ER Social Work

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pharmstudent993

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Hey all,

I wondering what the duties of a ER social worker entail? Since i am totally oblivious to what ER social workers do, any information is greatly appreciated. Also, if anyone has some links or textbooks relating to this field of social work, i would be ecstatic if you posted them. Thanks for taking your time to read this thread; in advance, thank you very much for all your replies.

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Hey all,

I wondering what the duties of a ER social worker entail? Since i am totally oblivious to what ER social workers do, any information is greatly appreciated. Also, if anyone has some links or textbooks relating to this field of social work, i would be ecstatic if you posted them. Thanks for taking your time to read this thread; in advance, thank you very much for all your replies.


Well, think about why many people end up in the ER? Medical Social Workers do a great deal in hospital settings:

1) help deal with intoxicated patients;
2) triage accident victims and assist their families;
3) counsel and help family members who lost a loved one in the ER;
4) help patients obtain Rx at no or low cost if inner city or rural areas;
5) offer counsel to patients who received bad news, etc.

Most hospitals also have chaplains and psychiatrists that provide similar services.
 
When I worked in the peds ER, these were my duties:

Child protection- forensic interviews with children and adolescents brought in for suspected physical or sexual abuse or neglect. At my hospital, when a case like this hit the door, it was immediately sent to social work, who would then give recommendations to the medical team based on the interview (ie, internal pelvic vs external, rape kit, etc). This included taking pictures of any visible injuries and coordinating with state child protection services and law enforcement as appropriate. These cases may also entail testifying in court about the interview that was done.

Crisis intervention/Trauma: Our pager went off to each Trauma STAT, Major, and Minor. We were the liaison between the medical team and the family, including chaperoning the family into the trauma room to observe if they would like to go in (and are emotionally capable of dealing with seeing that). Lots of crisis counseling, support to families, assessment of whether the trauma resulted from child abuse or neglect and addressing that as appropriate. There is mandatory reporting to the police for gunshot wounds in my state, so that was our job.

Deaths: We were present for every death, and had some assistance from the chaplains. Crisis counseling for the family, crowd control because inevitably 30+ people are going to arrive at the hospital, clipping a hair sample for the family to keep, plaster molds of hand/footprints, photographs of the family holding the child one last time, calling the Medical Examiner's office, assisting in initiating funeral arrangements.

Ingestions: Any kid who ate or drank something they shouldn't have got a full assessment, especially if they're in the under-5 crowd. Lots of family education to parents on locking up their medications and household chemicals so the kids can't reach them. Exceptions might be a drunk teen who's just sobering up and will go home.. And ODs as a suicide attempt we'd tell the ER to call psych first and intervene only if needed.

Burns: If they were suspicious, they got a consult. If they weren't, we didn't get called. Suspicious would include the pattern of the burn not matching the proposed mechanism- ie spills get everywhere, so it would be highly unusual to hear "spill" and just see one blister. Like to get pics of these, too- b/c burns and bruises go away and it's nice to have on record.

Other: SW determines if any patients require visitor restriction, are used to assist with disruptive family members, can assist with housing, prescription, transportation, or meal assistance as appropriate, and provide supportive counseling to patients and families as needed.

In the adult ER, I'd include lots and lots of domestic violence counseling/referring and nursing home placement issues. Again, they'd be reporting the GSWs (they get a lot more) and working with the trauma patients.

Teaching hospitals often have psychiatry residents on-call in the ER so social work does not get as involved in that. Community hospitals are more likely to utilize masters-level social workers and counselors to do behavioral health intake and contact the on-call attending psychiatrist to determine the treatment plan (admit, day treatment, refer out, etc).

As far as texts, etc, I can't think of anythin off the top of my head. However, I believe that most ER social workers have gone through health concentrations while getting their MSW. Oh and yes- unless you're in a really rural hospital, hospitals generally require you to have your masters.
 
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I can't add anything to Pin's post other than a suggestion of texts.

When I worked in a hospital, I referred to nursing books for more information. (My sister is a nurse, so I had access.)

I even ended up purchasing two mental health nursing books for my own personal use as well as a child disability medical text.

From my undergrad, I had a psych child abuse and neglect class and I still have the text from it but I believe it was mostly legal stuff. I do remember a component of the class directed at recognizing abuse -- types of bruises, patterns of events, etc. Something like that might be helpful as reference... but I'd imagine that would also be a medical text.

I can't think of a single social work textbook that I own that could have helped in a hospital setting... but we didn't have any medical sw specific classes.

I also want to piggyback on Pinquoin's statement about masters levels in the hospitals. Here, they not only want you to have your MSW but they want you to be fully licensed as well. Only very rural community hospitals take provisionally licensed clinical social workers.
 
I thank you all very much! Any more information is appreciated🙂.
 
In my EDs (urban level I trauma and suburban community hospitals), we always have a social worker there (except over night). Here are the things that I can think of that they do:

Evaluate every pysch patient (sometimes before the doctor and sometimes after), and then discuss the case with the docs. Ensure proper care for psych pts through transfers, admission, and other options. This is the social worker's main duty in the ED.

Coordinate care for patients who are in between safe discharge home and hospital admission for medical issues. Making sure that patient has an appropriate place to stay. This is usually for older people who are losing their ability to be independent.

Be with families during critical care and death. Assist the family's. Very rare done in the ED.

Interview patients who have health care access issues.


Good luck! I think medical social work would be a great job.
 
Thanks! I think the emergency psych evals are the most interesting part of the job.
 
It will be hospital-dependent as to whether that's part of an ER social worker's job. Since most go through a medical concentration MSW, and not psych, it's often psychiatry who does the evals in academic hospitals (and then sometimes SW may have to do the placements, which sucks royally to do when you haven't done the eval yourself). There would be increased liability in someone who has never taken a psychopathology class (not required in the health concentration) doing the assessments. More common in the community, non-academic hospitals is that the hospital or hospital system's behavioral health program has an intake department that does the psych assessments and transfers while coordinating with the psychiatrist. Intake is usually LCSWs and LPCs, or those post-masters people working toward those licenses. The occasional psychologist is there as well but that's less common.
 
I am also interested in medical social work, especially in a children's hospital, so all of this was very helpful. Most of the schools I am looking at for my MSW have no classes on medical social work, so I've had a hard time getting a good idea of what it would entail.

Thanks for all the info!
 
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