Social work: Careers in schools or hospital/healthcare settings?
November 3, 2019 1:04 PM Subscribe
I’m interested in going to graduate school to earn a MSW. What’s it like to be a school social worker or a social worker in a hospital/healthcare setting? What is the demand/competition like for these jobs?
I work at a non-profit organization. Due to the nature of my role, I tend to feel disconnected from the impact of my work. I'm interested in a career where I can support people more directly on a day-to-day basis, so I'm thinking about applying to MSW programs.
I've primarily worked on issues and programs related to public education, but also have a long-standing interest in health services. I'd love to hear from any social workers (or those who know social workers) about what it’s like to work in a public school or in a hospital/healthcare environment.
I would be grateful for any advice, but am especially interested in the following topics:
I work at a non-profit organization. Due to the nature of my role, I tend to feel disconnected from the impact of my work. I'm interested in a career where I can support people more directly on a day-to-day basis, so I'm thinking about applying to MSW programs.
I've primarily worked on issues and programs related to public education, but also have a long-standing interest in health services. I'd love to hear from any social workers (or those who know social workers) about what it’s like to work in a public school or in a hospital/healthcare environment.
I would be grateful for any advice, but am especially interested in the following topics:
- Day-to-day responsibilities
- Job market for these types of roles. How hard is it to find a social work job in a school or hospital?
- Potential to positively impact the people you work with. Do you find your work meaningful and fulfilling?
- Biggest challenges
- Overall level of job/career satisfaction
I don't know what it's like to be a school social worker, but I can tell you about being a hospital social worker.
Day to day responsibilities can either be case management based, or clinical (therapy). Case management involves advocacy referrals, case planning meetings with interdisciplinary teams, and writing notes. Sometimes as part of case management I utilize interventions like motivational interview or brief solution focused therapy, to give my case management direction. The MSW brings a sense of the social and emotional parts of the client to interdisciplinary meetings where other practitioners may be mostly focused on biological stuff. Social workers have a major role in discharge planning - making sure people are supported when they leave hospital. This can mean formal supports, like external social service agencies, or informal supports - which often requires you to get the people in the client's life to work together. Many of the clients you'll deal with will have inadequate informal support systems.
Different hospitals have different cultures and attitudes towards social work. It's a good idea to find out something about the hospital you want to work out before you apply there, because it can vary drastically. No matter where you work, when there is a complicated interpersonal or psychosocial situation that the medical staff don't know how to deal with, they will frequently page social work.
If you want to be a therapist with an MSW, you'll need post graduate education in a specific modality or modalities of counseling. CBT is very useful and sought after by employers.
I don't know where you live. Where I live there are enough jobs that if I get tired of working in one area, I can easily move to another. I've heard that some parts of the US are saturated with MSWs and other therapist types - Portland and Seattle, mostly. In Canada, the programs where you can get an MSW with no BSW are being eliminated, partly because of this problem. Also partly because you can't really get the same skills in two years of education that you would in 6-7, and employers are realizing that candidates without a BSW have less skills.
Meaning and fulfillment come and go. Don't expect your work to be consistently more meaningful or fulfilling than other types of work, because it might not be. Sometimes it is. Case management can start to feel mechanical when you do the same things over and over again. The biggest challenges for me are feeling like my clients' lives are shaped by violent men and not being able to do anything about it, and practicing in the context of late neoliberalism, where all the good programs are getting defunded and everyone is more and more isolated and communities are undermined by individualism. But I keep showing up.
I practiced for several years with a BSW, and it kind of sucked. MSW level jobs give you a lot more autonomy and feel more meaningful. I like the complexity of working in acute care or psychiatry much better than I liked working in child protection or for non-profit social service agencies. MSW jobs are more likely to be 9-5, whereas BSW jobs often involved shift-work.
Memail me if you have more questions.
posted by unstrungharp at 1:43 PM on November 3, 2019 [5 favorites]
Day to day responsibilities can either be case management based, or clinical (therapy). Case management involves advocacy referrals, case planning meetings with interdisciplinary teams, and writing notes. Sometimes as part of case management I utilize interventions like motivational interview or brief solution focused therapy, to give my case management direction. The MSW brings a sense of the social and emotional parts of the client to interdisciplinary meetings where other practitioners may be mostly focused on biological stuff. Social workers have a major role in discharge planning - making sure people are supported when they leave hospital. This can mean formal supports, like external social service agencies, or informal supports - which often requires you to get the people in the client's life to work together. Many of the clients you'll deal with will have inadequate informal support systems.
Different hospitals have different cultures and attitudes towards social work. It's a good idea to find out something about the hospital you want to work out before you apply there, because it can vary drastically. No matter where you work, when there is a complicated interpersonal or psychosocial situation that the medical staff don't know how to deal with, they will frequently page social work.
If you want to be a therapist with an MSW, you'll need post graduate education in a specific modality or modalities of counseling. CBT is very useful and sought after by employers.
