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Hospice: 10 Things Patients and Families Need to Know

Hospice is a care philosophy that focuses on maximizing the quality of life as opposed to the quantity of life. Hospice may include services such as medication/pain management, medical care, spiritual care, and social services. 
As a medical social worker, my job is to handle all aspects of hospice discharge planning. This includes connecting patients to a hospice agency, ordering equipment, providing resources on care facilities (i.e. board and cares, assisted livings, non-medical custodial nursing homes), and arranging transportation for hospital discharge. Additionally, I provide support to patients and family members during an stressful and emotionally draining process.
What's not publicly discussed about the hospice process is the immense pressure put on hospital employees to discharge patients quickly and efficiently. Insurance companies only pay if hospitals can medically justify a patient's stay. Once a patient goes on hospice, there is no reason for that person to be …

My Social Work Values

I originally wrote this short post regarding my social work values several years ago but never published it. I'm publishing it now to remind myself that despite how burned out I feel, I am and will fundamentally always be a social worker at heart.

Sometimes, I feel so burned out by my job that I can't help but feel apathy about my patients and the social issues affecting society. During these times, I wonder if I still have the social worker mindset and belong in the social worker profession. Then, I interact with the people around me and am starkly reminded that deep down, I'm still a social worker. If you feel infuriated by any of the following, then you probably are too!

Retelling a story about a patient and having the first response be, "That person was black, right?"  Being told that mental illness is "just in someone's head" and that they simply need to "snap out of it". Being told that people who attempt/commit suicide are "b…

Inpatient vs. Outpatient Status: How It Can Bankrupt You

This post is about hospital Inpatient versus Outpatient Status, the difference between the two, and how being categorized as one over the other can result in costly medical expenses. While this content pertains mostly to individuals on Medicare, I feel everyone should know this information in the event they or a loved one are hospitalized.

Inpatient vs. Outpatient Status: How it Can Bankrupt You One of my least favorite parts of being a hospital social worker is being the bearer of bad news. On a typical day, I'll have numerous conversations with patients telling them that their equipment, transportation, and/or post-hospital care is not covered by their insurance. Telling patients that they're liable for up to thousands of dollars in medical expenses is not exactly what I had in mind when I became a social worker.

When it comes to talking to patients about what's not covered, the most infuriating and confusing expenses often stem from whether a patient was admitted to th…

Pinterest Group Board for Social Work Bloggers

Recently, I learned of Pinterest Group Boards and how they allow for communities of like-minded people to share pins with one another. Given the lack of places where social workers can gather to share their blog posts, I've decided to go ahead and start a Pinterest Group Board specifically for social work bloggers: Social Work Bloggers
To be added to this group, you'll need a Pinterest account and I'll need to know your pinterest name. You can either post it here, DM it to me on twitter (@CheapMSW), or email me at
There are so many talented people in our profession. My hope is for this group to grow and become a centralized place where social workers and anyone interested in social work can share and learn from each another.

Racial Profiling of Patients By Healthcare Providers

I hate having to write yet another post on discrimination against patient by healthcare providers, but I think it's important.

Recently, I was called to investigate an abuse incident. The only evidence based on chart review and talking to the staff was "the nurse heard the family member yelling at the patient". As a result, this family member was essentially banned from seeing the patient, who was confused at the time.

To avoid violating HIPAA, here is a super abridged version of what happened next:
-The family member returned to the hospital asking for the patient's location and an explanation for the ban. I received a phone call from the nurses station, claiming that the family member was on the verge of aggression.
-I was with the family member in minutes, and the person was completely appropriate with me. The family member acknowledged speaking loudly due to the patient's confused behavior and seemed apologetic. The explanation was sound, and added details no…

A Day in the Life of a Medical Social Worker

One of the problems of being a medical social worker in a hospital is that my work is so varied that people get confused as to what I actually do! To give you a better idea of my job functions, here's a rundown of a typical day at work. At some point, I may write different versions based on what unit I'm working on and what model of social work the hospital uses. For a comprehensive overview of the medical social work profession, please go here: About Social Services at a Hospital
A Typical Day in the Life of a (not so) Cheap Medical Social Worker

 6:20am: Alarm clock goes off. I hit the snooze button.

6:30am: I drag myself out of bed, wash up, throw some clothes on, and slap my makeup on my face.

7:00am: I run out the door and proceed to sit in traffic for the next hour.

8:00am: I arrive at work, clock in, and head to my desk to print out the hospital census. After figuring out who all the new patients are, I go through each one to determine if they need to be "trigge…

Discrimination Against Patients by Healthcare Providers

Recently, I was speaking to a nurse (whose identity will remain anonymous for her sake) regarding President Donald Trump's travel ban on seven Muslim majority countries. This nurse is an immigrant from another country and has been working in the United States for roughly 30 years.

This nurse expressed her support for the travel ban against Muslims, saying that it's "for the better". Her support was not based on any fear of terrorists. She stated that having been a nurse for 30 years, she's encountered a number of people who come to America and "mooch" off the system. With regards to the seven banned countries, she stated that she's had a number of "birth tourist" patients whose purpose is to give birth to American citizen babies and take advantage of the system. She described the patients as "demanding", "knowledgeable of the system", and not knowing how to speak English. In her opinion, banning Muslims would prevent th…