The Inside Scope of Social Workers in Health Care as Told by 7 Different Accounts

Medical Social workers take on various responsibilities depending on the shift they are assigned, the setting, and patient’s needs (DiNitto & McNeece p. 204). These account reflects the constant flow of different people who bring different concerns, calling for different actions on behalf the social worker.



Chapter 1: Social Work in the ER

 Ogden Rogers

  • “No Matter the costs of tragedy, there are little moments of quiet heroics as well. Sometimes hours of boredom are punctuated by minutes of terrific activity. One has to think fast on one’s feet. The ER is more like a beach, where the sea and the land meet, changing each other over and over. To do social work in the ER takes the heart and mind of a surfer, each new person off the street is another wave to meet well” (Grobman, p. 36).


Chapter 2: Social Work in the Neonatal Intensive Care Unit

Merle T. Edwards-Orr

  • “I had to two pagers to carry on this day. On my right side pocket my usual pager so the Neonatal Intensive Care Unit could track me down. On my left side, I carried the pager for the emergency room, as I do every other Monday. In the minutes between phone calls and talks with medical staff, I filled out some SSI applications. Name, condition, demographics about the doctors and hospital, a little bit about tests, & a couple of releases and that was about it (Grobman, p. 39).
  • “This was a routine conversation, helping people locate and sort out resources” (Grobman, p. 42).
  • This all happened between miscellaneous phone calls, SSI applications, pages from the pharmacy for permission to approve social work department payment for prescriptions, and the rest of the little stuff that no one remembers but takes up minutes and hours in the day. No meetings today. And charting, I needed to make sure each of these major contacts had a note in the chart, so other team members were aware of mu observations (Grobman,p. 44).

 


Chapter 3: Remembering Why I become a social worker: Lessons learned on internal Medicine

Jodi Goldstein

Jodi Goldstein received a referral to assess a severely cognitively impaired and frail senior whose primary caregiver is her son Paul. He wanted to place her in a specific nursing home.

  • “Today I assisted in reducing these feelings of despair experienced by Paul. Paul helped to remind me to look deeply into the lives of our patients and, rather than personalize negative events, to remember to allow time for the healing process. Paul needed that time to come to terms with the fact that his mother needed to be placed in a nursing home now, not in 5 years (Grobman,p. 45)
  • Despite beginning with feelings of dread, I realize once again why I am in this field. As much as I can be helpful to my patients, I am constantly learning about myself and others. (Grobman,p. 48)


Chapter 4: Social Work in the Infertility Clinic

Gretchen Gross

  • My position as a counselor in a university-affiliated outpatient medical clinic provides me with much more autonomy and control over my professional life, my case load, and diversity of population and services offered (Grobman, p. 49)
  • Each day I see a variety of couples and individuals who are referred to me by physicians, midwives, and other practitioners who provide reproductive services to our patients. I provide services in the same manner that I do at my private practice. I schedule my own clients, attend weekly in-vitro fertilization (IVF) team meetings, present at resident didactics, and present at department grand rounds. I counsel with physicians on troublesome cases, and treat or refer clients as needed (Grobman,p.49)
  • I must always challenge my own ethical standards & learn more to keep up with developments and changes in many areas (Grobman,p. 53)
  • One drawback of this field is that I miss working with other clinical social workers (most clinics have one staff counselor) (Grobman,p. 53).


Chapter 5: Working with pregnant women in public health (55)

Aldreda Paschall Gee

  • I work with pregnant women. I am paid by the county from funds I generate by billing Medicaid for the contacts I make with patients in the maternity clinics. I follow each patient from time to time, I meet her until roughly two months after her pregnancy ends, regardless of the pregnancy outcome. I work in two settings: the local hospital’s Ob/GYN clinic, and a newly-formed private OB/GYN office (Grobman, p. 55)

 

  • The job has specific requirements set out by state guidelines, but affords a good deal of autonomy and professional judgment. There are four social workers involved in the maternity team, and we work with nurses and are supervised by a nurse (Grobman, p. 55)


