That was a phrase one of my boss's actually said out loud in a team meeting about a year ago. It was really disheartening to hear that at the time because I was really enjoying my role within the company, in which most of my team was comprised of social workers (my PhD boss included). The issue at the time was based around a company decision that stated only licensed MEDICAL personnel could perform health assessments, and every patient had to have one yearly. The social workers felt as though they were being unfairly discriminated against and demanded to be included as health assessors. As an RN who understands pharmacology, pathophysiology, disease process, signs and symptoms to look for/rule out, review of labs, and the importance of educating patients on these things, I couldn't understand why they felt qualified. Nor would I feel qualified to do the job they have their degrees in. Besides that, their insistence on being able to do it was going to require more time than they were bargaining for. In the end, our entire team was granted the "privilege." As suspected, they were completely lost, and I had to bite my "I told you so" tongue. Even more insulting, since just Googling didn't quite pan out for them, they turned to me to ask me to create "medical cheat sheets" on things like Diabetes and HTN. As if I could sum it all up on an index card without the pathophysiology. "Yeah! Let me do that real quick...and would you mind just taking a minute to sum up all of your degrees in a few flash cards for me too?" Sigh.
Unfortunately, I also work as an RN in another facility which just recently updated their policy in regard to admissions. Apparently, the social workers that populate the admissions department are no longer required to have an RN view the labs prior to admission. They have been given a table of normal lab value ranges instead to ensure the patient is "medically cleared" for admission to our facility.
I'm certain these practices are not only unethical, but must be illegal too. Has anyone here had similar experiences? I'm tired of risking my own license for medical decisions made by non-medical personnel.
Did you know that many Social Workers have a Masters degrees, can set up independent offices and can "diagnose" for referrals especially in psychotherapy? Educate yourself about a profession before making assumptions about an entire profession. There as also many other health care professionals, many with higher education than an RN, who do assessments to initial treatment in a variety of settings. EMTs, Paramedics, Athletic Trainers and Physical Therapists are examples. Healthcare is a big world.
They are not capable of a medical head-to-toe aseesment. The fact that you can compare the fact that they have a masters in social to work to what a nurse does medically shows how informed you are.
Are you actually a licensed nurse? Do you have formal training? Do you know what a Masters in Social Work is?? It's not even close to the same as a licensed nurse.
Nor would I claim I could do their job. I would never say that. But legally, they can not perform a medical assessment.
Did you know that many Social Workers have a Masters degrees, can set up independent offices and can "diagnose" for referrals especially in psychotherapy? Educate yourself about a profession before making assumptions about an entire profession. There as also many other health care professionals, many with higher education than an RN, who do assessments to initial treatment in a variety of settings. EMTs, Paramedics, Athletic Trainers and Physical Therapists are examples. Healthcare is a big world.
Possibly so. However, I'll bet dollars to doughnuts that if you look up the licensing and scope and standards of practice for social workers you will not find making health assessments listed. Sure, anybody can hand a patient a questionnaire, or read it to him, but that is not a health assessment.
I have so many thoughts on this. Social workers have many roles and a very different scope of practice than nurses. While RN Case managers and SW Case managers do similar roles, that is the extent to similarities for the professions until you get to psych nursing.
There is, quite frankly, a lot more psychology and social science underpinning to the work licensed SWs perform. Which is logical. The type assessments they are trained for are often a person-in-environment perspective that aims to discern biopsychosocial aspects of the client and how those systems are affected by a presenting problem.
And that's just the basic MSW. After state-dependent required hours are obtained there are post-graduate certifications for specialties such as clinical social workers or advanced practice social workers.
While I am grateful for the money I make as a nurse, it's crying shame that as a mere AASN RN (before I continued to my current MSN) I made more than what was offered to a Master's level SW.
Health assessments by a registered nurse are of course very different from MEDICAL clearance which is outside the scope of practice for both RNs and SWs. (no matter the degree). MEDICAL clearance can be performed by an advanced practice nurse (but not an advanced practice social worker because their training does not cover advanced assessment of anatomy and pathophysiology).
With the information provided by the OP, it sounds like no one understands their role, scope of practice, or the regulations governing them.
I don't disagree that they are underpaid, but comparing what they do to a medical professional in terms of a medical assessment is laughable. I work with social workers every day. I would not want their job, but they cannot do what I do. They cannot go in, look at my patient, and decide what my patient needs. At all.
If you read what SWs actually do you would know they must have enough knowledge to distinguish a problem be it medical or psychiatric to refer the patient to the appropriate care. The problem can be one or both.
I am curious. If a social worker walked in to assess a patient and observed, upon looking at their abdomen, that there was a slight visible flutter that matched the pulse rate. All labs are normal and patient is not in any obvious distress. Buried in the bowels of the record is a note that the patient is being monitored for a small, existing AAA. Would a social worker know what, if anything to do with this? I'm going to vote a resounded "not likely."
Just as equivalently, would I know how to guide a patient through an ongoing set of psychological issues. Would I know how to teach CBT or coping skills. Would I know how to guide a parent through dealing with a child with behavioral issues. I'm also going to vote no on that one. Frankly, as a trained nurse i would be terrified to do that. i should think that any social worker would (or should) be terrified of having to makes the kind of assessments that we do.
Yes folks, nursing (and social work) are both professions where Dr. Google is not and never will be a substitute for the training and education needed and to think otherwise is to do patients of both professions a severe disservice.
NurseGirl525, ASN, RN
3,663 Posts
They are not capable of a medical head-to-toe aseesment. The fact that you can compare the fact that they have a masters in social to work to what a nurse does medically shows how informed you are.
Are you actually a licensed nurse? Do you have formal training? Do you know what a Masters in Social Work is?? It's not even close to the same as a licensed nurse.
Nor would I claim I could do their job. I would never say that. But legally, they can not perform a medical assessment.