Doing an admission with the social worker

[RNSUEIA]

I have been doing hospice for a couple of years and mostly on the weekends. Two days ago the social worker asked if she could go along on my admission as we were going to admit this pt in Jan. but she was scared and refused the admission then. The sw reasoning was....she thought she might not get to make contact if she didnt go to the initial meeting. The pt has two young children in the home and the sw wanted to get some info to her.

Heres the question........imo this was far to much for the pt too soon. Do your sw go on admissions with you?? I am not sure if i can refuse to take them with me or not, that is something i will have to check out if the occasion arrives.

I know the sw is a very important part of our team, but I really feel badly about subjecting the pt to such an overwhelming visit.

I dont always bring up death and funerals on an initial visit, I like to kinda feel out the situation first, and I dont case manage so I may or may not see this person again. Sometimes I think it is helpful to build a relationship with someone before getting right down to it (if there is a probability of the pt lasting at least a month)

Please give me some feedback on this and how you might handle it.

Thanks much!!

[CANRN, MSN, RN]

Yes, I have done several admissions with our social workers and it has always worked out very well. You are very sensitive to your patient's feelings, and that makes you a great nurse, but honestly, the social workers presence will only help, at least that is my experience. Personally, I love doing the admission with our social workers, makes my job easier!

[doodlemom]

Yes, I have done several admissions with our social workers and it has always worked out very well. You are very sensitive to your patient's feelings, and that makes you a great nurse, but honestly, the social workers presence will only help, at least that is my experience. Personally, I love doing the admission with our social workers, makes my job easier!

Agreed...we used to do admissions as a team in our agency until the administration figured out this was too expensive. There are usually a whole lot of psychosocial issues at admission time and who better to deal with them than a SW?

[jerseyRN]

You can spend your time on nursing assessment if you allow the social worker to do the consents and paperwork. Depending on the skill and personality of the social worker, it often works well to let the social worker arrive first for the nuts-and-bolts, then you show up a short while later for the nursing piece.

Families need their social workers. It does help them develop a connection if the SW comes on the admission.

[EmptytheBoat]

I've had it both ways, SW helpful with consents and allieving some of the

families' fears; then, merely present to complete their psychosocial assssment

and distracting/delaying the admit. I've also had both the SW and Chaplain

present at an admit, overwhelming and chaotic. My druthers would be to

have the SW/Chaplain do consents and address psychosocial matters prior to my nursing assessment.

[RNSUEIA]

At my hospice, the nurse does all of the paperwork, signs consents, fill out emergency contacts sheet with md, pharmacy numbers, calls for equipment etc. The social worker only gave out some printed info.{on this particular visit} I do see the importance of our s.w. you bet, I personally dont care to have them accomp. me on admissions. Plus it throws off my whole routine. I dont think our chaplains have ever gone on admissions.

Thank you all for your imput.

[steelcityrn, RN]

I can see how to some people it may be just too much at one time to answer all the questions of the nurse, be assessed and sign all the peperwork, be educated on any new medications and equiptment, then to talk with the s.w. also. Some people would be overwhelmed.