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| Article by: | |
| Pat Stricker, RN, MEd | |
| Senior Vice President | |
| TCS Healthcare Technologies |
Congratulations to all our Social Work Case Managers!
March 16th was World Social Work Day, and the month of March is dedicated to celebrating the Social Work profession!
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The theme for Social Work Month 2021, as identified by the National Association of Social Workers, is “Social Workers Are Essential.” That is definitely true this year (and last) during the pandemic. Social workers were essential workers, just like the physicians, nurses and other clinical care providers who worked as valued members of the care team. It would have been difficult to manage the overwhelming numbers of critically ill patients without the assistance of social workers. In some instances, social workers who worked in ICU or COVID-19 units took on immense workloads, handling some of the referral, resourcing, communication, and discharge planning tasks that nurses would normally do. They also worked closely with families who were unable to be with their loved one in the hospital. Whether you worked in hospitals, care facilities, or community agencies, “Thank You” for the help you provided during this extremely stressful time. You were an integral part of the case management team, as always.
Social Work History
Social work has been around since the Middle Ages, when church-based care was given to the poor, which led to social justice and philanthropic movements in the 19th century. The social work profession is said to have begun in the United States over 120 years ago, when the first social work class was given at Columbia University in 1898. The development of professional social work and publicly funded human services followed, with social workers and public health nurses providing care for the poor, coordinating services, and trying to contain healthcare costs. This was prior to any organized government role in the delivery of these services.
The first hospital-based social work program began in 1906 at the Massachusetts General Hospital. In the 1920s, the need to manage chronic illnesses in psychiatry and social work increased, and house calls became commonplace. Then in 1932, the Social Security Act established a major role for the federal government in meeting human needs, bringing together several different programs (e.g., public assistance, social insurance, maternal and child health). Following World War II, insurance companies began to employ social workers and nurses to coordinate care for soldiers with complex injuries requiring multidisciplinary interventions. In the 1960s, federal legislation moved to strategically target problems by coordinating services and focusing resources. Medicaid and Medicare demonstration projects in the early 1970s created separate social service agencies, resulting in a delivery system of separate bureaucracies. Attempts were then made to establish programs that would integrate services. These programs usually employed a social worker to arrange and coordinate health and social services.
National Association Social Workers
The National Association of Social Workers (NASW) was founded in 1955 and is now the largest membership organization of professional social workers in the world, with more than 120,000 members. It has an international chapter and chapters in all 50 States, plus Puerto Rico, Washington D.C., Guam, and the Virgin Islands. There are more than 3 million professional social workers worldwide and more than 700,000 professional social workers in the U.S. Ninety-three percent (93%) of the members have some type of license, certification, or registration in their state, and 70,000 hold advanced credentials from NASW.
NASW defines social work practice as “applying the values, principles, and techniques" of social work to achieve one or more of the following: “helping people obtain tangible services; providing counseling and psychotherapy with individuals, families, and groups; helping communities or groups provide or improve social and health services; and participating in legislative processes." In addition, NASW says the professional social worker “assesses the needs of the client and the client’s family, when appropriate, and arranges, coordinates, monitors, evaluates, and advocates for a package of multiple services to meet the specific client’s complex needs.” The social worker’s education, philosophy, and code of ethics enable them to work independently on behalf of their clients, as well as work cooperatively as a member of a clinical team. These attributes allow social workers to focus on the needs of the whole person, creating a holistic approach.
The following provides a high-level view of just some of the tasks and functions that social workers perform, especially as they relate to case management:
Social Workers’ Roles During the Pandemic
Social workers are on the front line of providing services to patients in hospitals and other healthcare settings. However, during the COVID-19 pandemic, work tasks and responsibilities were changed for many members of the healthcare team. Some workers who were not “essential” were told to work remotely or were assigned to other outpatient facilities or clinics that did not deal with COVID-19 patients.
At the height of the pandemic, healthcare workers who were assigned to direct patient care areas of the hospital were working long hours under extremely difficult situations. With extremely high volumes of critical patients, normal standard processes and procedures were not always able to be followed. For example, it was not possible to have a full, standard admission assessment on each patient. Patients needed to be assessed immediately for critical needs, and the formal procedures needed to be abbreviated due to the patient volume and seriousness of the patients. There was no time for lengthy, detailed documentation and updating of care plans. Documentation needed to be abbreviated to include just critical, necessary information.
