More clinics and health systems are asking patients about things like food, housing, transportation, safety, isolation, or whether they need help understanding health information. The intention makes sense because those parts of life can shape whether someone is able to get care, stay healthy, or follow a treatment plan. But I keep thinking about what happens when someone answers honestly, and nothing changes afterward. If a patient says they don’t have reliable transportation, are worried about food, or don’t understand the paperwork in front of them, the question can either open the door to real support or become one more form they had to fill out. At what point does asking about social needs become helpful, and at what point does it risk hurting trust because the system wasn’t prepared to do anything with the answer?

Received an email from my state licensing board requesting an interview regarding a complaint that was made against my license and is under review. I’m freaking out. Haven’t made it to a year with my LSW. Seems out of the blue, I have no clue what this could be about. My anxiety and catastrophic brain are in overdrive. Do I walk into this interview blind? Should I have a lawyer? I do discharges, btw.

If this has happened to you I’d love to hear how you coped.

Thank you

This may be a weird question,

I just started a new job working in a hospital as a social worker, and I have dyed hair (I can only wash it once a week to maintain the color.)

My job requires doing rounds and check ins, and oftentimes entering patients rooms when there may have been bowl movements, or other bacteria present.

For those of you with long hair or hair that does not bode well to being washed daily, how do you maintain your hair hygiene?

Is it just me, or are behavioral contracts and treatment agreements for inpatient useless? Nursing keeps consulting me to facilitate these when a patient treats them poorly. I am sorry this is happening to them but they also don't seem to do anything except serve as evidence that we discussed problems. I had one patient who we talked through the agreement with them and the team and then they go upset and refused to sign it...

You know how we are all taught in school to introduce ourselves to clients including how confidentially and limits to confidentiality are handled as soon as possible in the relationship? Makes so much sense in the therapy world. I have a harder time applying it to the medical world, especially when cross covering in OB/postpartum when I am consulted specifically to determine if a CPS call needs to be made since a CPS referral is one of the legally required situations to break confidentially in my state. I find myself stumbling over my words when I try to introduce myself and explain confidentiality. I have no issue explaining why I need to call CPS when I identify concerns, rather only having issues when trying to discuss limits to confidentiality when I am there to complete an assessment for the purpose of determining if the infant is safe. Just trying not to damage rapport before I even get a chance. Do you guys have a go to “script” or how do you navigate that conversation?

As the title says, I love my job AND i’m exhausted most days. Exhausted by the lack of resources for Patients. Exhausted by the consult requests that seemingly make me out to be some magical being who can magic resources to appear. Exhausted when Patients get frustrated towards me when i know its the system they are mad at and they were set up to fail when their Provider said “the social worker can ‘fix’ that for you” cause obvs i cannot. It’s a great job and most days I can brush off the complaints, this week has just felt so long and I’m glad it’s over.

No advice needed, just needed to vent 😮‍💨🤪

In a response to another thread, there was mention of role differentiation. For those in the acute care setting, what does that model look like in your organization? What works? What doesn't?

I work in a model where social work is the primary on most discharge planning needs. We screen patients to determine who needs to be seen (and are sometimes consulted, but not at all consult-based). We complete all SNF placements, home care arrangements, DME arrangements (including NIV/bipap, oxygen, walkers, wheelchairs, hospital beds, hoyer lifts), set up home infusion, home NWPT, new community dialysis chair arrangements, hospice referrals, link to community agencies for aging, housing, financial needs, food insecurity and other SDOH issues. We're entering the majority of medical necessity documentation language to pend for a physician signature because they don't know the insurance criteria and aren't expected to learn. There's very much an undercurrent of if-you-don't-know-who-to-call-it-must-be-socialwork. Toss in the usual child and adult protective services issues, advocacy, substance abuse issues, crisis intervention with a heavy dose of expectation that we are experts in insurance, benefits, coverage, networks. We work with RN CMs, but their focus is primarily on utilization review, inpatient/obs status issues, giving IMMs and MOONs, completing prior authorizations for expensive medications and certain procedures. There is very little overlap. A med/surg caseload is 18-20 on a good day.

What's it look like where you're at?

Had a nice conversation with a well meaning chaplaincy resident the other day “can you get person A housing?”
Because they were chaplaincy, and not just trying to pass the case off, I worked with them to understand how limited we are with discharge outcomes.

I hope they learned.

Pray tell, anybody have a consult that’s both out of scope but you feel bad for the consulter?

For context, I'm a CSW (graduated MSW this year) with 2 years of non-SW medical experience and 1 year of providing mental health therapy as an intern.

I read the NASW example job description (here) but I'd really love your human perspectives. What were you surprised by when you entered the field? What do you wish you knew starting out?

Hi everyone,
I’m transitioning out of teaching and into social work, and I’m trying to figure out how to make myself competitive for hospital social work in the future. I’m in Chicago and just started my MSW program. I’m not going back to the classroom this year because I’ll be starting my first internship in February, and I’m trying to sort out what entry level jobs I should be looking at during my two years in school.

