Sunday, September 15, 2013

Social work in a nursing home

This is how I kind of view some new social workers

I know this is really not a nice thing to say, but I do view new social workers as being 'by the book and inexperienced' which, in turn, makes me question their empathy when dealing with people.  

For example:  I had an interview at a nursing home in my small town of Penn Yan a couple of years ago.  I was grilled for 4 hours, one would think I was applying for a job and was in front of the senate ethics committee.  So I figured, gee they must be really careful and choosy about their social workers, that is, until I met the social worker in their employ at the time.  She showed me around, even though I'd been a nurse aide in this nursing home before, and she said to me: "Nursing home social work is not a difficult job at all."  I, in turn, wanted to reply: "Then you aren't doing the job right."

Why would I want to say that?  Because while there are social workers in all packages, some are good, some not so much.  Yes, one can put in their 8 hours a day, doing what the big wigs want in any agency, or, they can actually do their jobs right and work for the client's best interest.  The first type of social worker is a dime a dozen, the second kind is hard to find.

Personally I found it exhausting to do a good job when everyone in a nursing home is a social worker, or at least they think they are.  We had a Social Services sign on the door, but it might as well have read: Complaint Department.  Now I know the director of nursing thought her department got lots of complaints, but then, nursing ignored them all and nothing got better.

Social work in a nursing home is draining because we got all kinds of things dumped on us.  We'd get 'behavior complaints' concerning an elderly person's behavior even if it consisted of the person complaining about no one answering call lights in a timely manner. 

 Now, personally, I think call light issues were a nursing problem, but everyone else thought it was a social work problem.  I'd direct the complaint to nursing, just to be ignored, have it tossed back to me, telling me it was a flaw in the elderly person's character.  I guess no one has a right to complain about nursing in a nursing home.  That is the main problem with nursing homes run on the medical model.  Nurses just do as they please.  

Social Services also got an office full of things residents left behind when they died or went home, WE had to call, call, call and find out if they or the relatives wanted the items.  Social Services was asked, by maintenance, to call and tell families if their loved one's chair needed steam cleaning, we also were asked to call and tell relatives if the resident's closet was too full.  Just busy work junk on top of the regular jobs we had to complete.   Much of our work consisted of the MDS (minimum data set) this minimum data is supposed to show we knew the resident by asking stupid questions.  Much like a job application where the interviewer does not know you at all, but they attempt to know you by reading a five minute piece of paper.  Just can't be done.

Nursing and therapists are the little darlings of a medical model nursing home.  I see, even now, in our local paper, the nursing home here lauds the medical people with special, huge ads.  While those are needed, never mind the social worker who: set up in home care, when needed, set up your oxygen tank services so you can breathe, set up meals on wheels so you won't starve and set up your link to life so if you have an emergency you can call for help easily.

Most times, families would send a thank you note to the nursing home thanking only nurses and therapists.

If you have a loved one in a nursing home, remember, as long as it is run on the medical model, it's NOT a good nursing home.  It's NOT home, it is a damned hospital disguised as a nursing 'home.'   If your loved one has meals on wheels, or any in home services, don't forget to thank a social worker. 

If you are a person going into nursing home social work, remember that you work for the resident's rights, not the rights of the nursing home. 

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