Licensed Clinical Social Worker, Amanda Silva

[00:01] Michelle: There's just nothing like doing a face-to-face interview, even if it is in my closet of dolls. And there's nothing like talking with social worker Amanda Silva. Social workers are a crucial part of any medical team, and in this interview, Amanda and I talk about it all: communication, collaboration, and the key to keeping your social work happy, all with Amanda's comedic flair. In the five-minute snippet: Amanda, just take the money and run. Here's Amanda Silva. Well, good morning, Amanda. Welcome to my podcast.
[00:56] Amanda: Thank you, Michelle. So excited to be here inside your cute closet.
[01:01] Michelle: Yes, we're in the closet, the famous closet of dolls. And so far, no one has been freaked out. I've even had comments that said, it's cute, it's cozy. So I don't think you're freaked out just looking at your face.
[01:18] Amanda: No, but the dolls are creepy, they are. But my mom has a collection, so I think I've grown to adapt to this.
[01:26] Michelle: Okay. You're like, yeah, crazy mom with dolls. Thank you for being here today. Part of my goal for 2023 was to branch out and talk to disciplines other than nurses, disciplines who work with nurses, who support nurses. And so that's why you're here. You're a social worker. I just want you to start by talking about how you came to be a social worker.
[01:58] Amanda: Oh, goodness. Well, I didn't start out that way. So when I originally went off to college, I went for nursing because that's what my parents wanted me to do. So that's where I started. I did all my prereqs, got all of that done. And I remember taking the TEAS exam and having an epiphany. As I'm sitting in front of a computer taking this test, I'm like, is this really what I want to do? And growing up, I've always been interested in the psych side of life. I remember in high school how they always make you take those tests about what career you should go into. Well, mine was a clinical psychologist. That was where my little thing landed up. But I wanted to appease my parents, so that's the route I took. But as I'm taking this exam, I'm like, this is not really what I want to do. And I just wasn't enjoying the classes, and everything about it just wasn't feeling right. So I kind of was in limbo for about a year. Just took some extra classes to transfer to Fresno State at this time. And during this time, I was working on campus at COS and the lady I was working for, she's actually a social worker. She used to work at Kaweah back in the day, but at this time, she's kind of in a director role for the Human Services program and teaching the intro Human Services classes. Well, I got to know her and all the things that she's done with her life. And I was like, this sounds amazing. This is exactly the kind of the stuff I want to do. And so then that's when I looked into social work. And not long after that, I transferred to Fresno State and started on that route. And I remember just like, my first day of classes, and I'm like, yes, this feels right. This is up my alley. And just even the people I was meeting were like, even my people, it just felt right.
[03:56] Michelle: Oh, my gosh, as long as I've known you, I never knew that part of your story. That's so cool. First of all, what I love is that you listened to that inner voice, which so many of us don't do. We just kind of go forward and kind of ignore it. And you listen to that and you're a fabulous social worker. I have no doubt that you would have been a fabulous nurse, but you probably wouldn't have been as happy and fulfilled as you are as a social worker.
[04:38] Amanda: I mean, who knows? But definitely now working in the medical field and working next to nurses, I'm like, yeah, I'm really glad I didn't take this route. I love that.
[04:47] Michelle: Well, let's talk about that. So you work in a hospital, so why did you choose to work in that setting?
[04:54] Amanda: So that was a completely foreign setting. So I was actually working as a therapist prior to coming into the hospital setting. And I just applied because it was closer to home. It was something I've never done. I didn't really have much knowledge about it. I just wanted to explore it. I truly came into the hospital setting not knowing a single thing about what I was going to do. I came in blind, and it was by far a great experience because it was something completely new that I had to take on and learn. Because social work school does not prepare you for everything. They just give you the foundation. And once you go into your specialty, that's where you're like, what is this? I mean, I still joke around to this day how I've been in the field for six and a half years, and when I have to go to NICU rounds, I'm still like, what does that even mean? Because I'm not only a social worker, but I'm also in the medical field, so I have to learn everything medical. And they don't teach you that in social work school. That part was complete, it was just a huge learning curve, and it still is. I feel like I'm still learning stuff every day, but that's kind of what I was interested in. I wanted something different. I wanted to try something different. I've always been big on wanting to have a lot of experiences in my field so that it would make me a more well-rounded social worker, so that's kind of where I started, and six and a half years later, I'm still hanging it out. So that's not too bad.
[06:31] Michelle: There's so many similarities, I think, in nursing. Like, when you're in nursing school and then you graduate, it just feels like I think towards the end of nursing school, you're like, yeah, I got this. And then you get out into the real world and you're like, holy crap, I'm not prepared for this. So I see so many similarities there. And you are a Maternal Child Health social worker. So what interested you in that field that you are in? Like, I want to do that.