Chapter 6: Managing in Managed Care

David C. Prichard

  • “My specialty is in crisis intervention and trauma, and therefore I select cases in which clients have clear precipitating events that have led to the presenting symptoms. My treatment is crisis-oriented and focused on reducing the immediate symptoms of the trauma (Grobman, p. 62-63). 
  • I spend most of my afternoons on the phone with providers, discussing cases. Although many 0rivers appear to view me as someone whose job is to restrict treatment, I see my role as one of collaborator, providing free, collegial, peer supervision (Grobman, p. 62-63). 
  • I am relieved when 5’ o’clock arrives. I feel as though I’ve been on the phone and computer all day, yet there remain many charts and unanswered phone messages scattered on my desk. These will have to wait until tomorrow. (Grobman, p. 62-63)


Chapter 7: Social Work in the Commissioned Corps

Gary Lounsbery  

  • My current assignment is as a mental health consultant in an Indian health service unit in Northeastern Oklahoma. I have been here for two years, and this is my second assignment since receiving my commission six years ago. Officers change assignments every four years. I enjoy the opportunity to experience different parts of the world with different cultures (Grobman, p.65).
  • Within a broadly defined position description, I have a great deal of latitude in how I structure and carry out my duties. I can initiate new services in my current position or seek to transfer within the whole range of the commissioned corps. This range includes all the programs in the department of health and human services, including the national institutes of health and the Centers for Disease Control (Grobman, p. 69-70).  


References

DiNitto, D., & McNeece, C. (2008). Social work: Issues and opportunities in a
challenging profession (3rd ed.). Chicago, IL: Lyceum Books.

Grobman, L. (2012). Days in the Lives of Social Workers (4th ed.). Harrisburg: White Hat Communications.

 

 

 

Major Matters from This Week’s Lessons on Medical Social Work – Julie S.

Social work in health care is a very important and needed field as it provides services beyond medicine and care.

The medical model practiced by physicians and caretakers emphasizes disease and the treatment of disease. In contrast, Social Workers can provide a biopsychological approach meaning they treat the patient holistically.

A social worker considers the “patient’s health, psychological state, family situation, employment, financial status, culture, religion, and neighborhood conditions” (DiNitto & McNeece, 2008, p.201).

In fact, medical social work was the first ever specialized area in social work overall (DiNitto & McNeece, 2008, p.203).

film sad death cancer ill

Oncology is a major field of social work in which works to provide patients and families with support through the diagnosis and treatment of cancer. They help promote psychological awareness and recovery while also facilitating treatment resources and plans with the patient (Class Presentation 6).

 

Kaylin Andres shared with us her experience with cancer at age 23 in her graphic novel Terminally Ill’in. She described waiting for the diagnosis as:

“The maybe’s are the sickness that spreads. The hypothetical continues to plague my thoughts and those of anyone close.I would like to know if this pain growing inside me will be my downfall. I would like to know, grieve, and get the hell on with it. I hate indecision. I hate the middle.” -K. Andes (Andes & Solo, 2011).

sisters keeper my sisters keeper

Her experience was unfortunately far from comforting, however, a social worker may have been able to address her needs during the intensive and emotional process through the biopsychological approach.

There are many other areas in which social workers can provide services in the medical world as well (DiNitto & McNeece, 2008, p.206-213)..

  • Primary Care
  • Emergency Department
  • Nursing Homes and Hospice
  • Pediatrics
  • Intensive Care Unit
  • Behavioral and Psychiatric Health 
  • Veterans Services 
  • LGBT clinics
  • Home Health Care
  • Palliative Care

 

 

Health care researchers predict that the need for social workers will greatly increase in the future as the presence of chronic illness increases, technology increases opportunities for lifetime care decisions, and the cost of health care increases thus requiring advocacy for high-quality and compassionate care as well as assistance to those with fewer resources and difficulties with health literacy (DiNitto & McNeece, 2008, p.206-213).

 

advocacy

Social workers can specifically ensure advocacy for patients and future patients (Class Presentation 6)

 

Health care literacy is an important service that social workers can provide, yet in the past it has not been a central concern.

One-third of U.S. adults do not have adequate health literacy to manage their health care needs; and low health literacy is a major concern due to its association with poor health outcomes, high health care costs, and heath communication problems” (Liechty, 2011, p.99).

Social workers can promote health literacy in several avenues including through everyday counseling and casework interactions, internet health coaching interventions, evidence-based staff training and awareness about health literacy rates, and screening for patients who may have low health literacy (Liechty, 2011, p.104-105).

