A common misconception I must deal with regularly in my professional career, is that social workers only work with abuse and the removal of children who needs care.
Social workers employed in a hospital environment however play a very important role in assisting patients and families to address the impact both illness and treatment have on their overall functioning (Social work …, [sa]).
Admission into hospital, whether it is planned or sudden, can be very stressful. This is often accompanied with, for example: a loss of control; information overload; change in functional ability and financial strain (Barello and Graffigna, 2015; Social work …[sa]). The latter can all lead to several emotional responses, such as: anxiety; anger or depression. The social worker thus has a responsibility to assess and identify appropriate interventions that can address those factors impacting negatively on a patient’s overall functioning. It is thus the understanding that social work as a profession plays a very important role in optimising the benefit patient and families receive from their treatment and ensuring that the transition of care is appropriate, safe and effective (Social work …, [sa]).
A social worker can have several responsibilities within the hospital environment. Some of them may include: assessment, identification of problems areas, working with the client to find solutions for identified problems as well as the evaluation of the designed treatment plan. The vision is for the patient to achieve optimum psychosocial functioning (Social work …, [sa]). This is achieved by: mobilising existing strengths, supporting the patient’s ability to cope, addressing dysfunctional behaviour patterns, linking the patient to community resources, minimising environmental stressors and providing psychosocial education related to a patient’s overall wellbeing (Social work …, [sa]). It is very important to note that the social worker alone cannot take responsibility for this process. A positive improvement of a patient’s perception of themselves and that of life as well as being empowered to achieve their life potential can be directly linked to a patient engaging in their own health care. resulting in a good quality of life (Barello and Graffigna, 2015).
As indicated above, the social worker within the hospital environment, can have several responsibilities. The paragraphs below will describe in more detail, what these entails.
- Psychosocial assessment
The purpose of the psychosocial assessment is to conduct a needs analysis and identify potential problem areas. The psychosocial assessment can further assist the social worker to identify a patient’s strengths, coping abilities as well as support network that can be used to address the areas of concern (Social work …, [sa]).
During counselling or therapy, the social worker assesses the impact, for example: social, cultural and emotional factors, have on patient’s behaviour as well as their health. The therapeutic process aims to address areas of concern by processing them, and then identifying and implementing suitable intervention strategies. A further goal of therapy is to improve a patient’s ability to cope with incoming stressors, such as loss or grief (Social work …, [sa]).
- Patient/family education
As indicated before, not only the hospital admission creates anxiety, but also the diagnosis, treatment process as well as what happens after an admission.
It is therefore very important that the social worker focusses on educating the patient and his/her significant others on the hospital process, the impact the illness has on everyday life for example relationships and on possible lifestyle adjustments, should it be indicated due to the diagnosis (Social work …, [sa]).
- Resource counselling and discharge planning
A big responsibility in the day to day activities of a social worker is to identify and address potential discharge barriers, and together with the team, minimise potential readmissions (Social work …, [sa]). The literature indicates that social workers are equipped to assist in preventing hospital re-admissions. They have the ability to ensure that the different role players have addressed the patient’s needs upon discharge, that the discharge instructions are understood and that systems are in place to ensure that these instructions are followed (Andrews et al., 2013, p. 67). Areas of importance may include education on the diagnosis, treatment plan, medications, medication side effects, potential warning signs that may indicate deterioration in condition and contingency plans (Aboumatar et al., 2014, p. 522).
Not all patients can however be discharged home directly from hospital. Some may require an interim placement, such as a sub-acute facility or physical rehabilitation unit. Others need a direct transfer from hospital to a long-term care facility such as an old age home.
Within the care transition, it is important that the social worker prepare the patient and his/her significant other emotionally for the transition (Social work …, [sa]).
- Supportive care to outpatients
By assisting the patient to identify and utilise appropriate resources as an outpatient, the belief is that it can enhance compliancy with regards to the prescribed treatment plan (Social work …, [sa]).
With insight into the responsibilities of a social worker, it is important to understand when a patient should possibly require a referral to the hospital social worker.
A patient may require the services of a social worker if:
- A patient has suffered a significant loss or is expected to make life impacting changes, due to for example: a life threatening diagnosis has been made; the patient does not have the ability to complete normal functional activities independently; the patient’s mental ability has been compromised negatively; or the patient is batting with an unknown diagnosis (Social work …, [sa])
- When the patient presents with inappropriate behaviour such as violence or anger outbursts and the professional team is concerned that the patient’s ability to deal with health changes are compromised (Social work …, [sa])
- When there are concerns that the patient does not have access to a suitable support network or appropriate resources that are required to ensure a safe and effective transition (Social work …, [sa])
- When the patient or family’s ability to decide and implement their long-term care decisions are compromised (Social work …, [sa])
Literature indicates that a social worker does not only add value to patient care, but can also be beneficial to the functioning of a health care facility, for example:
- Risk Management: The ability to conduct a comprehensive psychosocial assessment and appropriate follow up, enables the social worker to communicate effectively, thus addressing potential conflict or complaints (social work …, [sa]).
The social worker has personally observed that the ability to coordinate a patient care and creating a link between the family and the medical team, not only manages the family’s expectations, but also ensures that all parties involved are up to date with regards to the patient’s care
- Program development: Social workers are trained to use their initiative and think different from the norm. This enables them to assist in developing and evaluating appropriate programs within the institution (Social work …, [sa])
- Community linkages: Social Work has a strong ability to network and can compile a resource list that can be utilised to the benefit of the patient
- Research: A social workers skill set, can be appropriately utilised during research projects that are aimed towards, for example addressing psychosocial aspects related to a specific illness (Social work …, [sa])
- Teaching/Education: Many social workers have a strong teaching ability, and this can be used in the training of staff, but also to speak at workshops and conferences (Social work …, [sa]).
From the above paragraphs, it can be concluded that a social worker has much more to offer than just dealing with social issues such as abuse or removing children in need of care.
List of references
Aboumatar, H. et al. (2014) ‘Focus on Transitions of Care’, American Journal of Medical Quality, 29(6), pp. 522–529. doi: 10.1177/1062860613507330.
Andrews, C. M. et al. (2013) ‘Social Work and Implementation of the Affordable Care Act’, Health & Social Work, 38(2), pp. 67–71. doi: 10.1093/hsw/hlt002.
Barello, S. and Graffigna, G. (2015) ‘Engaging patients to recover life projectuality: an Italian cross-disease framework’, Quality of Life Research, 24(5), pp. 1087–1096. doi: 10.1007/s11136-014-0846-x.
Social work in hospital-based health care. [Sa]. Available: https://www.wrh.on.ca/Site_Published/wrh_internet/DocumentRender.aspx?Body.IdType+5&Body.Id=22232&Body.GenericField= (Accessed 2018/11/24)