I don't know where you live. Where I live there are enough jobs that if I get tired of working in one area, I can easily move to another. I've heard that some parts of the US are saturated with MSWs and other therapist types - Portland and Seattle, mostly. In Canada, the programs where you can get an MSW with no BSW are being eliminated, partly because of this problem. Also partly because you can't really get the same skills in two years of education that you would in 6-7, and employers are realizing that candidates without a BSW have less skills.
Meaning and fulfillment come and go. Don't expect your work to be consistently more meaningful or fulfilling than other types of work, because it might not be. Sometimes it is. Case management can start to feel mechanical when you do the same things over and over again. The biggest challenges for me are feeling like my clients' lives are shaped by violent men and not being able to do anything about it, and practicing in the context of late neoliberalism, where all the good programs are getting defunded and everyone is more and more isolated and communities are undermined by individualism. But I keep showing up.
I practiced for several years with a BSW, and it kind of sucked. MSW level jobs give you a lot more autonomy and feel more meaningful. I like the complexity of working in acute care or psychiatry much better than I liked working in child protection or for non-profit social service agencies. MSW jobs are more likely to be 9-5, whereas BSW jobs often involved shift-work.
Memail me if you have more questions.
posted by unstrungharp at 1:43 PM on November 3, 2019 [5 favorites]
A couple more things: In my jurisdiction, MSWs are unionized and paid at a higher rate than nurses - although the manager of a hospital unit here is more likely to be a nurse than a social worker. In psychiatry MSWs do case plans that map out how the psychiatric nurses should engage with patients. We also do individual and family therapy, assessment and discharge planning.
posted by unstrungharp at 1:48 PM on November 3, 2019 [1 favorite]
posted by unstrungharp at 1:48 PM on November 3, 2019 [1 favorite]
Hospital jobs tend to be about the best paying (maybe second to the VA) so they're somewhat competitive relatively, though within the framework of "social work as a whole is a field with a low bar to entry." Some of them, though not all, are LCSW level jobs meaning you won't be able to apply for them until you've spent two years in school and, on average, two years jumping through hoops. Schools, at least where I did my graduate work, you can do a track that is particularly for working in schools and go straight into doing that.
posted by less of course at 4:47 PM on November 3, 2019
posted by less of course at 4:47 PM on November 3, 2019
I'm a social worker in mid-career. Whenever I hear someone say "your work is so much more meaningful because you help people, I wish I did that" my alarm bells go off. Most social work jobs are very stressful, frightfully underpaid and very short in gratitude. It's best to be interested in learning the techniques and skills needed for successful practice, such as de-escalating people who wants to yell at you, advocating and navigating systems, etc. rather than the nebulous "helping people". I recently started saying "I'm a psychotherapist" because that is what I do, and people mostly don't says this stuff anymore.
As a hospital social worker you will be doing mostly discharge planning. In a school setting there is more case management and direct support for students, but your load will be enormous as there is usually one sw for the whole school. You can do a search for "school social worker job" and see the duties. I've known some school swers who love their jobs (plus get summers off!).
As I've said before, I personally don't work for thanks from people I work with. I get paid money to do what I do, and sometimes people are in no shape to be thankful. I love what I do because I am interested in psychology and love learning. I have sw friends who love management and solving problems, they are also very good at their jobs. I do like people and am happy when things go well for them, but they don't always and if I was discouraged by that I would not be doing this work.
Challenges - underpaid, super busy, stressful, frequently inflexible, sometimes dangerous. Rewards - for me this is doing what I like, seeing people for psychotherapy, teaching at a university level, and being independent. But it can take some time to get where you want to be, like you'll need to be fully licensed and have experience before you can get school social worker job.
posted by Shusha at 5:08 PM on November 3, 2019 [4 favorites]
As a hospital social worker you will be doing mostly discharge planning. In a school setting there is more case management and direct support for students, but your load will be enormous as there is usually one sw for the whole school. You can do a search for "school social worker job" and see the duties. I've known some school swers who love their jobs (plus get summers off!).
As I've said before, I personally don't work for thanks from people I work with. I get paid money to do what I do, and sometimes people are in no shape to be thankful. I love what I do because I am interested in psychology and love learning. I have sw friends who love management and solving problems, they are also very good at their jobs. I do like people and am happy when things go well for them, but they don't always and if I was discouraged by that I would not be doing this work.
Challenges - underpaid, super busy, stressful, frequently inflexible, sometimes dangerous. Rewards - for me this is doing what I like, seeing people for psychotherapy, teaching at a university level, and being independent. But it can take some time to get where you want to be, like you'll need to be fully licensed and have experience before you can get school social worker job.
posted by Shusha at 5:08 PM on November 3, 2019 [4 favorites]
A close friend of mine was formerly a burnt out hospital social worker. She is no longer in social work. You'll be dealing with people across the socioeconomic spectrum. They could be young or old, immigrants, non-English speakers, homeless, criminals, drug addicts, mentally ill etc. Some of your clients might be crime victims (e.g. child abuse, domestic violence) and you might have to make tough judgement calls and deal with the police.
