By Kaitlin Louie
About Sheila Clifford, LCSW: Ms. Clifford is a Social Services Team Coordinator within Kaiser Permanente’s Volunteer and Bereavement departments. She received her MSW degree from San Jose State University. After graduating from her MSW program, Ms. Clifford worked as a Pediatric Social Worker at Long Beach Memorial Medical Center for a year and half. She subsequently worked at Hospice by the Bay for six and a half years, managing a transdisciplinary team and also supervising MSW students during their field education. During her time at Hospice by the Bay, Ms. Clifford supervised a team of social workers, nurses, home health aides and spiritual care counselors for both pediatric and adult patients. She also oversaw the pediatric hospice team. During this role, she also participated in the implementation of improvements to the electronic medical system, and helped to launch programs to track patients who were discharged from hospice. In addition to her LCSW credential, Ms. Clifford holds an Advanced Certification in Hospice and Palliative Care.
[OnlineMSWPrograms.com] What types of clients did you work with as a pediatric social worker at Long Beach Memorial Medical Center, and what kinds of challenges did they face? How did you support them through these challenges?
[Sheila Clifford, LCSW] Every day was different and that is the beauty of pediatric social work. Some clients were frequently in the hospital and had established relationships with almost all of the staff. Some families faced the new diagnosis of diabetes and needed support and education on how to keep their child active and healthy. The most difficult cases were the accidents or incidents of non-accidental trauma. Shaken baby was heart wrenching to witness. The healthiest little baby’s life was dramatically changed in a matter of moments.
My role with patients was to listen and validate their fears, answer their questions, and support them through some of their toughest moments. In child abuse cases, families were often divided and struggled to accept the injuries to their child as well as the possibility that someone they knew inflicted these injuries.
Some patients were hospitalized after car accidents, fires or post op. Other kids were facing new diagnoses of diabetes, epilepsy, and sometimes cancer. The new diagnosis shifted the lives of all of the family members. One of my roles was to ensure that the families and patients understood the upcoming procedures and/or their instructions when they were discharged from the hospital. It is incredibly overwhelming to have a child hospitalized and this stress undoubtedly affects the entire family. Families often require multiple sessions of reviewing medications and having the opportunity to ask questions. I can remember sitting with several families as we tried to make sense out of discharge instructions from multiple doctors. It was key to understand the family system and who would be caring for the child once they went home.
Families who had chronically ill children struggled to maintain their employment and lives at home while also tending to the needs of their child who was hospitalized. The Ronald McDonald house was a huge support to families and allowed families to stay close to the hospital with siblings without incurring the cost of hotels.
Another part of the role was keeping families updated. It was important for them to know what to expect and when things would happen. Minutes can seem like hours when you are sitting and waiting for updates on your child. It was also important to discover the unique qualities of each family and child. It was important to make the hospital as home-like as possible and our child life department would have art projects and events to keep kids occupied and engaged.
[OnlineMSWPrograms.com] Could you please elaborate on your involvement with the Suspected Child Abuse and Neglect (SCAN) committee?
[Sheila Clifford, LCSW] The SCAN committee met monthly at Long Beach Memorial and typically members of the team would recommend certain cases to be discussed. The case would be presented and then members of the involved team would share how collaboration was successful or how it could be improved in the future.
I first became involved when I presented a case that I worked on with Child Protective Services (CPS), law enforcement and the hospital team. This case in particular needed advocacy to ensure that the law enforcement team understood the medical record and why this injury was non-accidental in nature. No one wants to falsely accuse anyone of injuring a child, yet children need to be protected. It was a delicate line to balance.
One of the key components of the SCAN committee was improving communication and ensuring that each entity understood the operational procedures of each group. For example, the hospital created protocols to ensure that hospital staff were aware of the any child on a Child Protective Services hold. If CPS was unsure if a child would be safe going home with their legal guardian, they were able to get an order from a judge to remove the child from the care of their guardians. A CPS hold would be placed during the child’s hospitalization, which meant that Child Protective Services would be responsible for finding a safe placement either in foster care or with another relative while the investigation took place. This was key information handed off between each shift. The aim of the Committee was to improve communication to ensure the well-being of families and children in our community.
