I know that there is someone called a socialworker who is "there to help ",but in our center ours is pt and seems more concern with let you talk and hope that you forget. Maybe it to much for a pt person to handle. Plus in our center most of patients are sheep. I don’t blame them , for the most part they are over 60 and more than likely have many problems. And I said in an another post , this center is the only game in town. I’m between a rock and a hard place. I just want to do home hemo and get out. But a part of me wants to stay and fight for these people. But I’ve been down road that before and I got my hands full right now.
Any ideas?
Bobeleanor :?
I am a social worker and worked in dialysis for 18 years in 3 different dialysis clinics. I enjoyed my role as patient advocate. As a patient advocate, I felt it was important to gather as much information about a situation and when appropriate I spoke for the patient and tried to help the staff understand the patient’s perspective when the patient wasn’t there. I often attended meetings with patients when there were concerns. I talked with staff about patient concerns in an effort to figure out the best way to resolve them.
I don’t mean to make excuses for social workers, but in dialysis clinics today the decision-makers who decide how many patients a social worker can handle and what are the important tasks that social workers should do do not know what patients want and need unless patients tell them. Even worse, decision-makers do not value what social workers can do with their masters degrees and counseling skills to help patients cope with kidney disease, deal with conflicts with staff and other patients, maintain hope and set achievable goals, and find the resources to help them and their families.
You can’t imagine how many times I’ve heard social workers complain that their clinics see their primary role as making sure that the clinics get paid instead of doing the counseling that they want to do. Some social workers must travel long distances to go to multiple clinics. Average caseloads are around 120 patients and some dialysis social workers have caseloads of 300 patients. They must chart on every patient, attend team meetings, do staff in-services, and spend time in their offices (usually shared) talking to patients and agencies on the phone to resolve problems.
I remember how good I felt as a social worker when I had a caseload of 76 dialysis patients half of whom did PD or home hemo. I made rounds and talked with every patient nearly every treatment. I also saw pre-dialysis patients, home patients, and transplant patients in clinics and I saw patients who needed me when they were in the hospital. I was very busy, but my job was very rewarding.
If you want to more time with your social worker:
– Make an appointment to talk with him/her in-person at the clinic or on the phone and do it regularly;
– When the social worker meets with you be honest with him/her about what’s going on with you and the help you and/or your family need;
– Tell the social worker that you value his/her help with not only the day-to-day tasks he/she performs like helping with insurance and financial questions, transportation, or travel but that you also value the counseling and advocacy that he/she provides;
– Tell the administrator or nurse manager that you value the help you and other patients get from the social worker so much that you’d like to have greater access to him/her. I’m sure the social worker would appreciate it and clinics think it’s self-serving when social workers tell decision-makers this.
– If the state surveyor ever comes to your clinic and talks with patients, tell him/her that the social worker is a valued member of the team but that patients don’t have as much access to him/her as you’d like. This might be more powerful thing that you can do as the surveyor has the ability to cite a clinic if it isn’t doing all it should be doing.
Social workers?
I spoke to a bright young thing once by phone and realised I was my best advocate. Along with the good folks on this forum ( beth included )who tell you when you are wrong, scrape you up off the floor when you are down and give you a cyber hug when you have done good!!
I don’t know what the regulations say in Australia so far as social workers are concerned. In the U.S. every dialysis clinic is supposed to have a social worker with a masters degree in social worker and specialization in their MSW training in clinical social work. Unfortunately, the regulations have no guidance for clinics so far as ratios and probably Medicare will never dictate that.
I’m glad that you speak up and advocate for yourself. I hate to say it, but in the U.S., most patients don’t speak up and don’t suggest or complain and some don’t even ask questions because they see busy staff and don’t want to bother them. Some patients have spoken up to complain about their own issues or have served as advocates for other patients. I’ve talked to a few that have been labeled as “difficult patients” and discharged from clinics. [By the way, being a “difficult patient” is not justification for discharge.] I think it’s important to speak your mind but the goal is to do it in a way that won’t make others defensive or dismissive of what you have to say. This is one area where social workers and patients need to work together.