[07:07] Amanda: Well, like I said, I came in not knowing anything. And so when I came to my interview, that apparently was the position that was available. And at that time, like I said, I was a therapist, so I was working with kids, parents, and families. And at that time, I kind of was like, I don't want to work with children. So then when I got my job at the hospital and they're like, oh, you're going to be Maternal Child health. I'm like children. What? I said, no more kids. But I was like, all right, this is a totally different role that I'm going to be playing in. Let's try it out, and I wouldn't change it. I'm so glad that that was where I ended up, and that's where I have been. I think if I ended up anywhere else, I wouldn't have enjoyed it. I truly love my specialty. Occasionally, I do have to go and help out on Med-Surg, ICU, and Critical Care, but I always come back so happy to have my tiny little humans and their families.
[08:11] Michelle: That just reinforces my decision. I don't do big people.
[08:17] Amanda: I only do big people for therapy. That's right.
[08:21] Michelle: As it should be. So one of the things I wanted to talk about today was the relationship that social workers, physicians, and nurses have. We are a team. We are team players. Those are some of the people on the team. And just talk for a moment about the importance of documentation of these different disciplines, nurses and physicians, documentation of, like, what they see, what they hear, basically their clinical observations of patients and families, and how important that is in supporting you as a social worker.
[09:11] Amanda: Well, before I answer this, I just want to clarify. I'm answering this based off of my experience and my specialty, with my people that I work with. I'm sure this could be different across the board for other people, but this is just my experience. So I feel like the relationship that we have amongst our team is really important. I feel like we need to have trust in each other and trust what each of us does in our roles. I trust that my nurses are going to take care of my tiny humans. I trust that my doctors are going to listen to my nurses when they bring up concerns. And with that, that builds trust in our team. So as far as documentation, when things are not what we always feel like is, quote, unquote, normal. By the way, don't like the word.
[10:04] Michelle: Normal, but normal, new normal.
[10:06] Amanda: Yeah, what is normal? But we're just going to use it for the sake of this conversation. But when they have a family or a situation that they don't feel like it's their typical norm, and they have a little bit more concerns or some red flags coming up, this is when I always encourage staff, to document this. It's okay to document outside of the medical assessments that you do. If you're observing stuff that's going on and you're not feeling good about it, then put in a note for that. It's okay to document your observations. It's not okay to put in biased opinions, but it's okay to put in your observations. And I think that's sometimes where some people do struggle because they maybe not necessarily don't know how to write that. And then I'm like, if you don't call me up, tell me what you're seeing, and let's figure out how we can document this. But we need to put something in that's been a struggle for a long time. And I feel like for some people, it's easier said than done. I go into a chart and I'm like, oh, my goodness, look at all these beautiful notes. Thank you so much. And then other ones, I'm like, crickets, did anything happen? I'm not really sure, because the thing is that when stuff starts to come up, the first person that gets called is the social worker. And so, of course, I'm always like, okay, well, what's going on? The second question I'm going to have is, well, what do you feel needs to be done or needs to be addressed? Or what can you as a nurse do differently? Because I do think sometimes nursing staff has a hard time addressing social issues with families or even just exploring them. And I'm like, we're human. It's okay to ask a mom like, hey, how are you doing? Or, hey, I kind of see that you have some stuff going on here. Do you need to talk about that?
[12:10] Michelle: Gosh, it seems like that would be such a natural thing to do.
[12:14] Amanda: It's one thing, but for some people, that is not in their forte. It sometimes makes you think because you get into this field, like, you're helping people, you're working with people. So we all have that desire to do that, but some of us struggle with doing that. Yeah. So I kind of find myself sometimes trying to just encourage that a lot, because as a nurse, you have the best rapport with the patient and the family. They see you. You're the ones doing all the care. They have the most trust in you. You are like the number one face of this team. And so when the social worker comes in mind, your moms have only met me once at this point, or maybe twice. And then it's like, I come in, I'm like, well, your nurse has some issues with X, Y, and Z going on. And then I don't think people realize how much that actually kind of can really what's a good term to say that disrupt the rapport that's going on.
[13:22] Michelle: That's such a good way to say it. It just breaks down all that trust that took so long to build up.
[13:31] Amanda: Yeah. So sometimes, depending on what a nurse is observing, I do encourage just to keep continuing those conversations and checking in with the family, documenting those conversations. And if situations continue to escalate, then at that point, I will come in and usually have my nurse come in too, and have that conversation. Or sometimes, depending on the situation, it's always best just to do, like, a family conference. But I mean, this is obviously a case-by-case scenario, but for example, if you have a mom who just appears to be depressed, I usually just encourage the nurse to kind of follow her for these first few days. And I always provide my mom with psychoeducation regarding the baby blues and perinatal mental health. And so I'm like, let's watch this and let me know. And then if that continues, then I always encourage the nurse, give me a call back for me to follow back up at that point. But that documentation. That's the first thing I'm going to do when you give me that call. I'm going to open that chart and I'm going to read, and if there's nothing in there, and be like, hey, so you've been telling me, X, Y, and Z have been happening for this many days, but this is not in the chart.
