From patient to social worker, Emily Chan comes full circle

Photo by Saty + Pratha / University of Toronto Magazine

By Louise Kinross

I will always remember Emily Chan as a six-year-old with shiny black hair who raced through the halls at Holland Bloorview in an electric wheelchair decorated with pink stickers.

Emily, who spent her early years living at our old hospital site, took a bus each day to attend our integrated kindergarten at what was then our outpatient site.

More recently, Emily was a Holland Bloorview volunteer, a research student, and co-chair of our youth advisory. Last month, Emily was hired as a social worker on our complex continuing care (CCC) unit—the same unit she lived on as a young child. She just graduated from the University of Toronto, where she appears in the photo above. We spoke about her return to Holland Bloorview as a clinician.

BLOOM: How did you get into the field of social work?

Emily Chan: It really started from my own lived experience. As you know, I was an inpatient myself at Holland Bloorview for six years. Then I was an outpatient until I turned 18 and transitioned to adult care. The really great care I got while both an inpatient and outpatient set the stage for me to want to have some sort of career in health care. I knew I wanted to help people like those who had helped me.

I did my undergrad in psychology. Originally I was going to apply for a master's of clinical psychology, but it worked out better that I got into the master's of social work program. I did the program with a focus on mental health and health. I did that deliberately because I knew there was a gap in services for people with disabilities and mental health care. I really wanted to help close that gap. An opportunity came up here and I said 'Why not?' and that's how I got my first job after graduating.

BLOOM: What is a typical day like?

Emily Chan: Every day looks different. That's one of the things I really appreciate about the job. You never truly know what you will walk into. A lot of my day is spent with clients supporting them around the transition to inpatient rehab. For a lot of families, this can be an overwhelming part of their journey, but also an exciting one. A lot of the work we do is making sure families feel comfortable and safe and empowered to navigate their six- to eight-week stay. Another piece of the job involves working with other members of the interprofessional team to coordinate services and make sure everyone is on the same page.

BLOOM: Is counselling part of your role?

Emily Chan: For some families that may be a huge need, while other families might not need it. I have done some brief counselling at the bedside, helping families cope with the stress and overwhelming feeling that can come with an inpatient stay. Most of my clients are here to receive intense rehab after a major surgery. Parents may need training on special equipment a child uses before they're discharged. Many of my clients use ventilators or have other complex needs. 

BLOOM: What's the greatest challenge?

Emily Chan: Personally, I'm still navigating the piece around how much lived experience do I build into my practice? What I mean by that is because I was a CCC inpatient, I know, and my family knows, to a certain extent, some of what families are going through. Of course, each family is different and unique and has their own journey. I did take this job knowing I could contribute this unique positionality of mine, in terms of my lived experience. So I'm thinking about how much or how little do I weave in my own experience in a way that's clinically beneficial to clients.

BLOOM: What's the greatest joy?

Emily Chan: The greatest joy is being able to work with families. I didn't realize how much I loved it until I started. It's getting to know the clients and getting to know the families' stories. The piece that really stands out to me is noticing how resilient a lot of our families are. It amazes me every single time I talk to a family member. I practise from a strengths-based approach and I see so many strengths in every family I've interacted with. The greatest joy is getting to know the families. 

BLOOM: What emotions come with the job?

Emily Chan: What emotions don't come with the job? There's a lot of happiness and joy for sure, but that's not to say that there aren't difficult emotions too. Of course, there's sadness. A lot of it is helplessness. We and our families are working within a larger healthcare system that is not easy to navigate. There are quite a few challenges in accessing services and funding can be difficult to navigate. Helping families work through a quite complex system can make me personally feel a bit small sometimes. I know I'm doing my part in helping families on the ground level, but I recognize policies and systems that don't always benefit them.

BLOOM: Is there anything you do to help cope with stress?

Emily Chan: Yes, I'm working on setting boundaries for myself. For example, I only work two to three days a week, and the days I'm not working, I don't check my work e-mail. This field is quite emotionally heavy, and if I want to be in it for a long time, I need to set those boundaries. Another part of taking care of myself is having people to talk to. I'm a big proponent of going to therapy, and I absolutely do see my therapist on a regular basis. I have that as a touchpoint. It's a place for me to be open and vulnerable and to have dedicated time where I can process emotions.

