Introduction
Peterborough, New Hampshire: A typical day for a hospital social worker may begin on the Intensive Care Unit with her trying to help a patient who attempted a drug overdose and is willing to stay in the hospital for psychiatric treatment as recommended. It's the social worker's job to find the patient a place to receive treatment and finding an available spot for can be time consuming and difficult. Many psychiatric facilities are often fully booked and cannot accept new patients.
First, the social worker contacts the patient's insurance company to get pre-certification for the psychiatric hospitalization. Next, she contacts local psychiatric intake departments to check if they can accept a new patient. Later, she will discuss the options with the patient and the family. The entire process of securing a place for the patient takes hours.
The social worker may then assist another Intensive Care Unit patient' s family with end-of-life decisions. The social worker will provide them with emotional support and talk to them about helpful resources they may know nothing about such as the hospital's Financial Grant Program or the Medication Assistance Program.
Next, the social worker may meet with another family to discuss changes in level-of-care required for their parent with dementia. This time she will help a family find a nursing home.
A Patient With Dementia
The social worker discusses the family's options, which may include information on how to obtain a Durable Power of Attorney for Healthcare or a legal guardian. (A Durable Power of Attorney allows you to appoint an agent to make health care decisions if you are unable to do so. A legal guardian is appointed by a judge to oversee an incapacitated person's affairs.)
By late morning the social worker heads to another ward in the hospital to see a post-operative 67-year-old gentleman who had a hip replaced and therefore, may require in-home services upon discharge. He is the caretaker for his wife, who has dementia. A family meeting with his daughters is arranged for the following morning. Topics to discuss include:
- Can the father be driven to outpatient rehabilitative services or will he require physical therapy in the home?
- Will he require meals on wheels?
- Will the mother need adult day care?
Before the social worker completes her psychosocial assessment for this family, she
receives a page. The Emergency Department needs a psychiatric consultation for a patient.
A Suicidal 16-Year Old
In the Emergency Department, the social worker assesses an actively suicidal 16-year-old Cambodian boy in the Observation Room. The young man's English isn't very good so his consultation with the social worker is translated via a telephone language line. The social worker then discusses her concerns with the teenager's mother and aunt. She also confers with the Emergency Department doctor and nurses, and determines that an in-patient hospitalization is required for the young man.
Next, the social worker confers with the covering psychiatrist via telephone and proceeds with the same placement procedure she used for the Intensive Care Unit patient at the start of the day. Unfortunately, the Cambodian teenager is becoming frustrated with all the waiting. Three hours and four intake-reviews later with area psychiatric units, a hospital agrees to accept the teen.
A Pregnant Teen
By mid-afternoon, the social worker is off to the Obstetrics/Birthing Unit. A six-months pregnant teenager has been sent directly from her doctor's office for admission for fetal monitoring. Her parents are quite distraught and she's upset, too. She's thinking about adoption for the baby. The social worker meets with the parents and teen to provide support and gives the family information about local adoption agencies.
At the end of the day with direct patient care complete, the social worker returns to the Social Services Office. Each social worker has to write-up statistics for the day's work, answer calls from facilities and patient families involved in the coordination of her patients' care, complete documentation of her work, and prepare for tomorrow.
hello im interested in this field. i was wondering what the pay scale is for a social worker working in a hospital
It ranges if its county starts @ 58,000 if you have a MSW. Other hospitals like kaiser between 61 to 63,000.
I am a social work student looking to do a research paper in hospital social work, I was wondering what are a couple issues/problems that social workers have to deal with in this line of work?
those numbers I would say are for larger cities. In a small city in a rural area you are looking at $33,000 to $45,000 for a MSW.
I agree with Colleen on the reality check for salaries in rural Social WorK. This article is right on as far as a day in the life of a rural Social Worker. I am an MSW in a rural 40 bed hospital and 6 bed ED department. This is just half my job, i also work the home health and hospice social work duties. However I LOVE IT and wouldn’t trade the variety for the world.