[14:46] Michelle: If you didn't document, it didn't happen, that's Nursing 101. Absolutely. And I think we forget that sometimes, and I think that's what you are so good at. That was one of the things when you first showed up in our unit and we met you, and that's one of the recurring themes that kept coming out of your mouth, did you chart that? And really bringing attention to that. I think what you said exactly hit the nail on the head in terms of, like, sometimes nurses were so in the clinical part that we forget the other parts, which is like the relationship part. And we feel uncomfortable maybe probing, asking questions. I think a lot of us don't know how to ask, like, open-ended questions. You have a mom come in and she looks visibly depressed. She's not talking, she's not looking at her baby. She might be crying, whatever it is. And first of all, we feel uncomfortable with that. And then second, we're like, Are you okay? And so many times, nine times out of ten, that mom is not going to tell you what she's really feeling. When she's asked a question like that, she's going to go, oh, yeah, I'm okay, and then the conversation ends. Instead of something like, tell me what you're feeling right now, or I see that you are not engaged with your baby. I saw you crying earlier. Tell me what's going on.
[16:38] Amanda: I believe labeling sometimes is the best thing we can do because some people don't even recognize that they're having those feelings or even doing those things, like not wanting to hold their baby or stuff like that. And so I think it's important for us to be like, I see that you're really not eager to hold baby is something going on? And just exploring that. And not only that, but that helps you as a nurse, because what happens if mom is just afraid to hold her baby? I mean, those tiny humans are tiny and they got stuff. I look at them like, yeah, I don't want to hold that baby, mom. Exactly.
[17:17] Michelle: It could be something just afraid to break them.
[17:20] Amanda: And so I think for me, I would need that reassurance like, it's okay, Amanda. Yeah, baby is good. I'll help you.
[17:29] Michelle: Yes, exactly. I think just exploring and this is a perfect example. When I was doing my bachelor's, I had to do community service time. And so I went with a visiting nurse who visited mom's postpartum and also antepartum, so before they had their babies. And she provided a lot of information about what's to come. So we're talking with this 16-year-old girl who's pregnant, and we were talking about breastfeeding, and she was like, no, I am not breastfeeding. No way. She looked really fearful like it was going to hurt her. And we saw her reaction and we said I said, tell me what you know about breastfeeding. What do you know about breastfeeding? And she said, well, they take a needle and they poke holes in your nipples so that the milk can come out. And so obviously a big misconception. And when we approached the topic of breastfeeding, that's where the fear came from. But if we had not explored that, we would have not been able to give her the correct information. And you should have seen her face when we told her, you already have the holes there and the milk will come out. There's no poking holes, no, none of that,  the relief because she said, I really wanted to do it, but one of her friends had told her, this is what's going to happen. We have to explore. We can't presume to know what they're thinking, or what they're feeling, unless we talk about it, unless we ask those questions, and then we have to document it. Because my experience has been with you that these issues come up very close to discharge, sometimes on the day of discharge, and maybe a family has been with us in the NICU for months, and we've had concerns, and for whatever reason, we haven't wanted to bring them out. But now the baby is going to go home tomorrow or today, and then we call you the social worker, and we go, hey, we have concerns about this. And that's such a disservice to you and to the family, really, and everyone, because it's like, what, the patient's going home today? Why haven't I heard about this? If it's been going on for weeks, why is there no documentation? So one of the things that you really stress to the nursing staff is that you are all mandated reporters, talk a little bit about that. What is a mandated reporter? And kind of what would be the responsibility of the nurse in filing one of those reports? If she had a concern he or she had a concern about the baby or the family.
[20:46] Amanda: So pretty much anyone who works in the medical setting is a mandated reporter. So what that entails is that if you suspect or see or witness or even have a hunch of any type of abuse going on in that home, you are mandated to make a suspected child abuse report, otherwise known as a SCAR. And this is something you could just pop on Google, type in California SCAR print out the form, you fill it out, you call the 1-800 number, and to the county where this is all taking place. And at that point, you'll speak to, we call them CPS screeners. So they're the ones that take the reports, and they will ask you all the questions. You don't even have to think about it. They ask you everything. And I always there's been times I've walked through some of these reports with the nurses, and I'm just, like, answer the questions that they ask you. And if you don't know them or you don't feel comfortable answering them, just tell them, I don't know. I mean, it's okay that you don't have all the information, but that is such a scary thing.
[21:54] Michelle: Not difficult.
[21:55] Amanda: It is not difficult. I, on average, probably make a couple of weeks. It's to the point I haven't even met these ladies that I talk on the phone with, but it's already like, hey, how's your family doing? Because I talk to them so often.
[22:08] Michelle: How was your Christmas?
