Rachel Rusch, a class of 2016 MSW graduate and MSW Fellow in Silver’s Zelda Foster Studies Program in Palliative and End-of-Life Care, was selected to be part of the seventh cohort of the Cambia Health Foundation Sojourns® Scholar Leadership Program. A clinical social worker within the Division of Comfort and Palliative Care at Children’s Hospital Los Angeles (CHLA), Rachel is one of twelve emerging palliative care leaders chosen for the 2020 cohort through a rigorous selection process from a highly competitive national pool of candidates from a range of disciplines and practice settings. She is the second Zelda Foster Studies Fellow to be selected for this prestigious program since it was opened to social workers in 2018, following in the footsteps of Bridget Sumser, MSW ’12.
The Sojourns Scholar Leadership Program is designed to identify, cultivate and advance the next generation of palliative care leaders. As part of the leadership program, each Sojourns Scholar receives $180,000 in funding over two years to conduct an innovative and impactful clinical, policy, educational, health equity or systems change project in the field of palliative care. Scholars also participate with other scholars in a collaborative learning community while receiving individual mentorship to design and implement a development plan that supports their growth as national palliative care leaders.
The project for which Rachel is using her funding is titled “The Perseverance Project: Transforming Resilience Through the Power of Story.” Comprised of two main interventions, the project stems from her hypothesis that “a patient’s ability to have their personhood acknowledged and celebrated through a community who listens with compassion may directly correlate to their ability to persevere throughout their disease trajectory.” She explained that the first intervention is an adaptation for pediatrics of the well-founded intervention “My Life, My Story,” which places a patient- or family- written narrative directly into the patient’s electronic medical record. The second builds on workshops she and colleagues have been running for clinicians and trainees that utilize improv and classical theatre as well as some narrative medicine interventions “to help them with their capacity to listen and bear witness while creating a renewed sense of inspiration and purpose in an increasingly stressful healthcare system.”
At CHLA, Rachel is part of a robust, interprofessional palliative care team that works in concert with the primary medical and social work teams caring for children from birth to young adulthood living with serious illness. “We're fortunate enough to be well integrated throughout our hospital, which serves a population that very much mirrors the diversity of Los Angeles County,” she said. “Our role varies depending on the stage at which we’re meeting a patient and their family, the different medical decisions they’re considering, or the different phases of their life they are moving through. We could be offering therapeutic support to a sibling as their loved one nears the end of their life; running a bereavement group; helping with resource support; or sitting in a meeting with a family and helping to facilitate communication. We aim to be an extra layer of support to patients, to families, and to our colleagues, tailoring our work to be thoughtful and specific to each individual case.”
In her work, Rachel sees herself as being part of a community not only of fellow clinicians but also of patients and families. “So often,” she said, “especially in healthcare, people experience marginalization, they experience racism, they experience not feeling heard or listened to. I hope my work as a social worker and our collective work in palliative care creates opportunity for patients and families to address things that might not otherwise be addressed and gives space for their stories to be told and shared and integrated into their medical care, thus enhancing their care, and our field’s provision of that care, overall.”
Rachel’s Sojourns Scholar project is, in many ways, a natural step in her professional path. Prior to pursuing her MSW, she said, “I was an artist and a performer in New York City and always had my foot in the world of volunteering with children with chronic and complex illness. As that volunteerism started to take up more of my time, I began to see a lot of overlap between the arts, humanities, and social work, and particularly between medical social work and the power of storytelling, lifting up one’s personhood, and listening, which are the same core tenets that you can find in the performing arts too.”
She chose to attend Silver for her MSW in part because of the dual degree program in Social Work and Child Development with Sarah Lawrence College. “I love working with children and I knew that I wanted to work in pediatrics,” she said, “and that felt like the right program for me.” Once in school, Rachel learned about Silver’s Zelda Foster Studies Program and its four-year MSW Fellowship open to students in their final year of the MSW Program. “It was really in my field placements and in talking with people within the NYU community that I realized this specific area of care that I’d been drawn towards had a name and it’s ‘palliative care,’” said Rachel. She was accepted into the Zelda Foster MSW Fellowship and it had a transformative effect on her career.
From the beginning of the fellowship, she said, “there were seeds planted that I am still thinking about in my career now. My field placement was within pediatric oncology with an incredible social work supervisor with a strong interest in palliative care, so I was awash in that education from the very start.” She cited her mentor in the program, Nancy Cincotta, the Director of Psychosocial Services at Camp Sunshine, with modeling the power of storytelling in palliative care and encouraging her to embrace her performing arts background in her work. “One week, I traveled to Maine with Nancy to watch her run bereavement programming at the camp, which serves families affected by life-threatening childhood illness. There were families, some who had known each for many years and others who were brand new to the camp, who were sharing the stories of their children in large and small group settings. And it was so striking to see this concept of storytelling alongside a listening, compassionate community in action.”
Rachel also credited Clinical Professor and Zelda Foster Studies Program Director Susan Gerbino with creating a strong, supportive community of palliative care social work students and practitioners that has continued to grow through the years. “During the final year of graduate school, it was so helpful having our cohort of MSW Fellows meet together, share experiences, and see each other within our field placements. We continued to meet as a cohort in the final years of the fellowship and now we connect, along with other members of the Zelda Foster community, at conferences, through email listservs, social media, etc. There’s a kinship and camaraderie. If I pose a question to the community, inevitably someone responds ‘I know somebody who is working on that ‒ let me reach out to them,’ and that generosity of spirit is really a clear part of the program and it has been there from the very beginning.”
Rachel, who is also a graduate of Harvard Medical School’s Interprofessional Palliative Care Fellowship Program and an active member of the Social Work Hospice and Palliative Care Network, noted that in addition to funding her project, the Sojourn Scholars program is investing in her growth as a leader. With that support, she said, “I will engage in trainings and opportunities that enhance my ability to lead this project and to pursue these interventions at their highest level. It will also help me to travel to events like national conferences to disseminate the project as it continues, so that it’s not only something that lives within my institution but, hopefully, something that can be extrapolated into many other settings as well.”
About Cambia Health Foundation
Cambia Health Foundation is the corporate foundation of Cambia Health Solutions, a total health solutions company dedicated to making health care more person-focused and economically sustainable. Founded in 2007, the foundation has funded almost $78 million in grants to advance patient- and family-centered care for all. Cambia Health Foundation strategically invests in philanthropy to change the way people experience health care from birth to natural completion of life. Learn more at www.cambiahealthfoundation.org, and follow us on Twitter: @CambiaHealthFdn.