LPN to social worker?

[Xyz123]

Hello everyone.

I'm an LPN in Louisiana. Recently with the hurricanes and Covid, life in the nursing home setting has been crazy, to say the least. The social worker at my job will be leaving soon and I was asked if I would like to take her place (we have limited room on the actual resident floor due to having several other nurses from other facilities working at our facility.)

Anyway, I was surprised to hear a nurse could become a social worker. I think her official title was social services director. But apparantly in my state, and in a small facility like ours, this happens. I obviously went to school to be a nurse, never thought about social work, but I do have appreciation for the type of work and am willing to help out my facility whatever way I can.

But, has anyone else ever heard of this? What are your thoughts?

 

Thanks!

[TheMoonisMyLantern, ADN, LPN, RN]

I would be very hesitant to play social worker it could definitely back fire. In my state in nursing homes "Social Workers" can have a range of credentials, degrees, training, etc. . But one of the big things they do is monitor a resident's psychosocial status and have to evaluate each resident every so often. It may not be in your scope of practice to conduct the type of psychosocial assessment that is required.

My personal advice would be to politely decline the position.

[neuron]

On 12/16/2020 at 1:59 AM, TheMoonisMyLantern said:

I would be very hesitant to play social worker it could definitely back fire. In my state in nursing homes "Social Workers" can have a range of credentials, degrees, training, etc. . But one of the big things they do is monitor a resident's psychosocial status and have to evaluate each resident every so often. It may not be in your scope of practice to conduct the type of psychosocial assessment that is required.

My personal advice would be to politely decline the position.

I believe that nurses are well qualified to do psychosocial assessments and work as social workers on a certain level. We do a lot of psychosocial assessments due to monitoring patients who are on psychoactive meds, their behavior, changes, side effects, interventions...etc. 

[TheMoonisMyLantern, ADN, LPN, RN]

12 hours ago, fibroblast said:

I believe that nurses are well qualified to do psychosocial assessments and work as social workers on a certain level. We do a lot of psychosocial assessments due to monitoring patients who are on psychoactive meds, their behavior, changes, side effects, interventions...etc. 

Nurses are certainly capable of performing psychosocial assessments but most of the time we require additional training to a more comprehensive assessment which is done by the social worker on each resident. Even as an RN until I began working in psych I didn't realize how in depth a comprehensive psychosocial assessment can go, and even thought the OP is in LTC the notes and assessments of the SW's I've read in LTC have been just as in depth on the resident. I've encountered that a lot of nurses who have worked the medical aspect of nursing have a challenging time accurately charting/reporting observed behavior and being able to name it for what it is. In addition most states are really funny when it comes to LPN's doing assessments.

Beyond the psychosocial, the social workers often will be asked to assess a resident's cognition to assess for the presence of dementia or decline in mental status, there's a lot more to it than just assessing orientation.

Social workers also have to be experts at what resources and support are available in the community for the residents. You may have to help determine which patient's are eligible for medicaid and how to guide the patient making an application to be approved. You'll likely be going over advanced directives and code status with residents and their families and while we deal with code status all the time as nurses, it's a little bit different when you have to draw up all the legal paperwork and knowing the laws in your state regarding when an advanced directive or DNR can be honored, when it can't and being able to explain in detail to families and patients what the consequences of their choices are. We think that this conversation should be done by the Doctor, and frequently nurses do have this conversation, but so do social workers especially in long term care.

I realize that everything I listed can be done by a nurse, with the caveat of requiring additional training. But since the OP works at an LTC they'll likely just throw her in the position and tell her to figure it out, which is unfortunate and also why I would exercise caution in accepting the position.

[amoLucia]

A couple concerns - first, as an LPN, would OP be pulled to the floor for staff floor nsg if 'push came to shove' as nec???? I believe it could happen, JMO.

Secondly, as the SW, OP would be responsible for MDS completion. Hopefully, she'll get some training in the instrument use.

Thirdly, concerns raised by PP Moon Lantern, are very real, esp re financial, legal and DNR are legitimate. But nothing that can't be learned.

I believe that OP would prob have to take turns being Admin Facility Manager on Duty for weekends/holidays This will be a signif  change as OP will now have become one of the Administrative Team and no longer one of the nsg team to do nsg tasks, like admission paperwork

I have known several Social Workers who were also nurses, but whose primary function was SW. And they did excellent jobs. Their nsg backgrounds were helpful, but not esp needed to be SW. Nothing that couldn't be learned by OP and it will be a steep learning curve.

*****  OP - before I'd take that position, I'd be REALLLLLY certain that you are the SW, not the sub med nurse. A REAL Dept Head, not just a sub.Even though you want to be helpful and a 'team player', working a med cart doesn't get your MDS section completed! And that's what your evaluation will measure - the Social Work responsibilities.

And just a thought, might you be getting a promotional salary increase for the added responsibilities???

Good luck. Come back and let us know how this works out for you.

[downsouthlaff, LPN]

This is not uncommon, despite what other posters have said here you are more than qualified. Surprisingly, state regs for nursing home (Social Service Directors) are very loose. Especially if the facility is under 100 beds. Lay people or CNAs can be trained for the role. As far as the psycho social assessments you are more so gathering the data with an assessment tool. Sock, blue, bed LOL. SSDs are also typically responsible for nursing home payments by the resident, referring residents to different programs, handling resident finances. Bringing grievances to the appropriate department. This position does not require a degrees social worker and most facilities don’t hire them. Yes a usually a CNA or another lay person if the facility is small. Your more than qualified. Our SSD is a CNA