Should I be this mad at a social worker's allegations?
January 30, 2011 12:39 PM   Subscribe

Am I wrong to be furious about allegations made by a social worker?

I was hoping that people could offer suggestions/advice on how to respond to allegations that were made by a social worker regarding how we are/are not caring for our son.

Brief Background:
My son recently spent four nights in the hospital after an admission for diabetic ketoacidosis-- this was not his first admit for DKA ( he's been admitted 7 times to this hospital, 1 to another hospital. )

He was admitted on Tuesday after having had labwork done as part of a normally scheduled appt. with a nephrologist to discuss the liver enyzme issues that were found on his last DKA admission approx. 4 weeks ago. No outward signs of DKA were present ( blood sugar was low, no Kussmaul respirations, etc-- on several previous admits, they've rerun the labs because doctors did not believe his was in DKA. )

The Social Worker Encounter:

Friday morning, I get a phone call at work from my son's hospital room-- "Dad, why'd this lady come to my room and ask me all these emotional questions? She was pushing me, it really bothered me."

Friday afternoon, my wife receives a call from the hospital social worker, which results in the following allegations being made by the social worker. ( Disclaimer: my wife is a nurse at the same facility, and is regularly required to document her calls to doctors and social workers. Ohio's also a single-party consent to record state. )

1. Our son is regularly not checking his sugar, and that the endocrinologists are concerned because they downloaded his meter.

I grabbed my son's meter Friday night, downloaded last 60 days of readings... except for his hospital stays, only one meal check was missed.

2. He was sneaking food in the hospital.

He was on an IV pole, no food was present in room, he was left with no money for vending machines, and the nurse that was on duty was a bit shocked at the accusation, considering the only source of patient food is in a refrigerator at the nurses station.

3. Our son's endocrinologist is incapable of managing a pediatric patient.

A1C initial diagnosis: Above 14
A1C after 8 months of care under hospital endocrine service: 13.
( Subcutaneous insulin, Novolog and Lantus. )

A1C after 12 months of care by his current endocrinologist: Dropped to 8.7.

Other problems were diagnosed ( celiac and thyroid ) around the time of his first DKA admission, after a year of fairly successful control for a diabetic teen under the current doc.

4. "He's sad because the house is so chaotic with 5 other kids running around."

We only have 4 kids -- if there's 2 extra kids running around, we seem to have misplaced the paperwork for them.

Am I wrong to be annoyed with the social worker in this case?
She seems to have crossed the line from patient advocacy into recruiting patients for the hospital's own endocrine service.

( My wife, for what it's worth, is now "ashamed to work at the same facility" and her coworkers have all said this social worker is known to be confrontational. )
posted by Ninevolt to Human Relations (13 answers total) 2 users marked this as a favorite
How old is your son?

Who initially called the social worker to your son's hospital room? Or is it a routine visit made by social workers around the pediatric unit?
posted by vincele at 12:48 PM on January 30, 2011 [1 favorite]

He's 14, and we've yet to determine who called social work to his room.
posted by Ninevolt at 12:53 PM on January 30, 2011 [1 favorite]

Is it possible that the social worker has mistaken your child for another patient?
posted by easy, lucky, free at 12:53 PM on January 30, 2011 [13 favorites]

This sounds like the sort of thing that must be reported, unemotionally and immediately, to their supervisor. "Social worker x made the following allegations against us, all of which are easily disproved by fact and impartial witnesses. I find this concerning, don't you?"
posted by L'Estrange Fruit at 12:58 PM on January 30, 2011 [45 favorites]

Plus the fact that she upset your kid. Grawr.
posted by L'Estrange Fruit at 1:01 PM on January 30, 2011 [6 favorites]

yes you are right to be furious but now is not the time to express it. the anger tht comes across in your post is more damaging to you now than anything this woman has done so far. Do not take you eye of the ball here because of your emotions, valid as they are.

you need to very carefully, and as calmly and unemotionally as possible document exactly what you wrote above, highlighting the discrepancies as you have done and find out who the supervisor is for this person.

Firstly, send it to her with a polite request that it be sent to her supervisor. By all means express in this letter how very upsetting it is to hear these erroneous statements when your child's health and social wellbeing are being questioned.

Ensure that a copy goes to the senior nurse on duty and the department as well as the hospitals legal department as basically the reputation of everyone caring for this child is being tarnished. See this as a team effort to protect this child.

there are some people in social work who for whatever reason and I suspect burn-out has a lot to do with it, cut corners and make more superficial judgements than they should.

Assume in the first instance that this is the case: that this lady just burned out on the last case she dealt with of the junkie parents who not only pimped their 3 year old but burned her regularly with cigarettes and put the pictures on the web.

I am not saying this for the shock factor but because I remember talking to a social worker in an ER who brought in a 3 yr old where this was the case. For the moment give her the benefit of the doubt that stress/horror/burn-out made her careless in your case.

the errors of fact in these allegations should be enough to get a more senior manager to address you concerns. Dealing with brittle diabetes is a minefield of itself, this is the last thing your family needs right now but please, in the first instance be as calm as you can.
best of luck
posted by Wilder at 1:03 PM on January 30, 2011 [9 favorites]

It is possible that this is an error, that there is another patient of similar age whose circumstances correspond to the ones the SW described. That does not make it OK--it's really important for people to get this stuff right--but given how overloaded case workers are right now in the underfunded public sector, things go wrong.