[22:09] Amanda: Yeah, like, hey, I haven't talked to you in so long, Amanda. Oh, I've been on vacation. But, I mean, it's nothing to be scared of. And you don't have to have actual evidence that abuse is happening, just like the report says, suspected. It's just that you're suspecting something. So if you feel that concern and you're hearing things and you're seeing things from your observations, that is something you can do. And sometimes, depending on the situation, I do encourage my nurses to actually make those reports themselves, especially if there's already been one made by one of our social workers. And this is already going to be a second follow-up. I usually do encourage them to make that report.
[22:53] Michelle: I would think it would just build the case a little bit more. And I think for nurses, it's something to do to first go outside your comfort zone, do something that you're not familiar with, but that you have a responsibility to do. And it's a part of professionalism. I love that about you, that you continue to encourage nurses to do these things that are under their scope of practice, responsibility wise, professionalism. And I love that you've always said, if you want me to walk you through it the first time, I'm happy to do that. If you need me to show you where to find the form or send you the link, you're such a great resource. Something I think that we do in nursing is compartmentalize, whose job is this? And I think we do that definitely with mandated reporting, it's so easy to pick up the phone and go, Amanda, I need you to file a report. I have suspicions about A, B, C, D, or whatever, and I don't think that's always the right approach. And I hear a lot about, why can't you do that? I'm so busy. Well, you're not busy, right, Amanda?
[24:25] Amanda: No, I knit sweaters in my office. Exactly. Doing crafts. Exactly.
[24:31] Michelle: That just can't be a thing anymore. I'm not dismissing that nursing is challenging to get everything done in your twelve-hour shift or your eight-hour shift, it's really difficult, but it's difficult for everybody. And that can't be like our go-to all the time of, like, I'm too busy to do that because ultimately you're putting that family in jeopardy.
[25:04] Amanda: I was just about to say we have to go back and we have to look at that hierarchy of needs and what's at the top of that. Safety.
[25:11] Michelle: Safety. Safety. Yeah. So thank you for just kind of clarifying that about mandated reporters. So we've been talking about communication this whole time, communication with the team. And like you had brought up earlier, we do patient rounding in the NICU, and is that something that they do, like, on postpartum?
[25:38] Amanda: No. So that is only done for us on NICU and Pediatrics.
[25:44] Michelle: Okay, that's right.
[25:46] Amanda: We do call our charge nurse on 2East every morning to just say.
[25:52] Michelle: Hey, what's going on?
[25:54] Amanda: Yeah, it's just like, hey, how's the floor treating you today?
[26:00] Michelle: Where you really don't want to know the answer.
[26:02] Amanda: Are you okay? Am I going to be okay? All right. Call me if you need me. It's kind of more so to just know that that charge nurse, we're here, we're available if you need that.
[26:17] Michelle: Yeah, we love to know our resources and we love to know that we're not going to get hung up on.
[26:24] Amanda: Because realistically, we are not only there for the patients, we're also there for their families, but we're mostly there for our nursing staff and our medical staff.
[26:36] Michelle: Huge support like that cannot be said enough times. And we feel that, and we want to know that. And so knowing that, that you just check in, hey, I'm here. Give me a call. That takes one thing off of our plate. And so we love that. But one of the things that I missed most of all, oddly, when I retired, was patient rounding, and I think it was more for the social aspect.
[27:11] Amanda: I know people can't see my face right now, but I'm giving her crazy eyes.
[27:16] Michelle: I also miss wearing scrubs, and I hated those things, but, yeah, I guess just I don't know, maybe I just missed the good, the bad, and the ugly. But we had some fun on rounds with the families, especially the ones that have been there a long time. But once they start knowing the lingo and they'll say, oh, he had a brady this morning, or whatever, and seeing their rooms decorated for the holidays and all of that is super cute. Yeah, super fun. But as someone a part of the team that's on patient rounding, what is your take on it? Would do you like about it? What would you change about it?
[27:58] Amanda: I just love the team piece of it the most. I just like that we're in a circle or a table. We're all together, and at this moment in time, we are all just one. We're all on the same team. And it's nice because we're talking with each other versus when we don't do that. I feel like a lot of things get lost in translation or get lost in communication or even forget to get mentioned to a certain person. So I personally love rounding. I just wish we had the time to get to it more. But I personally do enjoy it myself as well. But when we have a full unit, it's long. It's a long time.
[28:39] Michelle: And then you get into different discussions.
[28:42] Amanda: And bless my doctor's heart, some of them love to talk.
[28:46] Michelle: Yes, it's true. Neonatologists, I was talking to Adam Wood, a NICU dad, and we both agreed neonatologists are special people, and we mean that with all the love in our hearts.
[29:01] Amanda: We do.
[29:02] Michelle: But definitely some of them really like to talk, and it could take a long time, and there's a lot of people crammed in a very small room, and it gets hot and my feet are hurting, and I'm kind of claustrophobic.