 

Working in the medical field as a social worker can be one of the most challenging and rewarding experiences. Not only do they aid in the grieving process for families, but they also serve to provide support and relief for physicians. In the book Days in the Lives of Social Workers, we especially see this as Ogden Rodgers, Ph.D. ACSW, works throughout the emergency department helping doctors address family members and even more challenging, providing moments of relief and support as Doctors are forced to say goodbye to a patient they have worked very hard to revive (Grobman et.al,2012, p.34).

 

” Don’t get me wrong, I love being a social worker. I adore the work that I do with vulnerable patients who need an advoacte. I went into this field so I could make a diference in their lives. Some days, however, are more challenging than others. This is one of those days” -Jodi Goldstein (Grobman et.al,2012, p.45)

Many circumstances can be challenging in the medical field, but as social workers, people in this career continually note that the moments of reward and success always make the challenges worth the work.

Most importantly, social workers are able to look at situations from a strengths perspective. They can work with many patients to create opportunity and hope.

The strengths perspective is an important counterbalance to the medical model’s preoccupation with pathology and deficits” (DiNitto & McNeece, 2008, p.202).

This process of evaluating a patient’s strengths is very important in the assessment portion of DAP notes in hospitals and emergency care and allows encouragement for the patient.

 

Pictures feature scenes from the movie My Sister’s Keeper.

Grobman, L., & Clark, Elizabeth J. (2012). Days in the lives of social workers : 58 professionals tell “real-life” stories from social work practice (4th ed.). Harrisburg, PA: White Hat Communications

DiNitto, D., & McNeece, Carl Aaron. (2008). Social work : Issues and opportunities in a challenging profession (3rd ed.). Chicago, Ill.: Lyceum Books

Liechty, Janet M. (2011). Health literacy: Critical opportunities for social work leadership in health care and research.(Report).Health and Social Work, 36(2), 99

 

4 Reasons Why Leadership in Social Work is Under Attack Part 2: Social Work in Health Care

By: Mindy Barnes

 

Medical social workers are vital members of the health care profession. These social workers are often the only health care professionals able to assess and address all of the client’s biopsychosocial needs. Unfortunately, few social workers hold leadership positions within health care settings. Before are four reasons why:



 

#1. Reengineering of the 1990s was a major threat to medical social work leadership, as decentralization took supervisory positions away from social workers. And according to Judd and Sheffield, “[a]s social work leadership began to evaporate and free standing departments were absorbed into case management units, hospital social workers were placed into a position of competing for roles they had historically filled” (2010, p. 858). Today more than ever, patients are in need of social workers, and social workers are gaining back their valued positions within health care settings. However, social workers are still missing from prominent leadership roles. 

day party people year our

 

#2. Social work leadership is overlooked by professionals at all levels. DiNitto and McNeece say that, “[s]ocial workers are taught to place a high value on collaboration, whereas physicians are generally taught to assume leadership roles in interdisciplinary groups (Mizrahi & Abramson, 1985)” (2008, p. 206). Interdisciplinary collaboration is certainly an important aspect of social work, but perhaps social workers could also learn to incorporate leadership styles into their practice within health care settings. Also, “[a]s in other important areas of social welfare policy, social workers have generally not been at the table when government or proprietary health-care organizations have made important policy changes in health-care programs. Social work’s multilevel perspective provides an important point of view that should be considered in any major policy shift” (DiNitto & McNeece, 2008, p. 214).

 

#3. According to Liechty, “[d]espite the extensive knowledge and skills that social workers can bring to bear to assist patients with low health literacy, the concept of health literacy is underused in social work scholarship. This gap reflects missed opportunities for social workers to contribute their expertise to the evolving field of health literacy and to strategically align their work with organizational and national priorities” (2011, p. 99). The disconnect between health care providers and patients with low health literacy often leads to patients being referred to social workers, as social workers are highly equipped to deal with this vulnerable population. Unfortunately, health literacy terminology is rarely used within social work literature, which can hinder social workers’ ability to become leaders and advocates in health care settings (Liechty, 2011).

doctor medicine dr spaceman medicine is not a science

 

#4. DiNitto and McNeece point out that, “[s]ome of the struggles social workers experience in the medical field can be attributed to the various ideas other medical professionals have concerning what constitutes medical social work” (2008, p. 194). The fact that medical social work encompasses a variety of roles is beneficial in that it allows social workers to assist and advocate for patients in many different areas within the medical field. However, because medical professionals differ in their ideas of what a medical social worker’s purpose should be, social workers could lose out on important leadership positions within medical settings.

