By Dina Weinstein

As a social work student at Virginia Commonwealth University, Corey Cruppenink completed his undergraduate field placement at the VCU Health adult sickle cell program. It changed his life. 

 “I fell in love with medical social work and working with folks who are navigating seemingly insurmountable odds in their life,” Cruppenink said. “I found what I want to do for the rest of my life.”

Cruppenink now works in the VCU Health emergency department as a medical outreach worker, connecting people experiencing homelessness with primary care, mental health care and housing services. He is also pursuing a master’s degree in social work at VCU School of Social Work.

Real-world experience you can’t get through a textbook

Shirley Johnson, VCU sickle cell research operations manager and patient navigator supervisor, created the sickle cell field placement for social work students five years ago. Field placements are required of all VCU undergraduate and graduate students in the School of Social Work.

Students in the sickle cell placement learn what sickle cell disease is and the emotional and physical challenges it exerts on patients, who are primarily African American.

Scientists believe the sickle cell gene arose in Africa as a means of protecting humans against malaria. As a result, many people who have sickle cell disease are of African descent. As authors of a New England Journal of Medicine opinion piece stated in November 2020, because many of these individuals with African ancestry are Black, the majority of individuals with sickle cell face the challenges not only of sickle cell disease but also of structural racism in America.

More than 700 adult patients and 300 pediatric sickle cell patients throughout Virginia receive care at VCU Health. Hundreds of people with sickle cell disease routinely come to the VCU emergency department for care. The field placement gives students the opportunity to work with patients in the community as well as in inpatient, outpatient and emergency room settings.

Students shadow members of the sickle cell team and discuss what they’ve learned. Cruppenink primarily shadowed patient navigator Marla Brannon, observing how she helped find solutions to patients’ individual challenges. His responsibilities included identifying patient needs, such as accessing health care and maintaining compliance with their treatment plan. At the same time, he built trust and rapport with patients to better serve them.

“That’s not something that you can learn in a classroom, and it honestly has to come a little bit naturally, too,” Cruppenink said.

Interns who are white, like Cruppenink, reflect on historic racial disparities in sickle cell and how they can make a difference in the lives of people unlike them.  

“I explored myself in a way I never would have been able to at any other placement,” Cruppenink said. “That led me to be a more competent social worker, with a better understanding of issues like diversity and injustice. Working with these folks changed my life and changed how I viewed the world.”

Once considered a pediatric illness, sickle cell now presents adult challenges

As sickle cell patients live longer lives, many need help navigating adulthood and its related social challenges. During his internship, Cruppenink became immersed in helping sickle cell pediatric patients transition to adult services. That meant referring patients for occupational therapy or life skills training, helping with applications to trade schools or arranging financial aid for college.

Cruppenink also visited sickle cell retreats sponsored by Children’s Hospital of Richmond at VCU and answered questions teens had about adult care and nourished a transition age support group that met regularly.

“Sickle cell is an added burden for any 18-year-old who is moving off and leaving their parents’ nest,” Johnson said. “They want freedom and to do all these things, like going to college or trade school or whatever. They think they know everything, but on top of that, they also have a chronic disease. So it’s really important that they have people that continue to reach out to them and try to engage them in adult medical care.”

“All of these can be stressors in life,” Cruppenink said. “We are point people for folks who might need a little bit more help to navigate all those things.”

Medical social work feeds passion

Social work student Isabella Kitzmann was drawn to her yearlong placement with the sickle cell program because of its impactful work in a medical setting. She shadowed nurses, social workers and patient navigators, experiencing intimate, often raw Zoom therapy sessions. She also worked with Johnson and other colleagues in the adult program to plan the second annual SCCAPE conference (Sickle Cell Care Coordination for Achieving Patient Empowerment). The conference trains participants from across the country to function as a sickle cell disease health navigator or work as part of a sickle cell medical care team.

The sickle cell placement solidified her passion for health care social work, Kitzmann said. As she begins her master of social work at VCU, she’s staying on as a coordinator for patients transitioning from pediatric to adult services. As part of her responsibilities, she’ll develop best practices.

“I feel my voice is heard, and I can make a big contribution,” Kitzmann said. “I’ve gained an understanding of how to apply the social work skills I learned in the classroom to real-world experiences. I developed a better understanding of how interdisciplinary teams work.”

Placements vital to program’s success

To assess the sickle cell program’s success, Johnson gauges patients’ levels of depression and anxiety as well as their independence, attendance at clinic appointments and medication compliance. For college-age patients, she looks at whether they seek out academic support services at their school. These services are often indispensable for sickle cell patients. Her team works with patients on realistic planning as they navigate the transition to adulthood. Social work students help with this planning.

“We went from a 50% transition success rate to a 95% transition success rate,” Johnson said.  “Social work students are a big part of that,” she said.

To sign up for field placements

Social work students interested in medical social work for their field placement might hear from Johnson, who looks for students who are confident and can work independently.

Learn more about field education and field placements through VCU’s School of Social Work.

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