[29:18] Amanda: Is this conversation still productive? What are we getting out of this right now, exactly?
[29:24] Michelle: Well, it is important. And again, I think a lot of bombs are dropped in rounds where somebody is like, oh, yeah, this patient is going home tomorrow. But so and so has this concern. And then all heads turn towards Amanda.
[29:43] Amanda: Yeah. And that's usually when you see my head turn around and look behind me.
[29:47] Michelle: She's like, wait, who are you looking at? Yeah. So it's a little bit of pressure and a little bit of fun, but it's necessary for us to all be on the same page, right?
[30:01] Amanda: Yes. I 110% agree. Anyone who knows me, who has to work with me, knows how much I will go and knock on my Neo doors to get what I need and what I want out of something I'm just really big on, just advocating.
[30:18] Michelle: Yes, you are a very big advocate and you're like me. You're like an in-person person. I don't like to try to chase you on the phone.
[30:29] Amanda: I will come to your door with a smile underneath my mask and be like, hey, I need a favor.
[30:35] Michelle: Your eyes will be smiling, right? Smize. Well, let's just do like a little pivot right now because I want to ask you a question that I think I know the answer to. But working in Maternal Child Health, there can be a lot of drama with patients. These patients are experiencing life changes, having a baby, becoming a parent, and maybe some of them aren't in good relationships, maybe some of them are using substances and their child is going to be detained. So it's not all like happy and smiles.
[31:22] Amanda: Absolutely not.
[31:23] Michelle: Rainbows and unicorns, right? Are you an adrenaline junkie? Do you like that kind of stuff? Or are you good without it?
[31:33] Amanda: I live off of caffeine, hopes, dreams, and anxiety. That is my motto. That's what I tell everybody. Everyone knows it. Yes and no. I do like some adrenaline in my day, but with certain drama, it's a no for me. And that's where I'm just very blessed to have a coworker. And I'm sure if she was here, she would probably agree, but there's just some days you just don't have the mental capacity to deal with certain things. And that's when you look at your coworker and you're like, I need you to take this one for me today.
[32:16] Michelle: That's so awesome. And she's amazing.
[32:20] Amanda: She is. She's the best. And I hope she would say the same about me, but if not, never mind. Yes. And so because of that, like you said, we do experience a lot of I don't like to use drama, but we do experience a lot of that and that takes up a lot of our time. This is where I say about knitting sweaters. I can have one patient come in and that patient can take my whole entire ten-hour shift absolutely. Depending on what is going on in that patient's life that day.
[32:54] Michelle: Yeah.
[32:54] Amanda: And sometimes that could even roll over to the next day. So that's where it's important for me to have that co-worker who's like, you take care of that because this is important. I'm going to take care of these other things. So, yeah, sometimes you might call us and I'm like, I can't get to that today, sorry. But I will put it on my to-do list. And it's usually because we're dealing with things like that. Like you were saying, a lot of people think of mother-baby, labor and delivery as this beautiful experience. You're bringing a child into the world. Yeah. Thumbs down. That always doesn't happen. It's not a great experience for everybody. And some people actually don't love it. It's going to be a traumatic experience they're going to have for the rest of their lives.
[33:38] Michelle: Yeah.
[33:40] Amanda: Depending on what is coming in. But I meet with moms who are still trying to get over their last delivery that they thought was just going to be a simple push a baby out, and flowers and rainbows, and suddenly they have to have an emergency C-section. They end up in ICU because they have bleeding issues. And suddenly what they thought was going to be their beautiful birth story is now a nightmare and they are just wrecked.
[34:14] Michelle: They're on plan B.
[34:17] Amanda: And looking at you like, this is not how I wanted things to go. And that's when I got to pull the chair out and be like, let's talk about it.
[34:24] Michelle: Yeah.
[34:25] Amanda: So it just really depends. And it depends on the drama. I mean, it can be anything from like a mom just having a traumatic birth to a mom dealing with her baby going to the NICU with somebody who didn't even want to have this baby and is now here having the baby and she's happy, but this is not what she wanted. And then you have the ones who don't have the support, they don't have the family involved, and you have teen moms who are like that right there is just scary for them. And then you have your mental health who are not stable and don't even realize what's going on, and then you have drugs incorporated into that and it's a lot.
[35:10] Michelle: That was actually one of my questions about what you see and hear on a daily basis in your job is really heavy. And talking about mental health, there's been so much focus on mental health. So how do you maintain your own mental health and prevent yourself from being traumatized by their stuff? So talk about that for a moment.