I recently picked up reading again, this time for fun. I read a lot of fiction, which is a nice way for me to unplug and enter another world for a period of time. I've also picked up bullet journalling.

BLOOM: What's that?

Emily Chan: It's a system of journalling. I use it as a journal and as a planner. You can track whatever you need to track. So you can have a monthly calendar or a weekly calendar and a to-do list or your grocery list. I also use it as a mindfulness tool. I write down my thoughts at the end of every day, and I'll write down three things I'm grateful for each day. That's changed my mindset. 

BLOOM: Does the unit feel different from the time that you lived on it?

Emily Chan: I don't remember a lot of what the old unit at the Bloorview site looked like. The interesting thing is that I was on the new inpatient CCC unit for sleep studies when I was younger. So I've had the experience of staying in those rooms, even if it was only for a couple of nights. It feels weird to be back in an employee capacity. Some of the nurses I remember are still there. It's an interesting dynamic now, talking to them not as a patient but as a colleague. 

I walk in and I feel a sense of familiarity and warmth, and I think it's because that's what I felt when I was a client. I know that might not be the experience for every family.

Overall the response from staff has been really positive and I'm so grateful. The feedback I've gotten is that my lived experience can be of great value to the unit.

BLOOM: How does your firsthand experience inform the kind of care you want to provide?

Emily Chan: I practise in a way where before I interact with any family I'll think: 'Okay, how would I want to be treated if I were in their shoes 10 years ago? What would I have appreciated, as a 10- or 15-year old inpatient, at that stage in my life?' I ask myself that question, and I really try to reflect on how to say things and how to time things accordingly. I can use the knowledge of what worked for me, or didn't work for me, to inform my practice. 

BLOOM: Is there anything we could do better to accommodate staff with disabilities?

Emily Chan: More push buttons. My office didn't have one until my manager worked with me to get one. I don't think the patient rooms have them. I know the doors are light, but it would still be nice to have more push buttons.

I think Holland Bloorview is doing a really good job at giving staff the option to work from home when needed, and I really hope this is something we continue. 

I say that because working from home has been an accommodation that people with disabilities have been advocating for for years, and it hasn't had a positive uptake. The discussion has always been 'We don't know we can monitor you at home and we don't know if we have the financial means to send you all the equipment you need to work from home.' Since the pandemic, we have seen that this is quite feasible. It's something that not only helps people with disabilities, but people with kids, or who are caregivers themselves.

I know for people with disabilities that transportation can be quite tiring and quite burdensome sometimes, so working from home is a wonderful option. I really hope Holland Bloorview and other workplaces learn from the year or so we've had at home, recognizing it's a really accessible way to still be productive.

BLOOM: If you could change one thing about children's rehab, what would it be?

Emily Chan: We're getting better and more focused on the overlap between disability and mental health. I speak from my own experiences and also from feedback from friends who are in the disability community. Being an inpatient or outpatient for a long time can have repercussions on our mental as well as our physical health. I think children's rehab needs to have a more intentional focus on mental health care, and proactively being aware of these issues, instead of having a reactive approach. 

For me, when I was receiving physio or rehab, I had a lot of anxiety around 'Am I going to miss school? I'm not going to be able to do as well as I could if I dedicated more time to school.' I knew physio was important for my physical health, but that added an extra layer of stress for me. I didn't have anyone to talk to at the time. 

Sometimes the focus in rehab can be on the physical and the mental health impacts aren't addressed as quickly as they could be.

BLOOM: It's often challenging for families to find pediatric therapist who knows about disability.

Emily Chan: That adds another layer of complexity. Having a therapist that understands disability is really hard to come by. And not every family has the resources to be able to go with a private therapist.

BLOOM: Is there anything else you'd like to cover?

Emiliy Chan: I'd like to give a shout-out to my team and co-workers who have made this a really nice and good transition into my first job. I really appreciate the team approach present on the unit.