Film Society of Lincoln Center seth rogen what do you do steve jobs nyff



 

Ida Cannon, the first identified medical social worker, said that medical social work, “strives to bring to the institutionalized care of the sick such personal and individual attention to the patient’s social condition that his recovery may be hastened and safeguarded” (DiNitto & McNeece, 2008, p. 193). Cannon’s words still hold true today. The patient’s health and well-being is the sole concern of medical social workers. So, it only makes sense that patients and medical professionals at all levels would benefit from having social workers fulfill leadership roles. To accomplish this, social work programs could promote the integration of leadership skills with interdisciplinary collaboration, and they could acknowledge the importance of addressing health literacy and evidence-based approaches within the academic literature. Also, all health care organizations should recognize the necessary work and specific knowledge provided by medical social workers, as well as the potential benefits of having social work leaders within their facilities.

 

Sources: 

DiNitto, D., & McNeece, C. (2008). Social work: Issues and opportunities in a challenging profession (3rd ed.). Chicago, IL: Lyceum Books.

Judd, R., & Sheffield, S. (2010). Hospital Social Work: Contemporary Roles and Professional Activities. Social Work in Health Care, 49(9), 856-871. doi:10.1080/00981389.2010.499825

Liechty, J. (2011). Health Literacy: Critical Opportunities for Social Work Leadership in Health Care and Research. Health & Social Work, 99-107.

7 Facts About Social Work Practice in Health Care Settings

by Marisa Bordowitz 

  1. Medical social work utilizes three theoretical perspectives: 1. the biopsychosocial model 2. the strengths perspective (aforementioned) and 3. a multilevel practice. (DiNitto & McNeece, 2008, p. 200.)
  2. The biopsychosocial model model views the patient under a holistic microscope, amalgamating ties to a patient’s health, psychological state, financial state, family life, employment, culture, and religion (just as it is sensitive to the types of oppression and its impacts) It fixates on the disease and its treatment. The concerns of a social worker (in application if this model) extend past merely how the disease affects the patient. Social workers are also concerned with how the patient’s environment affects the disease and the patient’s general healing process.  (DiNitto & McNeece, 2008, p. 201-202)
  3. The strengths perspective within a medical field, as in other fields, recognizes and elucidates the strengths and resources of the patient (rather than pointing to the deficits that accompany diseases – as the medical model may do). The strengths perspectives strips the patient of his/her victim status, and tries to see an inherent capacity for survival ( despite adversities). (DiNitto & McNeece, 2008, p. 202)tumblr_mjx5whxoZy1rio9qmo1_500.gif
  4. The multilevel approach is just what it sounds like. It entails both the biopsychosocial model and the strengths perspective. (DiNitto & McNeece, 2008, p. 202)giphy.gif
  5. Medical social workers are a massive help to the LBGTQ community. They are essentially a voice for minorities. Their services are culturally sensitive, aiding patients with their physical and psychological well-being. They arrange support groups specific to gays (such as groups namely partners of transgender individuals and lesbians with cancer). (DiNitto & McNeece, 2008, p. 208).giphy.gif
  6. Part of the social worker’s obligation is to advocate for their patients in the “health care organization or community.” They are an asset to the recovery process, as they can in some sense be a voice for the voiceless. (DiNitto & McNeece, 2008, p. 204).
  7. The main goal of social work within the medical practice is to ameliorate the health of people through one of the most mediums – communication. Social workers will interact with individuals, their families, organizations, communities, nations, and global structures. It is evident that social workers are a very necessary ingredient in the health care system – especially considering the emotional, physical and financial tolls dealing with diseases/illnesses can entail. (DiNitto & McNeece, 2008, p. 214)

 

Sources:

DiNitto, D., & McNeece, C. (2008). Social work: Issues and opportunities in a
challenging profession (3rd ed.). Chicago, IL: Lyceum Books

10 Interesting Facts About Medical Social Work Everybody Needs to Know

1. Medical social workers employ three different types of practice. The three are: the multilevel practice, the strengths perspective, and the biopsychosocial practice. (DiNitto & McNeece, 2008, p. 200)

2. Ida Cannon launched the field of medical social work, in 1907, at Massachusetts General Hospital. She was hired by Richard Cabot who had identified a need in the medical field: someone to identify with patients on a more intimate level. Thus, medical social work was born.(DiNitto & McNeece, 2008, p. 194)