[35:38] Amanda: Yes, and that's another thing, too. As a social worker and as a clinician, we always have to be aware of our countertransference, our biases, and when we're being triggered, huge. And anyone who knows me knows I'm very big on mental health. That is my passion. That is what led me into this field and into social work in general. But that is where my focus is. And that's what I will talk your ear off about all day long. But as far as taking care of my own, I have to. And I encourage anyone who works in that building to do the same. Because the nature of all of our jobs in that building is not easy. And it does take a toll on us, mentally, physically, and even though you might not be experiencing anything in the moment, it doesn't mean that later on, it won't stem up somewhere.
[36:33] Michelle: So true.
[36:34] Amanda: And so I always say it's important to talk about that, whether it's like with your co-worker just to have those conversations. And that's one thing me and my coworker do. We have those conversations with each other. We provide each other with that support. And then on top of that, I live at the gym when I don't have a pinched back that I currently am sitting here with. And I also go to therapy.
[37:02] Michelle: Yay.
[37:03] Amanda: I am active. I can't sit here until improvise your therapy if I don't even get myself any. So I do go to therapy, and I'm always constantly working on me.
[37:15] Michelle: I'm a big fan of therapy. I don't know if you've seen the patient yet on Hulu Steve Carell, so good. But I love that he's a psychiatrist and he has a psychiatrist, and it's pretty amazing. I think it's a really good idea. Well, that's good. I love your focus on mental health. Talk about a case. If you can remember a case that really shook you and made you kind of reconsider your profession if that happened.
[38:01] Amanda: Yeah, maybe it wasn't a particular case, but just like a day that I had where well, obviously I can't really talk too much on the case due to my client privilege. I wouldn't say that I rethought my career that day, but definitely it was a rough day. It was a day close to a holiday, and I got called down, basically a baby passing at birth. And I remember getting down to the OR. I couldn't even see the mom because she was still in the OR but it was dad. And I just remember that day and providing that support and thinking to myself, like, I don't even know what to say to this family, let alone, what can I do for this family?
[38:53] Michelle: You were just out of loss.
[38:55] Amanda: I was at a loss. And their reactions were so intense, as they should be. But I just remember never experiencing a family go through a loss the way they were experiencing it. And it just kind of caught me off guard a little bit. And I had to go back and sit in my office and reassess, what can I do here? And it's in those moments where it's like, I have to sit there and think about, okay, what does this family need? Well, I don't know. Let me ask for their baby back. Let me go ask them what they need.
[39:32] Michelle: Yeah.
[39:33] Amanda: And so that's what I do. There is nothing I can say or do for these families. And that was something I had to come to understand because this is such a raw moment in the moment that anything I say to them might not even register. And I have to be okay with that. And so I have to meet them where they are at.
[39:56] Michelle: I love that. Meet them where they're at.
[39:59] Amanda: And I remember that night when I got to my car, I just cried in the parking lot. It was just so overwhelming because you have to set your feelings and everything aside at these moments. This is not about you. This is not anything to do with you. And how about your feeling? Once I got to my car, I just sat there. I cried for, like, about ten minutes, and then I went home.
[40:21] Michelle: Well, yeah, that's a lot. It's heavy. And yet you probably came back to work the next day, and so that says a lot about you.
[40:32] Amanda: But I do feel like dealing with I don't want to say the dealing, but helping families through either an infant loss or a fetal demise. Are they're truly so emotional after you have so many? Because when we get them, we get them in three. It's the weirdest thing, and I never believe in it, but for whatever reason, superstitions really live in the hospital setting. And if you're the one that's just getting hit with two or three, it's exhausting. And that's where, once again, like, your team person comes in, because that's what will happen. It's going to be like, hey, Amanda, I've already taken two of these. I can't all right, it's my turn.
[41:17] Michelle: Looking out for your mental health and the mental health and that's important.
[41:21] Amanda: Knowing that I have to say no to this because I don't have it in me. And that's okay. It's okay to say that.
[41:31] Michelle: Yes. It's okay to say no. It's okay to not be okay.
[41:36] Amanda: Yeah.
[41:36] Michelle: All those things one of the things I always appreciate about every social worker that I've known is their knowledge of their own resources. How do you stay updated with your resources? And how do you keep up with your own education? Because, again, I feel like we should always be learning. There's new things coming all the time, so talk a little bit about that.
[42:04] Amanda: So once again, once I started my career, here at my current spot, I didn't know anything about anything. So a lot of it was I came in and saw what was being given. I was like, okay, and kind of just went from there. And occasionally when we have some time, we call, we check in these places, like, are you still running? When I meet with my patients, sometimes, they'll be like, oh, yeah, I went to this place before. I'm like, great, what was your experience? I do ask those questions and kind of get feedback from my patients who have gone to some of them.
[42:40] Michelle: Great.
[42:41] Amanda: But a lot of it is really just maintaining relationships. For example, Ernestina used to work at Building Bridges, which is a huge referral that we do give out to our families. They provide therapy services for moms and dads in this first year after having a baby. So they specialize in this postpartum period. So when she came on board, she came with all that knowledge because that's what she was working at before. And so then that's huge. And then we get our interns who come in like, oh, did you know about this place? No. And so stuff like that.
