'Hospital discharge role is changing from assessor to care provider'
Jaison Musindo, a social worker with a hospital discharge team in Croydon, explains how coronavirus has impacted on his job
Professional Social Work magazine, 21 April, 2020. Share your COVID-19 experiences here.
The COVID-19 pandemic changed the way hospital discharge social work teams work. Hospital social workers are used to being based in hospitals as part of multidisciplinary teams. They attend MDT meetings and assess patients from the bed and engage with their families too.
But since the pandemic this therapeutic intervention has diminished with patients discharged much more quickly under the new COVID-19 discharge plan. This takes away the legal framework that is enshrined in the Care Act 2014.
Hospital social workers are now working outside the acute ward, following up patients discharged back home under discharge to assess (D2A) pathways. Working in this way comes with challenges. Social workers are now having to ensure they wear personal protective equipment (PPE) when carrying out assessments and at the same time are expected to observe the two metre distance rule.
There are ethical dilemmas too that we now face, such as when a social worker visits a patient in the community and finds them soiled or incontinent. This kind of handling is not our role or what we are trained to do but we can’t leave a patient in this way.
This is where we find the social worker role changes from assessor and commissioner to care provider and the need to keep the two metre distance goes out of the window. It means social workers have to get intimate to provide the care required.
If the person has a carer the social worker can call them and they will need to wait for the carer to arrive. If the person requires two carers, then the social worker will become the second carer.
These changing roles mean that social workers are spending more time with the client which is a good thing in a way to get an evidenced-based assessment. Some social workers, however, are not prepared for this hands-on role. They require training in areas like manual handling techniques and the whole health and safety element that comes with performing such tasks.
When working with people who have COVID-19, the PPE that is provided is not as complicated as that used in acute wards. A plastic apron, face shield, mask and pair of gloves is all that is needed. However, there is the issue of PPE disposal after the intervention.
An issue community social workers face working in an acute ward is that we don’t have changing facilities or places to wash after interventions – all we have is alcohol gel.
These are stressful times for frontline social workers and we must look after ourselves. Teams should have weekly supervision and opportunities to offload so that they don’t get emotionally bogged down and feel alone and under-valued.
It’s important to encourage, if possible, a daily debriefing via video conferencing to ensure everyone is okay and feels safe.
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This article is published by Professional Social work magazine which provides a platform for a range of perspectives across the social work sector. It does not necessarily reflect the views of the British Association of Social Workers.