Hospital Social Services in Bangladesh (Fieldwork: Part-02)

Concept of Hospital Social Work:
In general the term hospital social work refers to the practice of social work in hospital or medical settings. Before analyzing the term Medical Social work we should know about Social Work, its nature and scope.  Social Work, in general, is a helping profession which helps people so that they can solve psycho-socio-economic problems that affect their social functioning with their own capacity and resources. 

According to Board of Directors of National Association of Social Workers (NASW):
“Social Work is the professional action of helping individuals, groups, or communities improve or bring back their capability for social performance and creating societal conditions positive to this goal. Social Work practice consists of the professional application of Social Work values, principles, and techniques to one or more of the following ends: helping people obtain tangible services; counseling and psychotherapy with individuals, families, and groups; helping communities or groups provide or improve processes. The practice of Social Work requires knowledge of human development and behavior; of social, economic, and cultural institutions; and of the interactions of all these factors.” (Barker, 1995)

Social Work is a professional service rendered to people for the purpose of assisting them as individuals or groups to attain satisfying relationships and standards of life in accordance with the particular wishes and capacities and in harmony with those of the community (Russell H. Kurtz, 1964).
According to the Social Work Dictionary Social Work is “The applied science of helping people achieves an effective level of psychosocial functioning and effecting societal changes to enhance the well being of all people.” (Barker, 1995)

In short, Social Work is the professional activity based on specific body of knowledge, skills and values. It helps people, singly or in group, to maintain, enhance and restore their capacity for effective social functioning in harmony with their environment as well as brings desired social change and resist unexpected changes for sustainable social development.

Fields of Social Work in developed countries include the following sectors:
1. Family And Children's Services
  • Family preservation 
  • Family counseling 
  • Foster care and adoption 
  • Day care 
  • Prevention of child abuse and neglect 
  • Prevention of domestic violence 
2. Health And Rehabilitation
  • Hospital social work 
  • Public health work 
  • Maternal health work 
  • Vocational rehabilitation 
  • Hospice care 
3. Mental Health
  • Mental health clinics 
  • Day treatment for drug and alcohol addiction 
  • Community integration 
4. Information And Referral
  • Provision of information on resources 
  • Publication of community directories 
  • First-call services 
  • Emergency relief 
  • Crisis management 
5. Occupational Social Work
  • Employee assistance programs 
  • Treatment for work-related stresses 
  • Job relocation programs 
  • Retirement planning 
6. Juvenile And Adult Corrections
  • Probation and parole services 
  • Police social work 
  • Work in detention facilities 
  • Work in training schools 
  • Prison work 
  • Deferment programs 
7. Gerontological Services
  • In-home support 
  • Respite help for family caregivers 
  • Adult day care 
  • Long-term care 
  • Nursing home services 
8. School Social Work
  • School adjustment counseling 
  • Educational testing 
  • Family counseling 
  • Behavior management 
9. Housing
  • Subsidized rents 
  • Homeless shelters 
  • Handicap accessibility programs 
10. Income Maintenance
  • Social insurance programs 
  • Food stamps 
11. Community Development
  • Social planning 
  • Community organizing 
  • Neighborhood revitalization

Medicine or Hospital service system is an important field of social Work where Hospital Social Workers help patients to dissolve socio-economic barriers which hinder the way of recovery of illness and their normal social functioning.

Medical or Hospital Social Work is defined as “Social work practiced in a responsible relationship to medicine and public health within the structure of programs of health care. Initially, this field of social work practice was concerned almost exclusively with the social needs of problems of ill person s under care in hospitals and civics.

Robert L. Barker defined Medical Social Work as “The social work practice that occurs in the hospitals and other health care settings to good health, prevent illness, and aid physically ill patients and their families to resolve the social and psychological problems related to illness. He also stated that medical social work also sensitizes other health care provides about the social psychological aspect of illness (Barker, 1995).

