It was Day 1 and I was entering the hospital as a student social worker, in acute allied health. This is the area of practice where I had always envisaged myself working. What was in store for me and would my expectations exceed the reality? I needn’t have worried; what I found was a fast-paced, stimulating, environment, where no day is ever the same. Within the hospital, the social worker considers the needs of the patient from a multidimensional point of view, by assessing their medical, social environment and emotional resources. (Beder, 2006). Social workers undertake assessment, assist in goal setting, provide some counselling and make referrals to community services and ongoing resources (Giles, 2013).
Health settings are a ‘secondary setting’ for social workers, meaning their role is secondary to the physical treatment task. They join a list of a least twenty other disciplines offering services to support individuals, families and communities in improving health and well-being. They bring to the multidisciplinary health team a unique set of psycho-social knowledge and skills to assist other team members, in understanding the social factors informing well-being and health (Giles, 2013).
Within health social work, nonetheless, there are challenges and some of these have been explored by Beddoe and Deeney (2012) in their article Discovering health social work in New Zealand in its published work: Implications for the profession. A lack of visibility and status of the profession is one. Role ambiguity is another, affecting the working relationship between social workers and other professionals. My colleagues have discussed patients who have not been referred to social work and need support, and others who have been referred but don’t need social work. This is not just a New Zealand issue with Greysen, Schiliro, Horwitz, Curry, and Bradley (2012) conducting a qualitative study in the States and their findings acknowledge role confusion and uncertainty about which team members perform components of discharge care. Within New Zealand McKenna and Staniforth (2017) assert that District Health Boards do not consistently provide services such as social work to meet the emotional and rehabilitation needs of older people.
Working in acute care hospitals, there is the constant pressure by administration, doctors and hospital wards to discharge patients. Social workers are often contacted the day of discharge to see the patient. This adds to an already heavy workload & can create social worker stress. McLeod & Bywaters (2000) state shorter hospital stays are creating reduced support to inpatients facing a range of problems. Social workers have to remain strong in the barrage from doctors and administrators, who want to know when the patient is to be discharged and free up bed space.
As a student health social worker I am seeing a demanding, fast paced, dynamic and at times, stressful work environment, but also one in which no day is the same and I see social workers making a difference in the lives of their patients. I also get to meet some amazing patients who have such strengths when dealing with adversary and I get to engage with a highly skilled and supportive allied health team.
Beddoe, L., & Deeney, C. (2012). Discovering health social work in New Zealand in its published work: Implications for the profession. Aotearoa New Zealand Social Work, 24(1), 41-55. Read here
Beder,J. (2006). Hospital social work. New York, NY: Taylor & Francis Group,
Giles, R. (2013). Contemporary issues in health social work. In M. Connolly & L. Harms (Eds). Social work: Contexts and practice 3rd ed. (pp 179-193). Melbourne, Australia: Oxford University Press,
Greysen, S., Schiliro, D., Horwitz, L., Curry, L. & Bradley, E. (2012). “Out of sight, out of mind”: Housestaff perceptions of quality-limiting factors in discharge care at teaching hospitals. Journal of Hospital Medicine, 7(5), 376-381.
Mcleod, E. & Bywaters, P. (2000). Social work, health and equality. London, UK: Routledge,
McKenna, D. & Staniforth, B. (2017). Older people moving to residential care in Aotearoa New Zealand: Considerations for social work at practice and policy levels. Aotearoa New Zealand Social Work, 29(1), 28-40. Read here