What do ur MSW's do?

KP RN · Oct 16, 2002

That may be dependent upon the agency one works for, Sandy. I have worked for certain agencies where the SW did not provide service of much value. No high standards or expectations existed.

In the agency where I presently work, the SWs are phenomenal!! I involve SW if a pt needs counseling or support, if they need lifeline, if they want meals on wheels, if they need help applying for medicaid, passport or other services, if they want a referral to hospice or respite services. Most importantly, if I suspect neglect or abuse, I get them involved pronto and they can deal with adult protective services.

I certainly rely and depend upon the SWs I presently work with--I wouldn't give them up for anything.

How 'bout the rest of you??

hoolahan, ASN, RN · Oct 16, 2002

I think the MSW's philosophy is to empower the family to take some initiative. I can't tell you how many times I have sent a MSW to assist with a Medicaid application, only to find the one thing the family has to do themselves, like gather a bank statement, is just not done. I can understand the frustration, and I think the MSW's really have to distance themselves, b/c some people will leech on, and expect the MSW to do everything for them.

I do find that our MSW is a list person, and it aggravates me to no end, b/c I could have handed them a list myself. BUT, I will still refer in some cases, just so I can document I saw a problem and initiated the proper channels.

I had one LOL who changed her story constantly. I was roped in at first, thinking her dtr was unreasonable, until she completely embarrassed me when she told the doctor she could not give her own insulin inj's. This after she c/o her dtr interfering too much in her life, after I had the commission for the blind come and do an eval to get her the equipment needed for self-inj, and got the doc to change her regimen to evening only lantus. She also c/o dizziness constantly, yet did not take her meclazine, which ironically, when she was hospitalized (and talking it all the time) she never had dizziness (Duh!!) She wouldn't allow a pre-pour or her pills would "go stale" She fell at home constantly, yet was supposedly eligible for Medicaid but refused to apply.

In hindsight, I am quite certain the reason she didn't want Medicaid was b/c she had some money stashed that she didn't want her dtr to know about, and if she applied, she knew she'd be turned down. This is the only plausible reason I can think of, either that, or she likes to have attention and be needy.

But, after so much head-bashing, I sent the MSW who gave her a list and agreed the pt was able to make up her own mind, and we would have to d/c her, and she would have to find someone to pay to privately give her insulin inj, since she "fired" her dtr. Suddenly, she is able to give herself the injections again.

So, when all you do is see those cases all day, I can see where they have to remain aloof. I have seen new grad SW's come in gangbusters, and burn out over time too.

You are really lucky Karen. What kind of populations are you working with? Rural, city, etc..?

KP RN · Oct 17, 2002

I work for a huge hospital based home care agency based here in Cleveland. My territory takes me to the more affluent areas primarily, but I have been known to go to the hood from time to time.

The agency has extraordinarily high expectations and standards for all of us. But, I have never worked with a more competent and capable group of people either in the hospital or out in the community. The sheer volume of voice mails from other disciplines on a daily basis can be wearing (averages an hour to an hour and a half daily-even on days off), but it's necessary.

They pay well and have a generous benefit package.

I guess I am lucky, Hoolahan.

sunnygirl272 · Oct 17, 2002

we have 2 MSWs in our agency..they cover longterm homehalth, CCHA, hospice and preventive....they are both wonderful ladies....not list people....they have assisted with applications, have found food pantries, do informational visits for potential hospice clients..have counseked, etcetcetc...hell, there are times they help holding legs for a cath insertion....

SandyB · Oct 19, 2002

Thanks everyone! Just finished my paper. I sure hope I find MSW's willing to hold legs for cath insertions when I do try out HH. (Gotta finish my BSN....don't want to commit to any place for more than a few days a month until then).

renerian, BSN, RN · Oct 19, 2002

Under medicare regs a social worker can council, do short term therapy, make community resource referrals, help them with financial aide or transportation issues, get a medicaid app, arrangment housing. Not a waste at all in my terms.\

What do you use your MSW for?

renerian