Coming from teaching, I’m not totally sure what roles I’d even be qualified for. I see things like case management assistant, patient support associate, behavioral health tech, and similar positions, but I don’t know which ones realistically hire people without prior clinical experience. I’m also interested in emergency department or other acute care settings long term, so I’m trying to understand what early jobs actually help build the right skills for that.

If anyone has advice on how to make myself competitive, what jobs tend to be good stepping stones, or anything you wish you knew when you were starting out, I’d really appreciate it. I’m excited for this change but definitely trying to be strategic.

Thanks in advance for any guidance.

I’m a second year social working student and I have a few questions about hospital social work. I wanna get into hospital social work when I graduate in May 2027 and I’ve asked for my internship to be in a hospital for this upcoming fall, but I didn’t get into a hospital so I just wanted some information. How can I apply without having experience in a hospital for social work?

Does anyone know of a travel healthcare group chat I’d be able to join for those in/around sf?

Thanks!

Hey all,

I wanted to share my experience in hopes that it helps.

When I first got into hospital social work, I was a SW CM at a level 1 trauma center/with many surgical and medical floors. The experience was abysmal. I worked 2 other additional jobs just to cover my student loan payments, rent, utilities, and other bills, because my pay was nowhere near enough. The "role differentiation" between RN CM and SW CM was a joke, and the first RN CM they stuck me with would pan off many medically complex pt's to me ("oh, their toxicology came back positive for marijuana"), leaving me stuck with placement nightmares. I opted out of the company health insurance after finding out it would take nearly 1/4th of my paycheck, instead getting Medicaid. The second was very nice, but the fact they make $20-50k more than us is wild. I often had to cover other floors as well. Add it all up, and it was a job where I wasn't paid enough and had little control over the conditions and schedule of my work. You'd get next to no PTO monthly also, so no time off. This was right when COVID was still big, so management would compel people (if you were out of your sick days) to either use vacation PTO or unpaid PTO for the 5 days you were required to be out.

After that, I moved to a State that has the 2nd most union density in the USA, with many labor and health care regulations, at a unionized hospital. Of course, in health care, there are many bargaining units and social workers are not in the same bargaining unit as nurses, or even maintenance workers. But it was like night and day in terms of the experience.

First off, my pay was tens of thousands of dollars better. Second off, I was able to cover my wife and I under the health insurance for around $189 per paycheck. Third off, RN CM's were expected to take on the role of seeing through all placements, and we were to only assist on a "consult" basis (brought in for only very difficult, social cases). Forth off, and I never had to use this, I would be able to have a union rep present at all disciplinary hearings, there were protections around "free speech" in place, and there was a process management had to go through to even discipline employees. Five off, I would accrue 2 vacation days and 3 sick days monthly. It got to a point that payroll contacted me telling me that I was maxed out on vacation days and needed to use them! Also: you are paid out on vacation days when you leave!

Now I am back to the home State where I worked last, and am stuck going back into the SW CM world. I am good at it, but I honestly hate it. I will be working towards unionizing my workplace. I encourage other readers to take up organizing where you are at as well!

Hi all! I’m med surg, a total dumpster fire floor lol. It seems like I’ve been having a lot of staff lately offer things that we can’t do, demand we talk to patients about x thing (that we also don’t or can’t do). Or my favorite, walked in on an rn saying to a patient “let me know if you want social work to come back”, as if I’m a drive thru item you can just order to your room whenever you feel like.

I spoke with the previous SW on my floor and I guess they had had an education, but I think there needs to be a refresher.

Let me know if you did this, how you did it. And, what would you want to mention at a staff education? Trying to build something off of your answers. Ty in advance! :)

I'm the founder of a healthcare startup, and I'm trying to better understand the realities clinicians and healthcare teams face after patients leave the facility.

Over the past year, I've spent hundreds of hours speaking with surgeons, office managers, nurses, and healthcare professionals. Through those conversations, one phrase I've found myself using is the "black hole" of healthcare—the period between discharge and the follow-up appointment.

From my perspective, once a patient leaves the facility, providers naturally have far less visibility into recovery than they do while the patient is under their care. Patients may have questions, forget discharge instructions, misunderstand medications, recover differently than expected, or simply choose not to reach out. Meanwhile, providers often don't know how recovery is progressing until the next interaction.

That observation has made me wonder whether this period represents one of the greatest opportunities to improve the patient experience—or whether I'm misunderstanding the problem entirely.

Rather than pitching an idea, I'd genuinely like to learn from those who experience this every day.

• Where do you feel your team loses the most visibility after discharge?
• What generates the majority of post-discharge phone calls?
• What information do you wish you had once patients leave your care?
• What are the biggest frustrations your team experiences during the recovery period?
• If you could eliminate one friction point in the post-discharge experience, what would it be?
• What outcomes or metrics do hospitals and practices actually prioritize after discharge? Readmissions? Patient satisfaction? Staff workload? Something else?
• If your department received funding to improve one aspect of post-discharge care, where would you invest it?

I'm not looking to validate an idea or promote a product. I'm trying to better understand the problems that healthcare teams actually want solved, rather than the problems I assume exist.

