Social Work Crisis In Our Hospitals
Healthcare in America has its share of problems these days. An increasing number of people are without insurance, health care costs are soaring, many working people are losing their benefits, and hospitals, particularly in New York, are under increasing financial stress. Everyone who works in the health care field is affected by these negative trends, but the social work profession is being hit especially hard. Traditionally, the hospital social worker helped patients to better understand and manage their illness and the changes that resulted in their daily lives. The social worker helped to shorten the patient’s hospital stay and allowed the patient to go home with dignity with most of the available supportive community services needed. The social worker did much of this by being at the center of discharge planning. 
“Without a defined social work department...hospital social workers today have no sense of a professional community where they can work collaboratively on providing quality social work care to our patients.” |
But times have changed and the scope and practice of traditional social work services are being marginalized and devalued. For years, hospital managements have employed “RN Case Management” models, resulting in the dissolving of social work departments, and social workers reporting to RN’s instead of their own profession. Hospitals are focused on reducing the length of stay of the patients, with little or no concern for all the needs of patients that social workers are trained to identify and address. This creates problems for both our patients and the social workers. Many patients in our community hospitals have more complicated and complex problems beyond their individual illnesses, related more to their environmental and psychosocial needs. Addressing these concerns to allow the patient to remain safely in the community with supportive services requires comprehensive discharge plans that are often outside the scope and knowledge base of the RN case manager. This is especially true with shrinking community services available to our patients. The hospital social worker has the expertise and knowledge about how to access community services and navigate the community based referral system that best suits the patient’s healthcare needs outside of the hospital and allows the patient to remain at home. Without a defined social work department, headed by an experienced and seasoned social work supervisor and/or director, hospital social workers today have no sense of a professional community where they can work collaboratively on providing quality social work care to our patients. The opportunities for additional on-the-job training and direct social work supervision are also gone, leaving less experienced social workers isolated and disconnected from their colleagues. Social workers find themselves depending for guidance on healthcare professionals who have limited expertise and knowledge of social work practice. These are difficult problems but 1199SEIU is starting to address them. Together with NASW, the Union has commissioned a Joint Committee to deal with the various aspects of the crisis in hospital social work practice. The Committee, consisting of two experienced 1199SEIU line social workers, and current and retired hospital social work administrators from both the public and voluntary hospitals, has been meeting on a regular basis since January to identify and analyze many of the factors contributing to the crisis. The goal of the Joint Committee is to develop a strategy to redefine and reclaim our vital role within the hospital, with a view towards a City Council Hearing being convened sometime in the early Fall. Our Union is also forming a hospital-based Social Work Sub-Committee to address the ongoing crisis. If you are interested in working on the Social Work Sub-Committee, please contact Cynthia Wolff, ProTech Specialist at either (212) 261-2368 or Cynthiaw@1199.org. Your comments on both this article and your hospital social work experience are needed and welcomed as we move forward together to address this crisis in the practice of hospital social work.
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