Do you ever feel like a social worker?

  1. 3 A lot of times I'll be talking to my patients about their labs, conditions, medications etc., and they want to talk about anything else in the world.

    EG

    ME: Mr. Soandso, your labs indicate that your blood sugars are elevated. Your doctor would like for you to start taking some Metformin. You should also try to watch your diet and eat fewer carbohydrates.

    Mr. Soandso: Well, I only get 100 dollars in food stamps every month and my wife left me so I can't cook and I don't have insurance to cover this medication or any ride to the pharmacy, and I need ride to get back to my house and I have all this pain in my back so who cares about my sugars and I got denied for disability again and BLAH BLAH BLAH BLAH BLAH BLAH BLAH


    Anyone else experience this 20 times a day? Or have any advice?
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  3. Visit  BlueLightRN} profile page

    About BlueLightRN

    From 'LaLaLand'; Joined May '13; Posts: 153; Likes: 166.

    31 Comments so far...

  4. Visit  klone} profile page
    2
    Yes. I work at an inner city clinic that is a "safety net" institution. All of our patients are either Medicaid or uninsured. So I see a lot of drugs, homelessness, abuse. It can be draining.
    BlueLightRN and NurseDirtyBird like this.
  5. Visit  elkpark} profile page
    17
    Umm, he's not talking about "anything else in the world," he's talking (in your example, at least) about the real barriers in his life to implementing your suggestions. Telling him what he should do without listening and attending to the information he's giving you about how that's going to be hard for him to do is not going to get him to follow your directions.
    Sweet Jane, turningred15, Everline, and 14 others like this.
  6. Visit  LadyFree28} profile page
    8
    Quote from elkpark
    Umm, he's not talking about "anything else in the world," he's talking (in your example, at least) about the real barriers in his life to implementing your suggestions. Telling him what he should do without listening and attending to the information he's giving you about how that's going to be hard for him to do is not going to get him to follow your directions.
    ^This.


    He was giving you important subjective information to help him be able to adhere to his diabetic therapy...when working in this setting the nurse is an important coordinator in helping the pt to adhere to therapy, as well as come up with strategies, despite his barriers-that's not a social worker's job, it's the NURSE's job.
  7. Visit  Hygiene Queen} profile page
    6
    Quote from LadyFree28
    He was giving you important subjective information to help him be able to adhere to his diabetic therapy...when working in this setting the nurse is an important coordinator in helping the pt to adhere to therapy, as well as come up with strategies, despite his barriers-that's not a social worker's job, it's the NURSE's job.
    Agree!
    The pt was communicating a real problem and was hoping for a solution.
    It is certainly my job to listen and make sure that I work closely with the social worker to help resolve the pt's issues.
    The nurse is the coordinator. I do what I can within my ability, but I'm obviously not going to be the one trying to figure out housing or food stamps, etc. Then I get the expert... the social worker who does this stuff for a living and knows all about what resources are available.
    To hear such complaints and to brush them off is neglectful... as sure as noting that your pt has pain and doing nothing about. That's not being the advocate we should be.
    Remember, nursing is holistic.
    The pt cannot be successful if they are unable to attain the tools they need to be successful with.
    Personally, I'm glad the social workers follow up on this stuff. It gets stressful and complicated. I love 'em but I wouldn't want their job
    Last edit by Hygiene Queen on Dec 30, '13 : Reason: I misinterpreted the intent of a post... but I caught it before I made a complete and total fool out of myself. I think.
    sallyrnrrt, LTCNS, NurseDirtyBird, and 3 others like this.
  8. Visit  iPink} profile page
    5
    I have patients who are struggling financially. When they tell me what's going on, I don't hear "blah, blah, blah," instead I hear "help." Unfortunately, I can only do so much but I immediately get case management/SW involved. I want do more but at least that much can hopefully help them. Remember, nursing is holistic which involves advocating on their behalf.
  9. Visit  Lola Lou} profile page
    4
    If my pt brings multiple issues up that I feel I cannot address I make a note and bring it up in the daily MDT (multi disciplinary team) meeting. The Doc, Nutritionist, PT, Respiratory Therapist, and Social worker are there, along with other departments. It's the perfect place to brain storm, delegate, and being devising a plan to help the pt holistically. We are so used to delivering messages "to the point" when dealing with other busy healthcare workers that it may appear like the pt is just "blah blah blah" but in reality they're trying to paint a full picture for you to understand where they are coming from.
  10. Visit  NurseDirtyBird} profile page
    1
    If you can't handle helping this patient overcome his obstacles to compliance, get someone who can. Sometimes you have to think outside the box to formulate a plan of care that will work, instead of giving him the boilerplate d/c instructions.
    sallyrnrrt likes this.
  11. Visit  xoemmylouox} profile page
    1
    At least you have a SW or Case Manager to help with these things. We don't. We try to figure out programs or agencies to assist our patients, but have no real person to manage this. It's heartbreaking.
    sallyrnrrt likes this.
  12. Visit  BlueLightRN} profile page
    1
    The issue here is this though. I CANNOT SOLVE THOSE PROBLEMS. I cannot get him more money or food. I cannot even get anyone else in for food pantries at this point because there are no openings. I cannot get him transportation. How am I supposed to solve these people's life problems?
    sallyrnrrt likes this.
  13. Visit  ClearBlueOctoberSky} profile page
    3
    Quote from BlueLightRN
    The issue here is this though. I CANNOT SOLVE THOSE PROBLEMS. I cannot get him more money or food. I cannot even get anyone else in for food pantries at this point because there are no openings. I cannot get him transportation. How am I supposed to solve these people's life problems?
    Sometimes, it isn't the solving that is needed, but the listening and understanding that that being compliant with a regimen just isn't the biggest priority that they might have at that moment.
    Laura in Canada, SHGR, and klone like this.
  14. Visit  LadyFree28} profile page
    2
    Quote from ClearBlueOctoberSky
    Sometimes, it isn't the solving that is needed, but the listening and understanding that that being compliant with a regimen just isn't the biggest priority that they might have at that moment.
    ^THIS.

    We DON'T solve problems; we HELP managing the holistic issues of our pts; sometimes active listening is the way to go...we are "healing managers" we can't solve all of the world's problems, sometimes we can't solve our pts; listening goes a LONG way for our pts; sometimes we are the light at the end of their tunnel; we may get them to make appointments regularly in order for them to go from non-compliant to compliant; never underestimate therapeutic communication.
    Everline and Laura in Canada like this.
  15. Visit  BlueLightRN} profile page
    0
    I try to listen but we see 150 patients a day and I rarely even get a lunch let alone a break. Some days I do not even get to pee. I feel so helpless when the doctor asks me to talk to a patient but then I get into the room to hear about all the other problems I can't possibly solve. If the patient can't afford 4 dollar metformin, how am I supposed to help? I can't buy medicine for all 50 patients a day who tell me the same thing. I also do not have enough time to call medicaid/caresource/molina about every little complain or question, don't have time to do paperwork for TENS unit, backbrace, kneebrace, penis pump, hospital bed, ensure, diabetes supplies, and 5 other things for just one patient. I also take all the clinic phone calls (patient questions, concerns) and have to do so many things that it becomes overwhelming. I don't know what to say or do for patients when I can't help them. I can't get you free diabetes supplies, free medicine, free rides, help with bills and food, and actually do my assigned duties. I just am really struggling with what seem like problems I can't do anything about, they're constant.
    Last edit by BlueLightRN on Jan 1, '14 : Reason: typo


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