[43:18] Michelle: We got a word of mouth.
[43:19] Amanda: A lot of word of mouth. And thankfully, a lot of these community services, when they first start up, they'll reach out to the hospital and we come by and do a presentation. We're like, yes, please come on over. And then the same thing. Like, when I'm working with adoption agencies, I always pick their brains, like, hey, is there additional stuff you can give me or that you can provide to me so I could be aware of this next case that comes in the future? So things like that, I do ask a lot of questions. When I do get somebody new on the phone or in person, I'm like, what else can I get out of here?
[43:57] Michelle: Yeah, that's awesome. It's just another resource for you to put down in your little black book of resources. Yeah, that's cool.
[44:05] Amanda: And as far as the education piece, that's unfortunate, it's something we kind of really have to do on our own. So a part of that on my social media account, I do follow a lot of groups revolving around mental health, revolving around social work, and revolving around prenatal or postpartum. And so with that, people post up trainings, will post up resources, things like that. So that's another thing that I do to kind of stay in the loop.
[44:34] Michelle: Yeah, very cool. Well, what would you say to the nursing community out there about how can nurses really make friends with their social worker?
[44:52] Amanda: We love food. I think it's just really important just to build a relationship with us, just like how you do with your coworkers, and with your other nurses. As my staff knows, when I have time, I'll walk around the unit, I stop and I talk to you, and I like to get to know you, and you get to know me. And when you stop me and be like, hey, how was your trip? I think it's important for us just to have that relationship as well, just like how you would want to have with your coworker. Yeah. The only difference is I can't use the needle to save my life, but I'm here for you. Yeah.
[45:32] Michelle: I love how you do. You're a part of the team, and you're a part of us, our tribe. It's like you come to potlucks, you come to functions. We follow each other on social media, so we do know what's going on in each other's lives. And again, it just built on that trust. And then when we have to call on you for something or when you call us out on something that we need to be doing it's like, okay, we're good, we're friends, we're coworkers, we're colleagues, we're teammates, whatever you want to call it, everything's going to be okay. Right.
[46:18] Amanda: Because I want you important, too, so that way you're comfortable with reaching out to me, whether it's for a personal or professional, whatever it may be, that I'm four numbers away and just give me a call.
[46:32] Michelle: Yeah. Well, what is your best day look like as a social worker that keeps you coming back the next day?
[46:41] Amanda: It's 05:30 p.m. and it's time to go home on a Friday. Well, clearly we know how I deal, it's with my humor.
[46:50] Michelle: Yeah, that's great.
[46:52] Amanda: My favorite days are always my adoption cases. They're so far and in between. But I truly do love it when I get one of those that come in and I just get to meet a mom who's making a very tough decision in life, but at the same time, she's making the best decision for her and her baby. And then I get to meet this family who, for whatever reason, they're here, and they're about to be essentially gifted a child and have formed a family they're clearly wanting so badly in life, and it's just the greatest thing to be a part of. And I always tell my nurses who were assigned to those cases that day, I always tell them, just embrace this, because, for some of them, it's hard. They get too emotionally wrapped up in it, and I'm just like, no, just look at it for what it is.
[47:41] Michelle: Yes, that's such a great message to everyone, but especially, I think, to nurses and other health care professionals to just take it at face value, look at it for what it is. Don't try to analyze it.
[47:57] Amanda: Because unfortunately, sometimes these moms who are adopting their child, they get a lot of judgment and they see that, and it makes them feel a certain way, as of course anyone would. And I'm like, this decision is already hard enough. They didn't come here lightly on this decision. And I think, once again, it's all about meeting your person, where they're at. And if this is where she's at, then let's help her with that.
[48:25] Michelle: Yeah. Let's remove the blame, the stigma, the judgment. Again, it's not about us.
[48:31] Amanda: It's not about us and what we would do in this situation. It's about what they're doing in this situation.
[48:36] Michelle: Yeah. I love that. It's a great message. Well, this time in my closet with you has been amazing, as I knew it would be.
[48:49] Amanda: Really romantic with the candle, too.
[48:53] Michelle: One day I'm going to do a video. I know. I'm going to do it. And then all of our listeners can see what we do every day. Right?
[49:04] Amanda: You have to.
[49:04] Michelle: I know.
[49:05] Amanda: Or at least post a photo.
[49:06] Michelle: Yes, I will work on that. I did post a photo of my closet, finally on Instagram, but at the end, I do the five-minute snippet.
[49:18] Amanda: Oh, goodness, yes.
[49:19] Michelle: And these are just questions for our audience to see the off-duty side of Amanda. And so are you ready to play the five-minute snippet?
[49:31] Amanda: Let's do this.
[49:37] Michelle: What would you do if you found a briefcase full of cash in a different country?
[49:43] Amanda: Look both ways and run with it.