Although I am no longer working with the SCAN committee in Long Beach, my experience there transformed my approach to cases. It is so important to include other agencies that are involved in a child’s life. A positive example of this would be offering to provide education to a child’s class or school about their disease or new diagnosis.
[OnlineMSWPrograms.com] For students who wish to work with children and their families in a pediatric setting, but who are also interested in making a difference at the mezzo or macro level (ex. working with community organizations, as you did with SCAN), how do you recommend they find and engage in opportunities within their community?
[Sheila Clifford, LCSW] Find organizations within your community that focus on a relevant social issue that interests you. One student volunteered at a diabetes camp in order to understand the needs of that population and later went into grant writing. She utilized stories from her first-hand experience that enabled her to capture the heart of the individuals who would be affected by donations.
Volunteering or obtaining a job in that field can be an incredible way to gain insight into a particular role. I was a unit secretary in the Intensive Care Nursery and this experience pushed me into medical social work. It is key to see what the “day in the life” of any particular field clinician looks like.
[OnlineMSWPrograms.com] What were the most difficult aspects of your job? How do you recommend students who wish to work as pediatric social workers prepare themselves to face these challenges and hardships? On the other hand, what was the most rewarding part of your job?
[Sheila Clifford, LCSW] The most difficult part of this job was seeing kids who are alone, hurt or abused. It was heartbreaking to see a family lose a child, but I held onto the stories of success. One teenager in particular was given a very grim prognosis when he entered the ICU but after months of rehabilitation he was able to walk across the stage for his high school graduation. These are the stories that keep hope alive.
It was also difficult to keep my own emotions, feelings and beliefs out of my professional role. This was the families’ story to write. It is important to be able to recognize our own beliefs, values and traditions and ensure that we as social workers do not allow our personal beliefs to sway our professional decision making. This can be a difficult task. It is hard to sit with a parent who has neglected or hurt a child.
Working in healthcare can sometimes shift our perception of normal. We see illness, accidents and sometimes death every day. I can remember sitting with several co-workers who joke about being paranoid parents because of what we see every day. It can sometimes seem like everyone is sick but it is important to have a group of coworkers who can process these experiences so that our own personal lives are not as affected. Humor is also a huge part of coping with some of the tragedies that we witness. Colleagues are sometimes the best part of the job and the camaraderie is incredible.
Self-care is a huge part of social work and I would recommend that students start their own way of “recharging” during grad school. Whether it is exercise, meditation, or socializing, you need to start a way take care of yourself.
I am also a huge advocate for healthy boundaries as a way of self-care. One of my colleagues would always leave the floor at 4pm in order to answer emails, phone calls and complete charting before the end of the day. It is so important to have balance and to have a life outside of work.
The teamwork is incredible. Some colleagues become like family since we spend so much time together. Also the small gestures of appreciation are incredible. No one goes into social work to make millions but to see the smile on a child’s face or get a note of appreciation is priceless. It is inspiring to realize the impact that you can make on someone’s life.
[OnlineMSWPrograms.com] For MSW students who are interested in becoming pediatric social workers, what advice can you give them about optimally preparing for this field while pursuing their degree?
[Sheila Clifford, LCSW] Any experience in pediatrics will assist not only in securing a job but also in gaining experience that will assist in your career. If you are serious about a certain population, volunteer if you can or try to get a job. I worked as a unit secretary, which allowed me to be exposed to the roller coaster of emotions in an intensive care setting. Although my role as a unit secretary was mostly administrative duties, it exposed me to diagnosis. Staff knew that I was in school to become a social worker and therefore allowed me to take part in a support group for women and couples who had received prenatal diagnoses and after receiving that news choose to end the pregnancy. The emotion in that room was so raw and it was an issue that I had never encountered. Some of these couples struggled for years to conceive and were heart broken to find out different diagnoses.
I found that the best learning and classes took place during my placement. One class that I wish I had the opportunity to take would have been a focus on The Diagnostic and Statistical Manual of Mental Disorder (DSM). Even though I do not utilize diagnosing frequently in my work, it offers a strong foundation in assessing patients and deciphering which type of approach may be most beneficial.
Thank you Ms. Clifford for your time and insights into pediatric social work.