"It's in moments like this that you realize you've touched someone's life forever."

BarcelonaWhen he heard that there had been a A car accident with numerous fatalities and injuries in BarcelonaLaura Morro was eating, at home after a full day's work at the hospital. "It was the very day I had returned from vacation. A colleague who was at the Fnac in Plaza Catalunya at the time called me and told me that something big was happening because they weren't allowed to go outside," she recalls. She's neither a doctor nor a nurse: she's a healthcare social worker at Hospital del Mar. "I immediately thought they would take most of the patients to our hospital," she says. She left home without a second thought and went to her workplace, as did many other healthcare professionals that day. "I remember there was no one on the streets; everyone had locked themselves in at home, and when I got to the Emergency Room, I said, 'What can I do?' And they replied, 'Do what you know,'" she explains.

At that time, there weren't many social workers working at the hospital, but the few that were there quickly became active. Montserrat Roig, now retired but having worked as a healthcare social worker at the same hospital for 44 years, also attended: "I was on vacation, on a terrace in Sitges with some friends, including a colleague, and we decided to go to the hospital to help," she recalls. Their response, and their work in the Emergency Department providing psychosocial care and support during the most difficult moment of the emergency, led the Generalitat (Catalan government) to change the healthcare emergency protocols in hospitals throughout Catalonia a few days later. Since then, social workers—who until then had not been included in the protocols or in the Emergency Departments—have become a mainstay in the immediate response to a crisis of this nature.

"Now the first thing we do is free up operating rooms, call the blood bank, activate the surgeons, the traumatologists, and the ICUs... And also call the social workers," explains Isabel Cirera, head of the Emergency Department at Hospital del Mar and the CUAP Peracamps. She also worked on August 17, 2017, side by side with Morro, Roig, and the rest of the healthcare workers. She was in charge of leading all the Emergency Department teams and resources. "I asked Laura and the rest of the social workers to set up a care point, but outside the Emergency Department, and they did so at the reception desk. Once we had the lists of those affected, we shared the information, and they saw everyone who arrived and began searching for and reuniting families," recalls the area head. "That took a lot of work off the doctors' shoulders. They were supporting the entire social and emotional aspect, and they do that much better than we do," she adds.

The importance of psychosocial care

Searching for family members scattered across different hospitals was no easy task. "At that time, medical records weren't linked electronically, and we couldn't access anyone's data," recalls Morro, who says they "took a straightforward approach." "Since there are very few of us social workers and we all know each other, we called colleagues at other hospitals to try to find relatives," she continues. "I told them, 'I have a woman with these characteristics who says she was with her young son. Does that make sense?' And that's how we started finding connections." In fact, it was the social workers who suggested to the medical teams that the families should be unified so they could be admitted together, to alleviate the stress and pain. "No one questioned us. All the directors understood that the families should be together, and although hospitals have very rigid procedures, that day they were flexible," says Morro, who assures that the doctors did everything possible to work not by patient but by family unit, and they focused on the least seriously ill patients.

"More and more people were arriving asking about their families, looking for answers," Roig continues. "We needed the doctors to care for the wounded, but we also needed them to help us." It was necessary to respond to people's anxietiesMany people also showed up at the hospital to offer help. "It was very nice. They offered us their homes, translators... And we also had to channel all this need to offer help. At a time like this, you can't tell people to leave; we're busy," explains Morro.

Reuniting families, locating patients, answering questions, finding translators, speaking with consulates and the ministry, channeling aid, and accompanying grieving workers, already with the Reds passing by. In hospitals, we were part of it, and we're used to working together. But the difference is that that day we led this psychosocial aspect: management fully trusted us, at a time when this wasn't foreseen in any emergency protocol," Morro gratefully recalls. "It's proven that stress affects healing; and they knew how to channel everything very well," acknowledges Dr. Cirera.

Roig recalls that they activated a kind of autopilot and divided up the responsibilities in a very "natural" way. "We're very used to managing situations of vulnerability or risk, and even though it was beyond anything we'd ever experienced," she retired. And so they continued, providing the most invisible care for days.

Changes in the protocol

"After a while, someone from the Health Department came to see us at the hospital. They wanted to know exactly how we had worked that day because they had heard that everything had gone very well," recalls Morro, who this spring is the new dean of the Official College of Social Work of Catalonia. They included social workers in working groups to design a new emergency protocol, and since then, they have been responsible for psychosocial care in times of disasters. "We have also published numerous articles in journals and participated in conferences as external coordinators for emergencies of this type," explains Morro. "Until then, emergencies were linked to the medical and health sector, and with April 17, the importance of psychosocial care at the moment of the crisis, not afterward, became clear," she concludes.

There were also changes at the hospital. "I asked for social workers in the emergency room, something that was unthinkable until then. Now we always have them. They're indispensable, but they shouldn't just be in hospital emergency rooms, but also in primary care centers," says Dr. Cirera.

Major disasters—such as the attacks of 2017 or the pandemic of 2020—have helped, these professionals agree, make their work visible to the outside world, allowing them to demand more resources. This is at the institutional level because, fortunately, internally, they often find recognition from patients. "I remember a girl who was admitted, along with part of her family, who asked us all to bring her a rock if we passed by the beach," Morro explains emotionally. "On the last day, when they were discharged, she had prepared all the little rocks for us to take back with her name on them so we wouldn't forget her. Someone forever," she says.

Days like the 17th of April leave an indelible mark on any professional involved in the emergency: "When I remember that day, tears come to my eyes," agrees the doctor, professionally accustomed to these situations. "We were prepared since the Bataclan incident, and we knew it," she concludes.