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    Hospital Social Work Interventions
    Hospital Social Work Interventions
    Hospital Social Work Interventions
    Ebook154 pages3 hours

    Hospital Social Work Interventions

    By Cesar M. Garces Carranza PhD

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    About this ebook

    The book is about the interventions of the social worker in the hospital:

    ER, MICU/CCU, Medical Surgical Units                                                                 

    LanguageEnglish
    PublisherGoldTouch Press, LLC
    Release dateJun 24, 2019
    ISBN9781733226431
    Hospital Social Work Interventions
    Author

    Cesar M. Garces Carranza PhD

    Doctor César Garcés was born in Lima Perú. His professional career began at the Universidad San Martin de Porres in Lima-Perú in 1973. In 1975 moved to the United States and entered Southwestern College, graduated in 1979 (BA) in Psychology and Social Work. In 1983, entered Fordham University (Graduate School of Social Work), graduated in 1985 (MSW). Worked at ¬ e Puerto Rican Family Institute Mental Health Clinic from 1985 to 1989. Worked at ¬ e Bronx Lebanon Hospital Center from 1989 to 2013. In 1997, entered Yeshiva University (WWSSW), graduated in 2002 (PhD). In 2007 was awarded "¬ e Best Social Worker" from the Department of Medicine at Bronx Lebanon Hospital Center. In 2008, was included in ¬ e Cambridge "WHO is WHO" among Health Care Professionals in the USA. In 2012, was included in "¬ e Latino American WHO is WHO." In 2013, received "¬ e Latino Task Force Award" from the City of New York. In 2017, was recognized as "Illustrious Expositor" at the IV International Social Work Conference in Santiago-Chile. In 2018, was recognized as "Illustrious Expositor" at the V International Social Work Conference in Mérida-México. In 2019, was recognized as "Illustrious Expositor" at the VI International Social Work Conference in Lima-Perú. Doctor Garcés has a long work history experience in Hospitals and Outpatient Mental Health Clinics since 1985 (Puerto Rican Family Institute from 1985 to 1989; Queens Neuropsychiatric Institute since 1989; Flushing Hospital (MHC); Community Counseling Services since 2013); and working with people of different ethnic and multicultural backgrounds. Has published several articles in Spain, Latin América and Puerto Rico. Has participated in several international Social Work Conferences in Perú, Chile, Ecuador, México, Colombia.

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      Book preview

      Hospital Social Work Interventions - Cesar M. Garces Carranza PhD

      cover.jpg

      Hospital

      Social Work

      Interventions

      César M. Garcés Carranza, PhD

      Copyright © 2019 by César M. Garcés Carranza, PhD.

      Library of Congress Control Number::      2019907874

      Paperback:    978-1-7332264-2-4

      eBook:            978-1-7332264-3-1

      All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any electronic or mechanical means, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.

      Ordering Information:

      For orders and inquiries, please contact:

      1-888-404-1388

      www.goldtouchpress.com

      [email protected]

      Printed in the United States of America

      Contents

      Acknowledgements

      Introduction

      Chapter 1:  Chronological history of social work in the United States

      Chapter 2:  Social work intervention in the hospital setting

      Chapter 3:  Social work and the importance of communication with families of patients admitted to the intensive care unit

      Chapter 4:  Social work intervention with families of patients with Alzheimer’s and Dementia in the intensive care unit

      Chapter 5:  Social work in the intensive care unit: Role Theory-Crisis Theory

      Chapter 6:  Social work and discharge planning in the hospital setting

      References

      DEDICATION

      This book is dedicated to

      my parents Luis and Domitila

      and to my sister Cristina

      Acknowledgements

      It is always a good idea for all of us to pay tribute to the people who have helped us with our projects in this life. I am not an exception when it comes to this notion for so many people have helped to mold and shape my ideas about social work in a hospital setting. First, I was lucky enough to land a job at the Bronx Lebanon Hospital in the South Bronx over twenty-three years ago. It is in this hospital that I have been brought to life about the historical link between social workers and the hospital. Moreover, since this is a busy hospital that deals with every possible medical and psychosocial issue in the world, I had been left alone to figure it all out by myself. I want to thank the hospital administrators, doctors and nurses for their undeniable dedication to their patients, regardless of how busy or overwhelmed they were, as that is what allowed me to become a pioneer in the field of social work. I never had a manual or a guidebook, but still, I have been a social worker in the Emergency Room, the Intensive Care Unit, and the Medical/Surgical Units of this hospital for almost a quarter of a century. I have had the maximum amount of time in this hospital to figure out exactly what social workers should be doing in hospitals in the first p lace.

      I would like to thank the patients, for they are the ones who have allowed me to grow. They have curiously enough shown me the road less traveled, for without the patients I would not know the things I know now.

      César M. Garcés Carranza, PhD

      Social Worker

      Introduction

      The objective in the following work is to describe the different interventions used by social workers who work with the families of patients admitted to hospital: to the emergency room (ER), intensive care unit (ICU/CCU), and Medical/Surgical Units. With all the interventions explained, however, the emphasis is placed on the communication that takes place between the medical personnel (doctors/nurses), and the families of patients. The social worker ensures that the emotional needs of both patients and patients’ families are met, which means that along with psychotherapy and counseling, they solve psychological problems as well.