Miss E.M.R Clarkson in her book Medical Social work defined Medical social work as a specialized branch of social work practice in hospitals, clinics, community health center, and sometimes in general practice. Its practice consists of understanding the sick person as a human being, temporarily or permanently incapacitated by illness, someone whose living habit may be disrupted, who may be away from home for long periods on end, who may be unemployed and consequently penniless, or who may react badly to illness or disfigurement, and working with doctors, nurses and others in trying to help them (Clarkson,1974).

It attempts to understand the needs of and the circumstances surrounding the individual patient and the bearing these factors have on his illness. Through this understanding and through the application of social case work principles and techniques, it aims to help the patient utilize to the fullest capacity of the medial care available to him and work out a pattern of life that is at the same time consistent with his physical limitations and which is also satisfactory to him.

The provision of social services in hospitals and similar health care centers, most often within a facility’s department of social services provided include prevention, rehabilitation and fallow up activities as well as discharge planning and information gathering and providing. Other services include assisting patients with the financial and social aspects of their care and counseling patients and their families (Barker, 1995).

Hospital social work is concerned with helping patients, who are unable to make use of medical service effectively because of social or psychological factors, in the light of Social Work knowledge, skills and values.

Aims and Objectives of Hospital Social Work:
Hospital social worker works in hospital settings as a member of hospital team consists of doctor, nurses and other therapists. Physician deals with physical problems of the patients. It is not possible for him to find out socio-economic factors behind illness him patient. It is the duty of hospital social worker to deal with these factors. Hospital social work aims to identity the socio-economic and psychological issues that are liable for the illness affecting the treatment of the patient negatively and creating problems in adjustment.

The primary aim of medial social workers is to help restore the patients social functioning the help him resolve the social and emotional problems that keep him from reaching a satisfactory level of adjustment to or recovery from illness. In addition, they provide all important links between the world of medicine, the family and the world of social services (Friedlander, 1982)

According to Encyclopedia of Social Work purposes of hospital social work include:
  1. Helping people facing illness, trauma-related crises, or disability to understand and manage the psychosocial impact on their lives and on significant relationships and to make decisions and plan for the future.
  2. Facilitating adaptive coping patterns and adjustment to chronic illness or disability and assisting with reintegration or adaptation to new environments
  3. Participating in multidisciplinary teams and providing insight and understanding of the psychosocial dimensions of the medical circumstances affecting particular patients and families
  4. Identifying and arranging community supports and practical resources to facilitate discharge from hospital or transfer to alternative care facilities
  5. Assisting with anticipatory grief and mourning, counseling people facing death, and providing other bereavement-related services to members of the family, including making practical arrangements
  6. Assessing the needs of selected patient populations, networking with community organizations, and developing services to meet these needs, including support and psycho-educational groups, educational forums, socialization, and reintegration activities;
  7. Identifying potential neglect, abuse, and exploitation in vulnerable populations and involving authorized agencies;
  8. Supporting institutional goals and purposes and encouraging institutional responsiveness to patient needs(Ross, 1995)
According to Minahan (1981) the objectives for social work in hospitals are consistent with following objectives:
  1. Helping people enlarge problem solving and coping abilities;
  2. Facilitating interaction between individuals and others in their environment;
  3. Helping people obtain resources;
  4. Making organizations responsive to people influencing interactions between organizations and institutions; and
  5. Influencing social environment policy (Ross, 1995).
In short, the aims and objectives of hospital social work are:
  • Assessing Psycho-socio-economic needs of patients and helping to face these problems;
  • Helping patient to face grief, counseling people facing death or acute illness;
  • Helping people to adjust with hospital environment;
  • Helping people to face illness and take necessary decision in time;
  • Making liaison among patients, families, communities and various agencies to ensure access and utilization of available resources.
Roles of Hospital Social Workers:
 a) Role as an Effective Service Provider
Medical social worker plays an important role to ensure effectiveness of health services available in hospitals and clinics. Medical social worker directly takes part in diagnosis causes of illness, formulation of treatment plan, giving follow up helping the patient to get after care services.