Hello, I am going to school in hopes of one day becoming a social worker. I was wondering what is the best educational route to go, some goods schools in CA and who to contact to get me informed and educated as much as I can about the job? Thanks!
I have worked in that field for 10 yrs. You will top out at @ 45k with HCA HOSPITALS.
nursing has no respect for social workers in hospitals. Remember you are not medical and are therefore in THEIR world. You are expendable. To survive you MUST KEEP YOUR MOUTH SHUT. Even when you see wrong being done.Shut up. Never trust anyone or especially never trust administration. 20 years of this crap teaches you that. Also pedi nurses live in a fantasy world so just give them what they want and don’t bother trying to help them understand that you can’t get everything for that baby and mother. Just go through the motions and make them think your fantastic. Chart and cover your ass in everything.
Wow, Victor. You should find a new job. You sound burned out.
Haha. I have to agree with Mary, this guy Victor needs to find a new job; or maybe some case management? Let’s just hope that Victor does not work in mental health. Whatever happened to the social work ethics. Also, what ever happened to dialauge and deliberation? Victor just sounds like a [xxxx].
I agree with the above rural hospital politics. NO ONE understands the role of the social worker and/or scope of practice and education. I need advice on convincing administration that a BSW, MBA HCA – business administration in health care – cannot successfully direct a social work department with 2 MSWs and 3 BSWs. She does not understand that MO DHSS requires a social worker to meet all social work needs of patients (BSW is not able to meet all the needs due to limited scope of practice, unable to work with clinical issues and emotional disorders and cannot do psychotherapy). She only understands that discharge planning requirement which does not distinguish between SW/RN to complete this requirement. I am seeing her ignorance as a manager due to not knowing the difference between BSW/MSW and she is doing things and advising social workers to do unethical things such as having dual relationships. I don’t know what to do?
While not as cynical as Victor, I too feel that it does seem that medical professionals have a “fix it” mentality and one may feel inadequate as a social worker if a resource isn’t readily available. You quickly learn that sometimes bandaids are ok, as long as the problem goes away. It can be a rewarding work environment or depending on the culture of the hospital very unrewarding. Luckily I’m employed with a hospital that values social work and I’m able to do perform comprehensive social work services to the patients I serve.
Hospital social work is a most difficult job – the knowledge and skills required to meet both patient and organizational needs is broad and requires depth – the role is overutilized, misused, not understood, not valued or recognized and quite underpaid – this is not cynical or ‘burned out’…just reality – if you can live with that you will be OK.
It’s my 30th year in nursing and I must say I appreciate and respect our social workers in the hospital. They provide direction to the patient and medical staff. As a nurse, I do not know all the resources available and I do not have the time to research them. I depend on their services. They are a big part of the healthcare team. I do agree they deserve more recognition for their hard work.
I’ve been a hospital social worker for 11 years and am currently looking for data on what hospital social workers “do”. Anyone know of a national organization of medical social workers other than perinatal and oncology? It would be great if there was such a thing to discuss scope of practice, licensure, etc. to benchmark against.
I work in a small rural hospital (80 beds) and I wouldnt trade my job for anything. I am respected by the staff and they treat me as a professional. I am the only social worker in the whole hospital, and so to the original description, which was accurate, add in another 20 patients that need to be seen on some level (my caseload averages 16-26 cases per day). Others that have posted are right on regarding Docs and ER not understanding what our role is and what we can and can’t do (how many times have we been told to place someone -wherever- when the resources just aren’t there and the Doc already told the family that we could and would-oh -and they are discharged..)..and the pay at least around here tops out at about 52K. But it is never the same two days in a row and I am ever learning. Yes, you have to be tough and never timid (or you will get eaten alive by the docs and the patients/families)… But like I said, I wouldnt trade it. I think you have to see it as your calling and then just dive on in.
This is a very interesting topic for us inspiring social workers. Thank you LizRN, I hope more people in your position feel the same . I cannot say I have ANY of the experience of alot of you, but I think just bringing to the table that our feild needs to be heard and seen as important and our input is valuable to other idiologies, is so important.