[49:45] Michelle: Just kidding.
[49:46] Amanda: I don't know. That's a scary one. My first response would be like, drug deal.
[49:51] Michelle: Yeah. Prison.
[49:52] Amanda: Yeah. I probably would just be like, I really should take this and run, but I'm going to leave this here.
[50:00] Michelle: But just like take one stack?
[50:02] Amanda: I've been out of the country too many times and there's too much shadiness going out. I would just pretend like I never saw it and then walk away pretending I had all this money. What would I have done with it?
[50:13] Michelle: Walk away. If you could add one feature to airlines, what would it be?
[50:20] Amanda: That all seats should be first-class seats. I don't understand why? Because some people are rich and some people are not, why we all can't just travel the same on a dang airline. Why can't we all have legroom and eat off of the glass plates and have free cocktails? I just don't get it.
[50:40] Michelle: And have that heated towel to wipe our face.
[50:44] Amanda: I just don't understand it.
[50:46] Michelle: Okay, I second that. I'm going to push for that. What was the most important item you lost on a trip or have you lost anything on a trip?
[50:55] Amanda: It's always Chapstick. I lose Chapstick every day and time. I have like 500 of them. I take 500 with me and I'm still trying to look for a dang Chapstick. Wow. Okay.
[51:06] Michelle: Got to have those baby-soft lips.
[51:09] Amanda: It's a struggle.
[51:11] Michelle: Would you rather explore space or the deepest part of the ocean?
[51:18] Amanda: That's a tough one. I guess my answer would be why can't I do both on different occasions?
[51:25] Michelle: You can.
[51:26] Amanda: Both are fascinating.
[51:30] Michelle: Okay. I love it.
[51:31] Amanda: And the most dangerous. So I'm like, I would want to do this.
[51:34] Michelle: What is the most hipster food you've ever eaten?
[51:38] Amanda: Oh, my gosh. If my boyfriend was here, he could probably give you guys a little. I was like, is that a thing?
[51:44] Michelle: A hipster.
[51:45] Amanda: I don't even know what hipster food is. Avocado toast. That's hipster, right?
[51:48] Michelle: Oh, avotoast. Yeah, definitely.
[51:49] Amanda: I don't eat that, though. I'm sure there's stuff out there.
[51:55] Michelle: Talking about your boyfriend. I know you're in a relationship and this is a question on dating life. But this is a really good one because how do you think relationships between people that are dating or in relationships are going to change in the next 25 years? 25 years.
[52:17] Amanda: Relationships are so difficult. And I always tell people this. I hate the ones that are like, oh, my gosh, me and my husband never fight. I look at them like, you're such a liar. I'm like, I pick a fight with my boyfriend just for the hell of it sometimes because I want to get inside of his brain, and that's the only way he'll give up. And so I just feel like there needs to be more of a normalization when it comes to relationships. They're hard. They are hard. They require a lot of work. They require dedication, time, consistency, and maintenance. Like my coworker Ernestina says, she tells me this all the time when I come in complaining and bitching about my man, "Amanda. Our relationship is like a tree. You have to water it for it to grow."  And I'm like, I want to rattle on my tree right now.
[53:13] Michelle: Well, you have a tendency to overwater your plants, and then they die.
[53:20] Amanda: Remind me of that. 
[53:21] Michelle: Right?
[53:22] Amanda: Yeah. So it's a balance. You have to find it.
[53:25] Michelle: Totally. What is one quality that you look for, let's say, that you look for in your boyfriend and that you also foster in yourself?
[53:36] Amanda: So we're both very goal-oriented people, and we always have these expectations set up for ourselves. Granted, they look very different, like, my goals are nothing like his goals, and the things that his experiences that he wants to do look nothing like mine. But what I think is cool about that is because we both have this in common but yet so different. It kind of makes you explore your goals and your experiences a little differently. How can I channel some of that into my life?
[54:13] Michelle: That's great. I love that.
[54:15] Amanda: Yeah.
[54:15] Michelle: I love that approach. Most exotic fruit you've ever eaten? 13 seconds.
[54:23] Amanda: I've eaten so much in Portugal, I eat anything like passion fruit, figs. I'll just pick those right off of the tree.
[54:35] Michelle: Our time is up. Wow. This has been so fun. So informative. It just makes me feel like, man. Now I know why I love Amanda so much. She's part of my tribe. She's an amazing individual. She's given me, she's given you, our listeners, so much information, about what we can do to really foster our relationship with our social workers, who are crucial for our patient's success and for our success as medical professionals. So thank you, Amanda, for being here today.
[55:19] Amanda: Thank you, Mama Michelle. It's been my pleasure to be in this closet with you.
[55:23] Michelle: I was hoping I would hear the Mama Michelle from you, and I do. But have a great rest of your day. Get your back healed.
[55:32] Amanda: Any drugs? See, now I need a nurse.