Clients and their families might be in pain, distressed, confused or struggling with their medical problems, financial and other personal issues. The atmosphere might be fraught and they might take it out on you. They might have complex problems that you are unable to solve given limited institutional and welfare resources. Clients might get worse or die or their lives might deteriorate due to non-medical factors while under your care. Things might get really stressful.
Having said all these, like all social work, it's an important and meaningful job regardless of whether clients may or may not be "grateful". Common duties include helping clients to figure out how to pay their hospital bills and hospital red-tape, handling discharge (e.g. at home care), referrals to other agencies and institutions like nursing homes and hospice, counseling clients and their families.
posted by whitelotus at 5:31 AM on November 4, 2019
Clients and their families might be in pain, distressed, confused or struggling with their medical problems, financial and other personal issues. The atmosphere might be fraught and they might take it out on you. They might have complex problems that you are unable to solve given limited institutional and welfare resources. Clients might get worse or die or their lives might deteriorate due to non-medical factors while under your care. Things might get really stressful.
Having said all these, like all social work, it's an important and meaningful job regardless of whether clients may or may not be "grateful". Common duties include helping clients to figure out how to pay their hospital bills and hospital red-tape, handling discharge (e.g. at home care), referrals to other agencies and institutions like nursing homes and hospice, counseling clients and their families.
posted by whitelotus at 5:31 AM on November 4, 2019
Beware of change. Despite its name, hospital social work is heavily on the business side of the equation - finding sources of payment for care for indigents, negotiating convalescent or drug treatment beds for those being discharged, negotiating transfers to public/charity hospitals from for-profit hospitals' ERs after stabilization. None of that work exists in its present form in a single-payer healthcare regime, and much of it goes away altogether.
Single payer is also likely to result in heavy consolidation of urban and suburban hospitals, which will impact support staff far more than front-line clinical staff, and may impact salaries as well.
posted by MattD at 8:45 AM on November 4, 2019 [1 favorite]
Single payer is also likely to result in heavy consolidation of urban and suburban hospitals, which will impact support staff far more than front-line clinical staff, and may impact salaries as well.
posted by MattD at 8:45 AM on November 4, 2019 [1 favorite]
Beware of change. Despite its name, hospital social work is heavily on the business side of the equation - finding sources of payment for care for indigents, negotiating convalescent or drug treatment beds for those being discharged, negotiating transfers to public/charity hospitals from for-profit hospitals' ERs after stabilization. None of that work exists in its present form in a single-payer healthcare regime, and much of it goes away altogether.
In the UK, which is of course a single-payer system, hospital social work is actually pretty similar. A lot of time goes into finding and arranging transfers out of acute wards to other places (including commercial nursing home care which is only partially publicly funded).
posted by atrazine at 7:11 AM on November 18, 2019
In the UK, which is of course a single-payer system, hospital social work is actually pretty similar. A lot of time goes into finding and arranging transfers out of acute wards to other places (including commercial nursing home care which is only partially publicly funded).
posted by atrazine at 7:11 AM on November 18, 2019
This thread is closed to new comments.
- Discharge planning, referrals to skilled nursing facilities, placements in shelters or other post-hospital settings
- Quick assessments
- Assessments and referrals around issues specifically mandated by regulatory requirements - such as assessments for elder abuse and referral to the appropriate community agency to address. Or assessment of patients who come in for a trauma.
Of note the social workers do overlapping work to me but in my state (CA) where nurses are union and paid well, the social workers get paid significantly less than us - although still a reasonable wage/benefits/etc.
Overall, IMHO inpatient case management and social work varies in how satisfying it is depending in part on what you put into it.
It exists to meet regulatory requirements for the hospital & to get pt's discharged. There is also a very high potential for burnout. Or actually, 100% of us get jaded working in the hospital at least to some degree. BUT, a caring and compassionate social worker who maintains their commitment to the patients is a wonderful thing that CAN make a big difference for people. It's just that the extra mile you go to really make sure the patient is connected with the services they need, or even has an ear to hear what's going on, is extra on top of what your boss is grading you on. Something to be aware of.
While inpatient case management and social work is in my opinion a mixed bag, there are other opportunities in medical social work that are very cool, such as intensive case management, or being part of various inovating programs for patients with specific diagnoses or who are homeless or whatnot. I think it's a field where you have potential to do really cool stuff if you want to.
I think I want to put a bug in your ear that nurses do a lot of overlapping work with medical social work, and are often paid better. But the downside is you usually have to start as a bedside RN and those jobs are really stressful especially for the first couple years while you're learning.
posted by latkes at 1:41 PM on November 3, 2019 [4 favorites]