVID-19 patients; he is experiencing distress because his mother, who is terrified for him, is distressed.
• Cynthia, who lost her husband in 2002, can’t stop wondering whether this scary virus will be the cause of her losing another man she loves.
• Aretha feels guilty; she believes that attending a church service resulted in her bringing the coronavirus home to her husband of 48 years, Frank.
• ICU Advanced Practice Professionals (APPs) grow increasingly anxious about their care roles as they contemplate how to best support COVID-19 patients and ICU RNs.
• Ninety-year-old, Sarah, has been wanting to see her great grandchildren since she was admitted to the hospital, but she doesn’t see how she will be able to do that.
• Mrs. Torres’ three adult children are confronted by the hospital’s one-person-only hospital visitation policy, shortly after making the decision to withdraw their mother from non-beneficial life sustaining therapies.

Who cares for these people and their souls? Who stands ready to meet the unique challenges they face? Who stands poised to help them psychologically, along with their families, and other health care professionals who are safely trying to navigate the nightmare that is COVID-19? We are talking about palliative care social workers and chaplains. These psychosocial and spiritual specialists not only stand in solidarity with people as they wrestle with this very serious threat to their existence; they also maintain a commitment to core values that demonstrate what it means to care.

Palliative care social workers and chaplains can provide four main areas of support for patients, families, and other health care professionals during the COVID-19 pandemic.

In these times of uncertainty, there is tremendous value in helping people become comfortable enough to share their feelings. To feel safe in a time of vulnerability. Social workers and chaplains are committed to creating connections with people to make them feel comfortable, and have a desire to reveal any issues that are troubling them. By facilitating connection, palliative care psychosocial/spiritual team members help people like Chris and Aretha to express, process, and possibly reframe the distress they are experiencing.

Sometimes, large health systems and their corresponding policies can limit an individual’s rights and values. But often, these rights and values are foundational to a person’s ability to cope with major traumatic events. By advocating to protect basic human rights in times of great pain, social workers and chaplains help people like the Torres children secure the ability to be with their mother, so they can support her, as well as grieve her impending loss with honor and dignity.

This COVID-19 pandemic is a major crisis for everyone around the world. In order to navigate it, people may choose to engage in course charting, to figure out what they want to do independently – and social workers and chaplains can help with this.

Reflecting helps people access memories of successful journeys from their past so that they are encouraged by knowing that this journey, too, is chartable. By opening space for advance practice practitioners and other staff to speak their truths (and fears), and then reflecting back to them what was said (and even praying with them about it), the psychosocial/spiritual team can help them to feel heard and embrace their own personal agency.

Two key tools that both social workers and chaplains use are conversation and presence. These are engagement tools, which help open people up emotionally, so they feel comfortable talking about how they are being affected by the circumstances in which they find themselves. The information gleaned from engagement is invaluable, in that it helps unearth issues that generally lie beneath the surface. Once uncovered, especially in times of crisis, we can ensure that people receive care that is personal, communal, and comprehensive.

These tools help Cynthia talk through her deepest fears, and help Sarah by offering use of technology to see her great grandchildren, despite the fact that they cannot come to the hospital to see her.

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While we seek to effectively treat serious illness in the era of COVID-19, it is important that we do not forget time-honored methods of treating the soul. As important as it is to heal the body, it is just as essential to care for the soul. The psychosocial and spiritual arm of palliative care teams across the country stand ready to answer the call to soul care. We stand ready to make our contribution.

*Names were changed in an attempt to protect personal privacy.