Takeaway
Hospital social workers can gather missing information essential to patient care. They can also assist patients in completing advance directives.
Lifelong Learning in Clinical Excellence | July 13, 2023 | 2 min read
By Abbey Becker, LMSW, Johns Hopkins Medicine
This piece complements a June 2023 piece on social work, “The Road Not Taken.”
“All we know is she was brought in from a Best Western. She didn’t come with any belongings except the pajamas she was wearing and some jewelry, including a bracelet with what looks like a nickname on it,” the MICU doctor said.
With these bits of information, plus the report from the ambulance crew who picked her up, I got to work trying to find out anything I could to help figure out who this intubated and sedated young woman was.
Within about 30 minutes, after a few Google searches and phone calls, I was able to learn the patient’s name and address that led me to an existing medical chart. The healthcare team contacted the patient’s parents, who came in to confirm the patient was their daughter.
While hospital social workers can help discharge patients and provide resources for needs such as financial assistance and transportation, we’re able do a lot more to help ensure every patient gets the best possible care. This includes:
1. Determine legal decision-maker(s) when a patient doesn’t have an advance directive.
Wondering who to call to get consent for a procedure for a patient who lacks capacity? Social workers can help figure out who has the legal right to make decisions for incapacitated patients. We often call multiple family members, friends, and listed contacts to determine surrogate decision-maker(s).
2. Locate names and contact info for family members of patients who don’t have any listed.
I can’t tell you how many times a week that patients without any contacts listed are admitted. If a patient is intubated and sedated, who do you call for consent and medical updates? Social workers can often locate family members using online searches, assistance from security colleagues, and other strategies.
3. Help identify an unknown patient.
See above.
4. Facilitate better goals of care conversations.
When social workers do initial assessments, we focus on biopsychosocial elements—the parts of someone’s life that tell us who they are outside of the hospital and who they are as a person. We oftentimes are able to learn about family dynamics and what’s most important to a patient. As non-medical staff, we can build a different kind of rapport with patients that’s more personal. Invite us to your family meetings or consult us before goals of care conversations—we might be able to provide some insight that can help guide these discussions.
5. Help patients complete an advance directive.
My number one hill to die on is advance directives. Whether you’re 21 or 101, you never know when you may land in the hospital, unable to make your own decisions. A core part of social work is to be a patient’s advocate, and ensure patients have decision-makers who represent. Social workers can complete advance directives at bedside with patients who have capacity—it can take as little as five minutes.
The above are just a few of the ways social workers can support patient care and make providers’ jobs easier. Ask us how we can help!
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.