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March is Social Work Month Role of social worker critical to family by Eileen Miller, LISW Clinical Effectiveness I am one of the social workers in the adult hospital and am assigned to the Surgical Trauma ICU, the Neurosciences ICU and the Medical ICU.   Social worker Eileen Miller, left, confers with neurosciences nurse case manager Tracy Weaver and Dr. Julio Chalea, NSICU director. The ICU social worker deals with patients who have experienced a traumatic injury, those who are victims of crimes, the homeless, those who have substance abuse and mental health problems, and those experiencing chronic illness and end of life issues.   Typically, it is the patients' families that I meet, as most of the patients are too critically ill to respond. It is my job to assess the patient's support system, funding status, and to begin assisting families in thinking about discharge plans for the patient. It is important for me to identify early on any problems that could potentially impact a patient's appropriate and timely discharge. A typical day for me begins in one of these units.   In the STICU, I met with the family of a young man who was critically injured in an automobile accident. The patient suffered a severe head injury as well as multiple fractures. He was employed, but carried no health insurance. Due to the extent and severity of this patient's injuries, I knew that his hospitalization would be lengthy and expensive. If this patient survives, he would most likely be disabled from the severe head injury. I met with his family to offer support and talked with them about what his long term care needs would be and what their options were. I encouraged them to think about these options so they can decide on a plan that is best for them and the patient. I also gave them information on how to apply for funding assistance such as Social Security Disability and Medicaid and other community resources such as filing for Guardianship/Conservatorship in Probate Court. Since the family felt they may not be able to provide 24-7 care for the patient at home, we discussed nursing home placement.   In the MICU, I met with the adult daughter of a patient who suffers from a chronic pulmonary condition. The daughter had been the patient's caretaker for several years. We discussed the assistance she was receiving from other family members and home health agencies and what other services might be available to her.   As the patient's condition worsened recently, we also talked about end-of- life issues. The daughter wanted to know about hospice services, so I made a referral to the hospice coordinator to talk with her about what hospice can provide. Later, I met with the physicians, nurse case manager and other team members for our multidisciplinary rounds where we discussed the treatment plans and needs of the patients on the unit.   I then went to the MSICU to discuss a patient's progress with the physician and bedside nurse. The patient was an elderly man who was recovering from a hemorrhagic stroke. The physical therapist evaluated the patient and felt he would be an excellent rehab candidate. I met with the patient's wife to discuss what rehab is and what facilities are available. I made a computerized referral to the rehab facility his wife prefered and talked to the admissions coordinator there about bed availability and a possible transfer date so ambulance transportation could be scheduled.   In addition to meeting with staff and families during the day, there is also the required medical record documentation that must be done, as well as returning phone calls, scheduling family conferences, and preparing for the next day. Editor's note: To honor MUSC social worker accomplishments and bring to light the issues faced by social workers every day, MUSC is celebrating National Social Work Month with a series of articles during March. Each week this month, The Catalyst will spotlight an MUSC social worker with “A Day in the Life of …,” giving readers a glimpse into a typical medical social worker’s day.     Friday, March 10, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.