During this time, physicians, nurses, and other clinical team members were being transferred to the COVID-19 patient care areas to help augment the normal staff due to the overwhelming influx of patients. And in some instances, social workers were also asked to work in the ICU, ED, or COVID-19 units. Others volunteered to do so, because they knew staffing levels were critical and they felt the need to help in any way they could. All levels of staff were going above and beyond.
Workers were asked to expand their duties and assist with or take over tasks normally done by other team members. For example, because the nurses were totally involved in the physical care of the patients, social workers were asked to essentially handle most of the non-nursing processes: documenting discharge plans; talking with family members; finding a rehab or nursing care facility and arranging the transfer; assisting with financial needs; assuring medications and other needed items were arranged; and communicating with the care facility. Even though many of these tasks are typically handled by social workers in normal times, there was much less involvement from nurses during this time period.
Social workers were also keeping patients, families and the healthcare team connected by acting as a liaison between the clinical staff and the family; arranging phone calls or coordinating video visits between patients and family members, if possible; assisting with financial and “paperwork” that family members would normally have done if they had been there; educating the families and answering questions about the patient’s care; finding resources and facilities; making referrals to care facilities; holding the hand of patients who were alone in their dying moments; and in some cases, helping family members with funeral arrangements.
Others social workers working in nursing homes or other care facilities were also overloaded with the high caseload of ill patients. Social workers working remotely or in community settings worked tirelessly to meet the needs of the clients after discharge:
Social workers in community agencies were handling crisis calls regarding rape, domestic violence, drug addiction issues, and other mental health issues. The number of these types of calls were down at the beginning of the pandemic because: victims were unable to find ways to connect with the hotlines; police were not taking reports (asking people to report online, if not an emergency); victims could not get out of the home situation due to financial issues and fear of COVID-19; and police and courts were overwhelmed and unable to provide protective orders, etc. However, the number of cases actually increased and even got worse later on due to increased stress levels and isolation. Abuse, alcohol and drug addiction, gun violence, depression, homicides, and suicides all increased as the pandemic wore on. These will definitely be major issues after the country gets back to some sense of normalcy.
Social workers also worked within communities to assist low-income individuals and the homeless to find resources, food banks, medications, shelter, and other basic needs. Social workers were also working in school systems to help obtain resources (computers, internet services, etc.) for children and provide counseling and stress reduction techniques for parents as they tried to handle their jobs from home, as well as manage each of their children’s school assignments.
In addition, social workers were also providing emotional support, resources, and critical stress management debriefings for their team members who were struggling because of the day-to-day situations they were facing.
Social workers continued to perform their work with clients, organizations, and other staff members in a professional manner, even though they often did not have proper personal protection equipment (PPE), which put themselves, and their loved ones, at risk for COVID-19. Yet, despite all that they did, they were often overlooked by the media for any praise and recognition.
Social Workers’ Roles After the Pandemic
Social workers are bracing themselves for when the stay-at-home orders are lifted and they will have to contend with a massive influx of clients who are now suffering silently and those who will be seeking care for delayed physical and mental issues that could not be cared for during the pandemic. Yet they will be faced with even less available resources due to cuts in staffing and funding.
However, social workers will be instrumental in helping individuals rebuild social connections and adapt to life after the pandemic. Their person-centered approach and unique skill-set make them valued members of interdisciplinary team. Social workers are not only “essential” workers, but vital workers who deserve to be recognized for all that they do.
We saw what you did and what you are continuing to do and we “Thank You”!
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CMSA’s Virtual Conference and Expo
The CMSA 31st Conference and Expo will be held
from June 7-10, 2021. The theme for this Virtual
Conference is “Staking a Claim in the New World”.
This is just a quick reminder for you that the conference information is ready for you to review on CMSA’s website. More detailed information about the conference offerings and fun events will be discussed in next month’s newsletter article.
Early registration is open now and members can save $100, if you register prior to May 2.
The conference schedule is also available. The Opening Keynote session and Concurrent sessions begin on June 8. Some of the sessions are still being finalized, but there are diverse sessions across a wide variety of topics and settings. You will also notice there are morning Yoga sessions, an Opening Reception, and an evening Cocktail Hour. Check out the schedule and click on individual concurrent sessions to see more detail about each session.
The conference provides an opportunity to obtain up-to-date information from industry experts, a chance to interact with exhibitors, and numerous networking sessions so you can communicate with your peers from across the country. If you have never attended a virtual conference, I would highly recommend that you consider doing so. It is truly an interesting and motivating experience.