Take off the blinders, social workers advised
Health care administrators often make decisions — such as downplaying, or even eliminating the role of social workers — at a level that is out of the caregiver’s sphere of influence. Your job may be eliminated, and there may be nothing you can do about it, says Kim Fuller, ACSW, director of social work at Research Hospital in Kansas City, MO.
On the other hand, suggests Fuller, president of the Missouri-Kansas Chapter of the Chicago-based Society for Social Work Leadership in Health Care, there are ways in which social workers can position themselves in as positive a light as possible, in case such drastic measures are avoidable. "Social workers have long had limitations in doing some of the research and publication that are more common [in the nursing field] and in coming to the table and saying, These are the things we add to the bottom line.’"
Because social work is more of a "soft science" in many ways, Fuller adds, it is difficult to quantify the interaction between social worker and patient. "The first time a person enters a nursing home, for example, a social worker — who is often master’s prepared in a curriculum that really focuses on human behavior — comes to that interaction with a rich repertoire of skills.
"Working from the clinical side, in this case clinical’ meaning psychosocial, the social worker can move to a decision that is better for the patient and the family," she says. "That is as opposed to the medical model, which tends to be much more outcome-focused, as in, We need to get this bed opened up.’"
Both approaches are necessary, Fuller says, but hospitals have been less likely to see social work as having measurable, positive effects on the bottom line. To remedy this, she advises, social workers need to educate themselves about the financial side of their organization.
"Don’t just have the blinders on, and say, I’m here to work with the patient, and that’s the only thing I care about,’" Fuller says. "Find ways to quantify and measure the contribution you’re making, even in some fairly simplistic ways. Do outcome studies and provide the data to administrators. Show that because of early identification of the patient’s needs, you were able to facilitate nursing home placement and reduce the length of stay. These are things that don’t necessarily require you to be a statistician."
Although social workers traditionally have been reluctant to think in those terms, she says, they should become more willing to articulate their contributions. Committee memberships, Fuller adds, are another way to demonstrate the breadth of one’s skills.
"Gaining more credibility in a general sense," she says, "might get you factored into decisions that are being made."
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