About Social Services at a Hospital

Medical social work is an expansive field, encompassing areas such as hospice, home health, skilled nursing, and acute hospitals. After a few scary moments in home health, I've decided to stay in the acute setting until I experience complete medical social worker burnout.

Though considered a specific area of practice, hospital social work is actually relatively broad. Social services departments vary in function from hospital to hospital, with individual social workers performing correspondingly diverse roles. I've found that certain tasks I perform at one hospital might be performed by a completely different profession at another, or just omitted entirely.

When asked what I do at work, I often have a hard time explaining due to the variety of tasks I perform every day. However, after some thought, I've manage to divide my roles into five categories. These categories are not mutually exclusive, and some hospitals may not even have social workers performing tasks in all of them.

Assessing
The psychosocial assessment is fairly universal not only in medical social work, but the social work field as a whole. Obtaining information on someone's health, mental status, social environment, and living situation prior to admission helps to provide a more holistic picture of a patient, instead of simply focusing on the admitting diagnosis. From here, social workers can determine if patients have needs for discharge planning, community resources, and/or end-of-life support.

Discharge Planning
The purpose of discharge planning is to ensure patients leave the hospital safely, so as to reduce the probability of readmission. Discharge planning is the role that most often overlaps with that of RN case managers and discharge planners. It is also one of the more time-consuming ones due to the paperwork required and the importance placed on it by the hospital administration, which is keenly interested in keeping costs down. Discharge planning is the role many social workers consider the most frustrating, as they feel that they didn't pursue masters degrees to perform "secretary work".

Discharge planning tasks include the following:
-Arranging skilled nursing placement for patients
-Arranging home health services for patients
-Ordering durable medical equipment for patients
-Arranging transportation to a skilled nursing facility or home
-Arranging follow-up appointments with medical doctors
-Copying/faxing patient charts to complete the aforementioned tasks
-Pulling strings, performing magic tricks, and making miracles happen so that a patient discharges safely and in a timely manner

Counseling
Social services give emotional support to patients and their families during hospitalization. Situations social workers may face include the following:
-Helping patients adjust to new illnesses/diagnoses
-Helping patients cope with chronic illnesses
-Supporting patients who are dealing with mental illness
-Counseling patients with substance addictions
-Comforting patients and family members in crisis situations

Providing Community Resources
Patients often do not know what community services are available to help them. This is especially the case for new parents and the elderly. Hospital social workers are well-versed in local community agencies and can provide information on the following:
-Applying for government assistance (Medicare, Medicaid, SSI, etc.)
-Low cost medical clinics
-Discounted prescription medication
-Caregiver assistance
-Board and care/assisted living placement services
-Resources for new parents
-Community support programs for seniors
-Food banks
-Homeless shelters
-Support groups for cancer/substance use/grief/etc.
-Paratransit

In some cases, social workers may also refer patients to the following agencies:
-Child protective services
-Adult protective services
-Public guardian (for conservatorships)
-The police

Addressing End-of-Life Issues
End-of-life is a sensitive topic that most medical professionals - including doctors - have difficulty discussing with patients. As a result, social workers are often called on to do the following:
-Participate in hospice/palliative care team consultations
-Arrange hospice care
-Educate patients on advanced healthcare directives

Hopefully this post provides a decent breakdown about social services in a hospital setting. While social workers at different hospitals may vary in function, their purpose in providing compassionate psychosocial assistance to patients remains universal.