Muzna Gulamali, MSW, Transplant Social Worker
The role of emotions within the practice of social work may initially seem obvious and imperative. A day in the life of a social worker is typically thought to be inundated with emotional material. Child abuse, domestic violence, emotional trauma, grief and loss are topics most of us touch on before 10 A.M. on any given day. Our gut feelings are heavily relied on, and we are trained to engage emotionally and unceasingly advocate for them. This emotion-laden profession is challenged when working in an interdisciplinary team, especially amongst professions that rely on numbers and data. The relationship between rational thought and emotions is often painted as an uneasy alliance.
Working as a Medical Social Worker, specifically working on a transplant team, places the worker in an environment where life or death decisions regarding a patient’s care sometimes need to be made. The role of a transplant social worker is to evaluate patients and assess their psychosocial appropriateness for transplantation. The transplant team, including the surgeons, other physicians, nurses and social workers, then have listing meetings to determine a patients place on the waiting list. Depending on the patient’s current medical condition, sometimes there is very little time to make an assessment and decide on an outcome. This challenged me to consider whether emotions were indistinguishably linked to the profession of social work. When discussing my psychosocial assessment of patients and their families to a team of healthcare professions, who heavily rely on objective tests to make their assessments, utilizing my gut-instinct did not feel sufficient. I found it difficult to explain why I feel someone who has relapsed eight times is worthy of a new life-saving organ, or why someone with previous suicide attempts makes an appropriate transplant candidate. With time, I grew to realize that I needed to rely on concrete certainties to guide my decision-making. These thoughts counter what I felt I learned in my education and training, where I learned people deserve second (or fifth) chances.
The differing thought-processes are especially highlighted to me when I interact with other social workers regarding a patient’s care. These differences are emphasized, for example, when a patient’s case manager, who works with them in the community assisting with basic human needs such as shelter, questions my decision making. The difference stands out because despite our similar moral compass, education and training, the demands put on us and the viewpoint from which we see the patient, differ immensely. I previously worked with a social service agency and remember feeling that same frustration with medical social workers, wondering why they picked the profession when it didn’t feel like they had the patient’s basic well-being in mind.
The tense relationship between utilizing emotions and the execution of rational decision making is even further tested in considering the ongoing fight for the professionalization of social work. Social work is a career that continues to struggle to be viewed as a profession. Some of the struggle of this is that our profession is based on several different fields, such as psychology, ethics, politics and law. Basing our decisions and practice on moral philosophy can be viewed as feeble and can set us further back in the battle for acknowledgement. Emotions are often seen as fickle, and in danger of clouding incisive judgement.
Given that social work was built upon emotionally-driven work, such as activism and challenging of social structures, is a “non-emotional” approach to social work contrary to the roots of our profession?