How COVID-19 Changed Social Work in the MICU

For social workers at the MGH, no two days ever look the same. Between advocating for patients and meeting new families every day, it is often what makes the job exciting and rewarding. So, when the COVID-19 pandemic began and the daily workload for social workers in the medical intensive care unit (MICU) became even more unpredictable, their ability to adapt was essential to the unit’s success.

Dannie McGonegal, LICSW, a clinical social worker in the MICU, has worked at the MGH for 16 years and has been on the front lines throughout the pandemic, finding new ways to turn her in-person practices to a virtual format. While the transition has not been easy, McGonegal says it has encouraged her to grow as a social worker, broaden her clinical repertoire and work with her colleagues in new ways.

“When the pandemic began, my biggest concern was how it would impact my work with families and patients,” she says. “Meetings with families are essential to building connection and trust, especially in disorienting or frightening moments. I wondered how I could build that trust when I wasn’t physically with them.”

Despite these concerns, McGonegal says families responded well to her phone calls and Zoom meetings and rarely declined offers of support.

“In retrospect, I think this desire for connection had a great deal to do with the fact that families couldn’t be at the beside of their loved ones,” McGonegal says. “I was able to provide comfort and lines to their loved ones despite the heightened fear and lack of control they were experiencing.”

Inpatient social workers have since gone back to working in-person as it quickly became evident that their calming presence on the units was crucial to collaborating effectively and creating a supportive platform for patients and their loved ones. In reflecting on those weeks working virtually, McGonegal notes her new appreciation for tools and techniques that became more meaningful for families when the pandemic began and are still applicable in practice today due to visitation restrictions.

The “Get to Know Me” poster, which is created by social workers along with nurses and support staff, is one of those tools. Families are invited to share photos of and details about their loved one such as their favorite activities and greatest accomplishments. The posters are then hung in the patient’s room where staff members read them and get to know better the individual whom they are caring for.

“The posters took on a deeper meaning for families when they were unable to visit,” McGonegal says. “I worked with nurses to develop a way to complete the posters remotely, and we hung them in patient rooms and sent their families photos.”

McGonegal recalls one man who created a poster for his wife, who was intubated and sedated in the MICU. He spoke to McGonegal about how devastating it was not being by his wife’s side, but also about the comfort he felt knowing that the people caring for her were learning about her so they could truly “be her voice.”

Despite the challenges McGonegal and her team faced during the height of the pandemic, the experience reminds her of how much she values her career as a social worker.

“I’m grateful every day to walk with patients on their personal journeys,” she says. “It is an honor and a privilege to be invited into the most intimate and personal experiences of people's lives.”