In fulfilling the expectations and requirements of his professional role in the study diagnosis-treatment of patient problems, the medical social worker accepts responsibility for the following:
  • Authoritative definition of the social situation of the patient;
  • Identification of the social forces and factors which are exerting influence upon the etiology and treatment of the patient’s health problems;
  • Selection of appropriate measures of intervention directed toward the modification of factors which may have adverse consequences for the patient’s care and recovery;
  • Participation in joint treatment planning and evaluation of treatment out comes; and
  • The execution of social treatment within the goals and structure of a jointly developed treatment plan (Cockerill, 1960).
The study diagnosis-treatment procedure of the medical social worker is guided by the philosophy, goals, and ethics of the profession of social work and by a theoretical teamwork common to social work practice. Inasmuch as it is directed toward the social functioning needs and problems of ill and injured individuals and their families, it makes extensive use of knowledge about the structure, roles, and culture of health and medical institutions and about the requirements and expectations of the patient role. The medical social worker is continuously engaged in assessing the consequences of injury, illness, and hospitalization for the performance of the patients’ customary social roles and develops special expertness in defining these relationships (Cockerill, 1960).

b) Role as a Policy Maker
The medical social worker from professional knowledge and practical experience gained from providing service to the patients is able to identify the gape in the services of the agency or the need of modification of policies and procedures that are needed for providing better and more effective service. This knowledge and experience is shared by the social worker with other members of the hospital staff. Medical social work administration of a hospital unit plays an important role in formulating service policy of a hospital or clinic. They can influence the management authority to formulate new policy and modify existing policy to ensure better care and effective service (Pathak, 1961).

c) Role as a Teacher /Trainer
Medial social workes play a key role in providing health eduation and training to the patients as well as the social work training in medical socvial service sectors. Many health, medical care, and rehabilation programs serve as field instuction centers for schools of social work. Students of social work school with a concentation in their educational program are placed in these programs. The fielw teacher is usally a member of the medical social work staff who are appointed to train the students. Medical social worker as a field teather selects and arranges learning responsibility, participantion in inter diciplanary case conference, word rounds, chart review and so on, desiged to enhance the ability to perform the role of a social worker in medical settings. He also helps the students to extend and deepen his his knowledge of health and disease, of the culture and social structureof health institutions of the potential consequences of illnessand injury for social functioning, of the concept of comprehensive patient care and so on(Cockerill, 1960).

d) Role as a Coordinator
The Hospital social worker coordinates existing social work services to help the patients and their families to deal with social, economic and emotional crisis. He works with the team of physicians, nurses, psychologists and others therapist in medical settings. The physicians possess highest authority in the team and others must cooperate wholeheartedly under the doctor’s directions to success completion of treatment plan. The hospital social worker interprets and coordinates the patient’s and his family’s requests and recommendation of the physician. Moreover he coordinates the external and internal services to ensure better care and avoid duplications.

e) Role as a Consultant
As a consultant, Hospital social worker is involved in two type of consultation e. g. case consultation and program consultation. As a consultant he aims to increase the ability of the consultee to understand and to deal with the problem situation. In case consultation the medical social worker assist the consultee to identity the interrelationships between the biological and psychological problems of an individual and his psychological and social functioning. Moreover, he may suggest appropriate ways of intervening in order to present or modify adverse consequences of these relationships and develop social and psychological functioning. Similarly in program consultation the hospital social worker may assist the consultee in thinking through the possible consequences and efficacy of different polices programs, procedures and patterns of rendering health and medical care services for individual in need of them ( Cockerill, 1960 ).

 f) Role as a Researcher
Conducting research is must for the development of any profession on discipline Hospital Social Worker can study on subjects direct related to medical social work profession or can cooperate with other professional people in a multi-disciplinary study. For example, if the medical social worker identifies certain problems during working with the patients, he can decide to undertake study regarding their problems to investigate their nature, causes impact and find out necessary recommendations to solve these problems in order to help the agency or hospital to provide better medical case. He can also undertake or participate in studies of problems which are of interest and concern to medical social workers or to field of social work as a whole (Pathak, 1961).
Part One Part Two Part Three Part Four Part Five Part Six
Share on Google Plus
    Google Comment
    Facebook Comment