3. Approximately 141,000 people work in the medical social work field, according to recent estimates. (J. Vassello, personal communication)

4. Medical social work was the first specialization within the social work field. (DiNitto & McNeece, 2008, p. 203)

5. There are job opportunities in all three levels of social work in the medical field. Micro practice social workers usually provide counseling to patients, and assists with discharge and case management. Mezzo practice social workers usually work within the community and educate others about health related issues and needs. Macro practice social workers usually work on funding, advocating, and research issues in the medical field. (DiNitto & McNeece, 2008, p. 204)

6. There are also many places to work while in the medical social work field. Job applicants can choose from opportunities in primary care, the VA, dialysis centers, hospitals, nursing homes, hospice, or many other specialized care facilities.   (DiNitto & McNeece, 2008, p. 206-211)

7. Medical social workers are more likely to work in metropolitan areas, rather than small towns. (Facts about Social Work and Health) This is probably because there are more job opportunities in these types of areas, and bigger hospitals have the budget to hire social workers, whereas smaller hospitals in small towns may not. (J. Vassello, personal communication)

8. The medical social work field is ever changing, and there is currently a shortage of medical social workers. So, if you are in the job market, this could be a great choice for you! (Facts about Social Work and Health)

9. The average annual wage for medical social workers, as of 2015, is about 54,000. this breaks down to about $24.00 an hour! (Healthcare Social Workers, 2015)

10. California, employs the most medical social workers in the country, with approximately 14,000 people. New York has the second highest employment rate, at approximately 12,000. Massachusetts is a close third, coming in at 11,000 medical social workers. (Healthcare Social Workers, 2015)

Sources:

DiNitto, D., & McNeece, C. (2008). Social work: Issues and opportunities in a
challenging profession (3rd ed.). Chicago, IL: Lyceum Books
Facts about Social Work and Health. (n.d.). Retrieved March 01, 2016, from https://www.socialworkers.org/pressroom/swMonth/2007/facts2.asp
Healthcare Social Workers. (2015). Retrieved March 01, 2016, from http://www.bls.gov/oes/current/oes211022.htm
Vassello, John. Personal communication. March 1st.

7 Ways Social Workers Work in Health Care- Carly Danowitz

  1. Hospital social workers usually take the role of direct patient care, which includes discharge planning activities, coordinating community support systems, relocation of patients, assisting patients and the families understanding their diagnosis, and crisis intervention/counseling services. (Judd & Sheffield, 2010, p. 863-864)

patient

 

  1. Low health literacy is associated with poorer health outcomes and worse quality of care. (Liechty, 2011, p. 99)

over head

 

  1. More and more managers in hospitals are obtaining degrees in fields other than social work, which makes it necessary to learn how these managers understanding of professional abilities, skills, values, and ethics effect the opportunities for hospital social workers. (Judd & Sheffield, 2010, p. 867-868)

andy

 

  1. Hospital social workers are able to design programs that focus on wellness and health education, and can work with employers to afford financial coverage for these programs to be provided to employees. (Judd & Sheffield, 2010, p. 868)

health

  1. Social workers have the ability to help patients and families increase their health literacy knowledge by performing casework interactions and counseling to ensure patients receive the right information, which they can also understand. (Liechty, 2011, p. 104)

counseling

 

  1. Social workers can lead initiatives to increase health literacy in hospital settings such as implementation of plain language (instead of using medial terminologies) in diagnoses and explanation of diagnoses, hospital staff training in health literacy, screening of patients for low health literacy, and referrals to patients of low health literacy for counseling and assistance. (Liechty, 2011, p. 105)

words

 

  1. Medical social work incorporates a psychological perspective, fueled by insurance reimbursement, and case management, including discharge planning, that has been driven by cost controls and managed care. (Di
    Nitto & McNeece, 2008, p.195)

psych

 

References:

DiNitto, D., & McNeece, C. (2008). Social work: Issues and opportunities in a challenging profession (3rd ed.). Chicago, IL: Lyceum Books.

Judd, R., & Sheffield, S. (2010). Hospital Social Work: Contemporary Roles and Professional Activities. Social Work in Health Care, 49(9), 856-871. doi:10.1080/00981389.2010.499825

Liechty, J. (2011). Health Literacy: Critical Opportunities for Social Work Leadership in Health Care and Research. Health & Social Work, 99-107.