      The author was a social worker in the Bronx Lebanon Hospital Center from 1990 to 2013. The hospital is in the South Bronx, which is one of the poorest neighborhoods in the United States. Even though the people who live near and around the hospital are in poverty, still, the neighborhood turns out to be home to an extremely diverse group of people. The streets are filled with immigrants from all over the world. Once again, what is different about this diverse population is the fact that almost fifty percent (50%) of the population lives below the poverty level. In addition, the citizens from the South Bronx live with chronic illness, such as AIDS, asthma, and diabetes. Moreover, the psychosocial problems are rife: gang activity, drug and alcohol abuse, prostitution, homelessness, unemployment, child abuse, elder abuse, and domestic violence are but a few of the common problems faced by people who live in the South Bronx (Bronx Lebanon Hospital, 2007).

      The demographic population of the South Bronx by ethnic groups in New York City: 2010-2016.

      Produced by the US Bureau Census for the years: 2010, 2011, 2012, 2013, 2014, 2015, 2016.

      The author’s intention in this book is to discover himself in the history (and traditions) of social work, to understand once and for all that the work he did at Bronx Lebanon Hospital has been done before by other social workers before him. Thus, in this book, he does something very important: traced the entrance of the social worker into the hospital setting, but especially into the ER, and later into the ICU, and eventually into the Medical/Surgical Units. For instance, he wrote about Dr. Richard Cabot from the Massachusetts General Hospital, who in 1905 was the first doctor to invite social workers into the hospital to make certain social work interventions that heretofore had not been made.

      This book on Social Work Interventions in the Hospital Setting is not really a history of social work, however, the author does not remain stuck in the past. He writes about now what he did as a social worker in the Bronx Lebanon Hospital in the South Bronx. Generally, the patients were very sick; they were often at risk of death. The families of these patients occasionally suffered in a multitude of ways due to poor communication with medical staff. This means, that from the time their loved one entered the hospital, they were in the dark. Everything about the condition of the patient was somehow unknown. Almost every question went unanswered. This is where he, the author and social worker, entered the picture. The social worker explained the situation in human terms, which made sense to family members, guided the families through a vast labyrinth (medical bureaucracy), which can often seem cruel. Ultimately, the social worker arranged for the patient to be discharged from the hospital, but at the same time prepared families for realities about a loved one. It might be the case that family members were facing the patient’s true condition for the very first time. This means that the families were in denial about something like drug addiction to prescription pills or in denial about the patient’s insistence on having unprotected sex, taking the chance of transmitting Hepatitis C or other sexually transmitted diseases to significant others, or having a terminal illness, and death.

      The author’s experience as a social worker in the ER, ICU, and Medical/Surgical Units is extensive. He has been that crucial mediator needed between doctor and patient. Over twenty-three years, he helped many patients and their families to recover. For example, in the intensive care unit (ICU), the author has been the go-between [between doctor and patient], who accompanied the family members during the admission of their loved one, helped families work through the terrible stress and anxiety associated with having a loved one in the ER, the ICU, or in the medical units, often dealing with explosive emotions. Family members are like time bombs ready to go off. He was able to intervene and brought sense and sanity to a very volatile situation. Just like the doctor or the nurse never abandons the patient, the social worker never abandons his/her patient, and, also, their families. The social worker did not just intervene. He also educated patients and their families about the medical conditions they were facing, as well as the hindrances that may have been added to their daily routine due to the condition itself. These are major tools of social work.

      It is important for social workers to educate the medical staff (doctors/nurses), administrators and the public about the importance of their interventions with patients, families, and all other systems. The value of knowing about these interventions will help to make social workers more of an integral part of every health care organization, but especially a vital part of hospitals.

      Social workers belong in the ER, as well as the ICU, and in any and every unit of general medicine. Social workers provide clinical services, as well as a myriad number of concrete services. Social workers help patients and their families to overcome the crisis at hand, such as the admission to the hospital, or the sudden death of a loved one, or an instance of domestic violence, child abuse, elder abuse, homelessness, drug abuse, or chronic alcohol abuse. Furthermore, the social worker is the ideal discharge planner, as he/she knows the entire case history of the patient like no other member of the medical team.

      Social work is a unique profession that has had to change directions on several occasions. Its history is sui generis (unique—one of a kind). Social work as a profession has made several adjustments and changes, but it has always come back again ever more adaptable—in this case, social workers and the essential work they do in hospitals. The author would like his effort here to contribute to the overall efforts of social workers; to alleviate suffering and give both patients and families the tools needed in order to return their lives to homeostasis, to balance, to regained health, and a sense of confidence in those people they have learned to call helper.

      Image_2.jpg

      Chapter One

      Chronological history of social work in the United States

      This summary represents a chronological recompilation of the origin of social work in the United States.

      Social work as a profession has its origin in the 19 th century. It starts as a movement that concerns the poor. The movement for the poor started principally in England and the United States. Up until this time, poor people in history were not in any way noticed or singled out for special regard by monarchies or by the nobility or the merchant classes. Even after the end of Feudalism, poor people

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