You guys are a great bunch and I wish I worked in a dialysis clinic with all of you.
Hi
Thanks.
I’ve had time with our socialworker, but the problem is just like staff and doctor they listen but don’t hear. I talked with my social, on2/16/06 on a subject that I had talked with him before. He had no clue, this time he said he would write it down, then just walk off. Like I said I’m not upset with him because he is only there maybe 2 days a week and yes he has to a good way to get there.
I know a social who works with the county (30yrs) and he has said the same thing he works his best but has too many cases . You know the story the county cuts things here and there and who ever is left has to pick up the for those let go. He seems to live out of his car.He spends so much time on the road. He is only given so much time to be with the people.
I’m my own advocate, but I meet a lot of resistance. I’ve even been told by long time patients “don’t get the tech or nurses mad” they can get back at you. I was already theaten with being kick out for not signing a paper before I had a chance to read over at home. The doctor step in and said that it would be fine for me to read over paper. The person who theaten me was a nurse. I don’t know what I do if I had not found this site. Here like everyone says we can share our thoughts and ideas. Is this really “american’s health sytem” the sad fact is yes and I don’t see it getting better.
bobeleanor
One of the nicest things in-center on the early years of dialysis…our headnurse would make rounds each morning to speak to each patient for several minutes…25 chairs 1st shift…
Rarely I’ve seen social workers make rounds like that…well, in my years of dialysis experience…
If I wanted to speak to them I would always end up going to their little office and spending several minutes there… :roll:
If you want to more time with your social worker:
– Make an appointment to talk with him/her in-person at the clinic or on the phone and do it regularly;
– When the social worker meets with you be honest with him/her about what’s going on with you and the help you and/or your family need;
– Tell the social worker that you value his/her help with not only the day-to-day tasks he/she performs like helping with insurance and financial questions, transportation, or travel but that you also value the counseling and advocacy that he/she provides;
– Tell the administrator or nurse manager that you value the help you and other patients get from the social worker so much that you’d like to have greater access to him/her. I’m sure the social worker would appreciate it and clinics think it’s self-serving when social workers tell decision-makers this.
– If the state surveyor ever comes to your clinic and talks with patients, tell him/her that the social worker is a valued member of the team but that patients don’t have as much access to him/her as you’d like. This might be more powerful thing that you can do as the surveyor has the ability to cite a clinic if it isn’t doing all it should be doing.
Beth,
I have had numerous SWs and I have liked every single one of them. But in each instance, they have been swamped with work and they have been so hectic that it has made me nervous trying to get their assistance. Several of my SWs have been very frank with me- they have taken me aside, privately, and told me they were so overworked they could hardly think straight and that the doctors/company were not about patient education etc. My experience has been that I’ve asked for dialysis related info. and the SW takes off and I have to remind the SW to get back with me half the time!
Now this is just on basic concerns. If this is the way it is on routine things, I can’t imagine the SW being able to do anything about the really serious situations like the fact that staff don’t wash their hands or the dirty conditions of the units.
In my experience, I have never encountered a unit where fairness reigns. In every unit the staff and patients fear retaliation. And this is not imagined retaliation. Serious unit offenses which affect patients’ health usually are not without the knowledge of the upper level. So, telling the SW about such problems hoping for his/her assistance is not going to happen.
Obviously, if the company, doctors and administators allow/perpetrate unit inequities and violations there is nothing the SW can do, and these are the type concerns patients are most bothered by. And I can tell you never has the upper management of any unit I’ve been in asked patients if they were pleased with the service. Well, there’s been a corporate survey or two, but no one trusts them- how can they when so much one sees/experiences is to the contrary of good care? Patients would probably die of shock if they were genuinely approached for their input-such is so rare in dialysis units.
So, the true role of SW is muffled and underused to the detriment of patients and I don’t see that changing unless those who control the units turn over a new leaf. I’ve been in units where patients put in grievances with the state and the units got no more than a slap on the wrist with business as usual as soon as the state was out the door. And I’ve known good staff, including SWs, who quit as there was no getting around the job inequities.