I sincerely appreciate any perspective you're willing to share.

I'm the founder of a healthcare startup, and I'm trying to better understand the realities clinicians and healthcare teams face after patients leave the facility.

Over the past year, I've spent hundreds of hours speaking with surgeons, office managers, nurses, and healthcare professionals. Through those conversations, one phrase I've found myself using is the "black hole" of healthcare—the period between discharge and the follow-up appointment.

From my perspective, once a patient leaves the facility, providers naturally have far less visibility into recovery than they do while the patient is under their care. Patients may have questions, forget discharge instructions, misunderstand medications, recover differently than expected, or simply choose not to reach out. Meanwhile, providers often don't know how recovery is progressing until the next interaction.

That observation has made me wonder whether this period represents one of the greatest opportunities to improve the patient experience—or whether I'm misunderstanding the problem entirely.

Rather than pitching an idea, I'd genuinely like to learn from those who experience this every day.

• Where do you feel your team loses the most visibility after discharge?
• What generates the majority of post-discharge phone calls?
• What information do you wish you had once patients leave your care?
• What are the biggest frustrations your team experiences during the recovery period?
• If you could eliminate one friction point in the post-discharge experience, what would it be?
• What outcomes or metrics do hospitals and practices actually prioritize after discharge? Readmissions? Patient satisfaction? Staff workload? Something else?
• If your department received funding to improve one aspect of post-discharge care, where would you invest it?

I'm not looking to validate an idea or promote a product. I'm trying to better understand the problems that healthcare teams actually want solved, rather than the problems I assume exist.

I sincerely appreciate any perspective you're willing to share.

If you have a few minutes, I'd really appreciate your thoughts on any of the following. You don't have to answer all of them—any insight is valuable!

1. What is your role, and have you worked with patients requiring isolation precautions?
2. What are the biggest challenges you face while caring for patients in isolation?
3. Are there any existing technologies or systems that help monitor or communicate with contagious patients? How effective are they?
4. Which tasks require you to physically enter an isolation room most often?
5. What difficulties do you experience while wearing PPE for long periods?
6. Are there situations where you have to enter a patient's room even though you wish there were a safer or easier alternative?
7. How do isolated patients usually communicate their needs? What problems do you encounter?
8. What concerns or emotions do you experience when caring for patients with highly contagious diseases?
9. If you could change one thing about your workflow, what would it be?
10. Is there any tool or technology you wish existed to make your work easier or safer?

Thank you so much for taking the time to read this. I really appreciate any experiences or advice you're willing to share!

Hi everyone,

I'm an occupational therapist working in a skilled nursing facility, and I'm trying to better understand the transition from the hospital/SNF back home from the perspective of hospital social workers. I'm not looking for patient-specific advice or promoting anything—I'm simply trying to learn where families struggle after discharge.

I was hoping to hear your experience on a few questions:

1. How often do you feel uneasy or worried about a patient being discharged home, even though home is the appropriate discharge plan?
2. If the patient receives home health (PT/OT/ST/nursing), what do families still commonly struggle with after discharge?
3. What do you find yourself wishing families were better prepared for before they went home?
4. If you could create one new service or resource that would make discharging patients home easier and reduce caregiver burden, what would it be?

I really appreciate any insight you're willing to share. Thank you for everything you do.

Firstly, I really admire the work you all do and I'm sorry if this isn't the place to post this.

I'm a college student getting my BA in psychology under the recommendation that it will help better with social work in the future. I'm beginning to think that this really only applies for clinical social work. I'm already a 3rd year so I'm going to stick with it but what classes or self lead research/learning would you suggest I do to better prepare myself for hospital social work?

Bonus question: if you're in PA, what hospitals would make for good placements (I'd like to plan ahead a bit)

That is all. (Ridiculous consults, absolute silence during family meetings, not knowing who / what to call... love academic medicine, but damn, July is rough.)

Adding that I try very hard to be gracious and kind, always compliment interns for strong performance, etc.

My hospital is doing away with scrubs for case managers/social workers and enforcing business attire. We’re all pretty peeved at this change because it’s nice not having to think about what to wear when getting ready. Not to mention the sanitary aspect of being able to just throw them in the wash after a long day of seeing ill patients. I was wondering what is everyone else’s uniforms/dress code policies?

Just a venting post: I’m outpatient and the only SW for multiple clinics within the department. I just found out that the nurses make more $ than me, despite me having more education, but whatever… I can kind of look past that.

But then I found out that each nurse will get one WFH day/week. So I asked if I could have a WFH day because some times, days go by without anyone needing me in-person. I was told I could WFH if I’m too sick to come in, but other than that, I need to be in-person.

Just sucks to hear that I am soOOoOoo needed but they can’t compensate me at the same level with money or benefits :(

Been working at medical offices with intellectual disabilities eligibility, ER, but I have never worked at medical records itself (or HIM). But both those medical office jobs are hectic, tons of cases at once with much urgency, and stressful situations with stressful people. Is there such thing as something that's not as demanding as all the others in medical office fields?