Victor-please don’t hurt people in your inablity to see that your feelings of such recentment are effecting how your do your work. If you don’t like how it is, CHANGE IT!!!!!! “Blindly accepting the system as it is, betrays the foundations of our profession” -Elizabeth Blue, MSW, UWS.
Hi, I am a college student studying social work for a class and was wondering if a social worker would be available to perhaps answer a few questions for me over email, I understand you are all very busy but it would be greatly appreciated! Thank you so much.
Liz where do you work?, im an inspiring to be social worker, currently undergrad pscy student. I would like to intern or shadow these medical/hospital social workers soo badly to know the difference between a regular social worker and a hospital/medical social worker. Any suggetsions?
I really am glad I found this site. Thanks for all of the interesting post. I am a SW student and regardless of the pay, I am looking forward to getting both hands in! I was born for this
What is the bench mark for the number of patients an oncology social worker sees a day?
It is true. No matter how good you are as a social worker in whatever setting you are not as respected. You have even more education or at least as much as nurses and they still get more money and more respect which is unforunate. I too have my stories and I have been told I am the best social worker ever. And BSW’s are just as experienced and knowlegeable as MSW’s. I appreciate the furthering of education as an MSW but it isn’t much further. I know I have one.
Sadly, victor is right. Social workers, but virtue of not having the same medical knowledge as nurses, are not as respected as nurses in a medical setting. Yes, social workers may have more education, but it’s more qualitative and subjective, compared to the quantitative, objective, and product oriented nature of nursing. In a hospital setting, you will encounter nurses that ask you medical related questions outside your purview. Then they will look at you like you’re stupid when you don’t know the answer.
In the hospital setting, social workers are being replaced by nurse case managers and mental health nurses. Instead of having a separate social worker, they are training nurses in community resources, counseling (because they can explain prognoses and diagnoses to patients), and insurance review. Sometimes, they’ll keep a social worker around to perform discharge planning tasks (i.e. copying and faxing charts to SNFs and home health agencies) because we’re cheaper to hire than nurses. NASW knows that nurses are hijacking our jobs, but ignores out pleas for help.
Sadly, this is the reality of medical social work. We are expendable. Our jobs are at stake. The best thing we social workers can do is perform our job to the best of our ability and hope that a handful of nurses respect us. Or get a nursing degree.
I have been a social worker for 4 yrs now, 1 yr experience in LTC and 3 yrs experince in acute care/cardiac step-down. I too found myself getting “burned out” on hospital politics and went to work for an insurance agency providing phone case management. Needless to say, I am returning to my old job at the hospital and couldn’t be happier. I was able to see another perspective of social work, which helped me realize I need to be working directly with people. Sometimes you must make a change to truly appreciate what you were doing before. Every day is different & a challange in more ways than one…but you must keep your eye on what is most important…the patient & meeting their needs to the best of you ability even if resources are limited. AND I totally agree with M P’s statement above: “And BSW’s are just as experienced and knowlegeable as MSW’s. I appreciate the furthering of education as an MSW but it isn’t much further.” Even though BSW’s are limited with being able to provide psychotherapy, experience speaks volumes. I’ve seen it.
Hello, my name is Susan and I am a L.M.S.W.. I have been working in the field since 2005. First as a residential adolescent counselor and currently as an inpatient and outpatient substance abuse counselor. I also work as a crisis worker for the mental health unit at the emergence department on an on call basis. My problem is that after I graduated school I was supervised by an LPC or 6 years. I am in need of 1500 hours of clinical social work supervision so I can earn my L.C.S.W. I am earning a very low wage working as a substance abuse counselor and am concerned with how much supervision will cost although I know I must do it. I live in Meadville PA and would appreciate any assistance or advise anyone is able to afford me with regards to affordable supervision. 1500 hours is along time. I wish I would have been better informed when I graduated with my M.S.W. My name is Susan J. Emminger L.M.S.W. Thank you.
In Belgian hospitals, social workers do the same things.