So I would approach this "as if" it were a simple error. Your son's equipment shows that he did not miss checks; he does not have five siblings; his endocrinologist is experienced with pediatric case management. Clearly, the report must refer to another patient in the system.

This gives everyone the opportunity to save a bit of face. As you respond to the supervisor/center manager/hospital ombudsman/patient advocate/whoever, if you take the tone of "Whoops! Something went wrong!" rather than "OMG THIS PERSON IS A JERK WHO IS INSENSITIVE" you will likely get less pushback.

That said, it sucks that this person was so incompetent at her job, and that she upset a sick kid who is trying to do his best to manage a challenging illness, not to mention his worried parents. GRRR! I growl on your behalf. Still, keeping that energy out of the follow-up will likely help you achieve the results you want.
posted by Sidhedevil at 1:44 PM on January 30, 2011 [5 favorites]

I suggest contacting the social worker directly and very frankly, but without anger, ask them this question. They should be prepared to work with you regarding your son. If they aren't willing to work with you, then that's when you go to their supervisor. You act as if you and the hospital social worker didn't have exactly the same goal: your son's health. If you approach this as a conflict, that's what it's going to be.
posted by fuq at 1:53 PM on January 30, 2011

Annoyed, no. Furious is maybe a little overboard.

First, remember that this person is used to dealing with a lot of parents not only neglecting their children but in some cases willfully abusing them, as Wilder pointed out. Now in this case your son has three conditions that would be serious on their own, and together can create cross complications which escalate exponentially the discipline your son needs to maintain optimal health. In her perspective, neglect doesn't mean you locked him in a closet for two weeks with no food or water, it means you didn't read the label on the ketchup bottle to see if they added flour to thicken the batch.

Remember, the social worker has the same goal as you do, to keep your son healthy and out of the hospital, only she doesn't have to watch him suffer when he can't eat the things his siblings and friends are. Right now you both have concerns, and I'm assuming that since your wife learned of this in a phone call there hasn't been an official report or complaint against you and her call was in fact to verify some of the information she had gathered. I also assume she wants to meet with you to discuss this.

Keep in mind the following on your itemized complaints above:

1. The endocrinologists may not have considered the hospital stays and saw these as gaps. I would suggest putting these readings you downloaded into a table and highlighting the gaps for the hospital stays, or trying to get the meter levels during the hospital stays and adding them to the table.

2. Maybe get a statement from the duty nurse, but consider this could be true, especially if he had friends visit or has made friends with other patients.

3. Even if this is not the case, it usually never hurts to have more than one opinion. The doctors at the hospital probably commented to her that it was unusual to have as many admissions as your son, but may have made the same choices for treatment. If you are attached to your sons endocrinologist you could possibly see another one to treat his thyroid condition and in theory the two should coordinate on both conditions. If you talk to your son's endocrinologist, he may even tell you he would be better off using the hospital service.

4. This was likely a misinterpretation of something your son said, likely something about "the six of us getting ready in the mornings" which she may have taken to mean 6 children instead of 4 and 2 parents. 14 year olds can be a little vague sometimes and their answers don't always line up with even direct questioning.

When you meet with her I would suggest you put your concerns in a letter to her. Right now I think your only complaints are that she was a little abrasive with your son and she did not check her facts very well, which I assume is what she is doing now.

And remember, do not get upset, it can only be counterproductive. Remember, you are trying to reduce the situation, not escalate it. And document, document, document. If you haven't already, it would be a good idea for your some to keep a daily diary of everything he eats, medications he takes and his meter readings. He may also have some food intolerances that have not been diagnosed yet and could skew some of the tests.
posted by Yorrick at 2:43 PM on January 30, 2011 [5 favorites]

OK, I think we're just going to take a breather first, and request the full copies of his charts/notes. After that, we're going to write a Nicely Worded Letter to hospital patient relations staff, with a cc: to the appropriate supervisor.

In retrospect, it's just been rather hectic trying to stay on top of his multiple medical conditions, but for pete's SAKE, this was a sore spot this person chose to poke with a stick.
posted by Ninevolt at 5:07 PM on January 30, 2011 [2 favorites]

If this goes anywhere, make sure you can document everything just like you did here. In fact, statements from doctors and nurses who treated your son would be awesome too.

This social worker needs to have her supervisors know what a bang up job she's doing.
posted by hal_c_on at 7:06 PM on January 30, 2011

Yes...don't get emotional.

If I may offer an alternative perspective, for which I will undoubtedly be flamed, I wouldn't take this lightly. Be aware that under the guise of "protecting children", social workers and their associated bureaucracy have significant latitude to act against your families interest on evidence that would be laughed out of a court of law, and frighteningly little culpability for bad decisions. Yes, this is in general a necessary thing, but for every extreme case of "3yo pimped out and burned with cigarettes", there's an extreme case of "social worker with an axe to grind unjustly takes kids away for months or years forcing family to spend huge money and unlimited time to 'prove' they aren't unfit parents, something they can never really do after the accusation has been made, and then left to deal with the damage to their family".

Personally, if I had someone fire a shot across my bow like this, especially one this seemingly unfounded, I'd take the accusations, the case documentation, all medical records, maybe some affidavits from the attending staff, and spend a bit on a consult with a lawyer who specializes in this sort of thing. At a minimum, you'll understand your situation and know what your options are with respect to a response.
posted by kjs3 at 7:43 PM on January 30, 2011 [4 favorites]

Does "sneaking food" mean she offered him a mint and he accepted?
posted by aimedwander at 7:19 AM on January 31, 2011 [1 favorite]

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