Social work diary: ‘A plan is all set, only to completely fall apart at 4pm’

Monday

It is my first day back after a week’s leave, so it is with some trepidation that I climb the stairs to the office wondering what awaits me. I’ve come in early to try and sift through my overflowing email inbox and task list and pick out the most urgent queries that I need to deal with, because I am also on duty today which is demanding enough by itself.

I survive the morning fuelled by caffeine and adrenaline and make myself take a proper lunch break despite the temptation not to. Plans change for the afternoon as I have had a particularly complex situation on my caseload recently which, as anticipated, escalated in my absence, so I am sent out to try and keep matters in check.

The case involves an older couple who both have physical health needs and cognitive impairment and we are trialling support at home. This has been turbulent to say the least with both showing concerning behaviour including physical aggression. I return late in the day, debrief and update relevant others and ensure my action plan is on the system before departing at 5pm on the dot. I head to my weekly bodybalance class in the evening which I find goes some way to calming me and easing the pressures of the day. And breathe…

Tuesday

My day is dominated by the same complex case and I find my time is mostly taken up with trying to resolve a situation involving chairs and duvets in an effort to seek to resolve what one of the couple says is the reason for their extremely volatile behaviour.

I have worked with these clients for over a year and I strongly suspect this is another example of masking behaviours, but I am determined to overcome the practical obstacles being presented to drill down to the underlying issues.

It’s one of those days where I wish I could share more outside work, as I often think no one would believe the random tasks that the ‘day job’ entails, and how often we find ourselves in odd situations and on random errands.

I am frustrated that my time and energy is yet again being dominated and the rest of my caseload gets pushed to the side. I make the effort to find time to pop in to another client. It may ‘only’ have been 15 minutes, but it’s worth it to see them so well today. And it’s a timely reminder to sit and be in the moment talking with them.

Wednesday

Yet another day all but consumed by the one situation, but by lunchtime I am beginning to feel that a plan is coming together. Remarkably all parties, and even the clients themselves, seem to acknowledge that the situation is not sustainable. I can almost see light at the end of the tunnel, but know not to get ahead of myself as in social work even the best laid plans can change in minutes!

I manage to sort through some emails and tasks for other clients and feel much better for it. I hate being torn and having to deprioritise those who are the ‘quiet’ ones. I have a meeting last thing with an older woman who was discharged from hospital to residential care after having a stroke. I first met her for a routine review earlier this year and she expressed a clear wish to return home. It has been a big piece of work, made more difficult by a complex family situation.

She has made positive progress through the rehabilitation flat pathway and we are all in agreement on a plan for an imminent return home. I don’t want to get carried away calling it a runaway success just yet, but I do give myself some credit and am pleased to end the day feeling optimistic.

I reflect on the difference that person-centred case co-ordination can have on people’s lives, and that this often requires courage on the part of the practitioner to promote positive risks and remain focused on the client in the midst of competing dynamics.

Thursday

I plan to start today working from home to have some peace from the office hubbub to complete a case audit for the unqualified worker I supervise, but my laptop simply refuses to turn on.  Grrr!

It is still all steam ahead on the particularly complex case and a plan is devised, agreed and all set to be implemented, only to completely fall apart at 4pm with an abrupt and defiant change of opinion from the client.

This means we are back to the drawing board, only now it is a very different set of circumstances to be working with and the weekend is rapidly approaching. I fully support the concept of positive risk taking, but I hate the feeling of setting people up to fail and then feeling powerless to prevent the fallout. I am left feeling drained, deflated and defeated. A night in with a curry beckons.

Friday

I start the day telling myself that it was better for matters to go awry at 4pm yesterday than 4pm today, as it means that we have the whole day to put an urgent plan together to ensure immediate safety. Strings are pulled and requests for assistance sent out with resounding success, with various teams rallying around to provide additional input to ensure the clients’ immediate safety needs are addressed.

It is at times like this that I am reminded of the importance of relationships with other departments and teams and that at the end of the day, we are all there to support each other and achieve for our clients. I make a prompt exit at 4.30pm more than ready for an overdue catch up over dinner with a friend. Here’s to the weekend. And to doing it all again next week!