Sample Essay On Bouncers, Brokers, And Glue: The Self-Described Roles Of Social Workers In Urban Hospitals

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Introduction. The intervention into social circumstances of the patients is crucial to provide holistic approach to health care. Though social workers have historically been fulfilling this role, their own perceptions of their function and professional contribution can vary. The study of Craig and Muskat (2013) synthesizes the input from social workers in urban hospitals, evaluating their understanding of their roles and expectations from them, as well as discussing the implications for practice.
The study. The purpose of the study was to solicit the input from social workers employed in urban hospitals about their perceptions of the roles, contribution, and professional functioning in a rapidly changing health care environment (Craig and Muskat, 2013). The study conducted in a large Canadian city with multiple hospitals was designed as qualitative research (7 focus groups, n= 65). The qualitative design allowed the researchers to ensure flexibility and focus on detail which is not always provided by quantitative methods. The specific design of focus groups ensured group interaction. The participants expressed their thoughts, gave clues to the others, and discussed the ideas which depicted similarities and differences in their responses, with possibility of comparison. The in-depth interview method enhanced flexibility. The researcher asked open-ended questions, which gave space for description in participants’ own terms, conveying shades of meaning specific to them. However the limitation arising from the use of focus-group methods, or a specific effect which the human (researcher’s) presence could have had on the responses modifications by respondents, should have been taken into account when analyzing the results as it might have impacted the outcomes. The latter also depended on the skills of the researcher in gathering, analyzing and evaluating the information. The samples were chosen by a purposive sampling method, and the specific measures were taken to provide a diversity of population who had been recruited in different hospital settings through their leaders. That let the researchers provide the satisfactory representation of participants of different professional, demographic and ethnic backgrounds, age and educational levels, and even job titles (e.g. social worker, professional practice leader or case manager). That ensured a good quality of sample; however, the diversity of settings and job duties was not assessed quantitatively. So the issue of transferability of findings among settings and\or to another setting, which is an issue in the qualitative research itself, became even more prominent. It seems the researchers tried to use additional methods to ensure credibility, confirmability, dependability, and transferability of their study. These included prolonged engagement, peer debriefing, thick description and audit trail. It appears that additional measures were taken to minimize possible bias by use of reflexivity and bracketing by each focus group. That gave the researcher a possibility of fair assessment of any possible influence of personal experiences on results’ interpretation and thus ensured good methodological quality.
The results were in line with previous studies’ findings suggesting that social workers’ role in health care settings was associated with assessment, case management, advocacy, delivering interventions, and administration. However the findings were more precise in “in-depth” definition of each of these tasks, having correlated them with the roles of janitor (providing interventions to set up the issues caused by others or other circumstances), glue (ensuring system administration and acting as connection between health team, patient and carers), broker (providing support to family, facilitating communication with the health team and discharge planning), firefighter (providing crisis interventions), jugglers (managing complex cases) and challengers( advocating for patients). The unexpected role which emerged was that of a bouncer (controlling setting, behaviors or relationships with carers). It seems like perhaps it resembles a role of mediator, but still it differs much at assertion level, as it implies full responsibility for the whole case management, with an element of forcible solution.
The study findings reflect both a wide spectrum of roles the social workers recognized themselves to perform in healthcare settings, and their attitude to these roles. The social workers appeared not to put a high value on simple roles limited just to service delivery (bouncer, broker) or requiring a sole effort (janitor) considering them low-status responsibilities, which did not fully conceptualize their professional identities. Instead, the roles requiring collaborative working skills, ability to work in a team and manage complex relationships within groups, were appraised as high-status roles. These implicit expectations revealed the gap between the actual focus of social workers’ basic roles ( meeting patients’ critical needs and demands) and the desired level of this focus ( facilitation of collaborative relationships to meet the family and the patient’s goals). However, further research is necessary to define the impact of such a shift of locus of responsibilities and the increasing level of professional involvement (sometimes beyond a social worker job description).
Apart from the abovementioned limitations of the study, the additional limitations were narrow coverage ( only one urban area and not all social workers) and the impossibility of extrapolation of the results to larger population.However the study outlined some trends and implications for further research, such as the need for acknowledgement of the breadth of social workers’ expectations, the effect of interdisciplinary training opportunities, the demand for a thorough understanding of social workers everyday job and the overall effect of their role on the urban hospital context.
Conclusion. The study suggests that the social workers’ perceptions of their roles outlined the major themes (janitor, glue, broker, firefighter, juggler, and challenger) corroborating the evidence from the previous studies. However participants emphasized the difference of these roles’ status, with the increased interest in those requiring collaborative work and professional skills to facilitate this work rather than in those connected with straightforward tasks focused only on meeting the patients’ urgent needs. The expectations of social workers on assuming complex roles of providing secondary support to other health care professionals, the need for their interdisciplinary training, developing enhanced crisis intervention, problem solving, and communication skills, and the effect of the subsequent interventions on the patients and families will be the subject for future studies.

References

1. Craig, S., and Muskat, B. (2013). Bouncers, Brokers, and Glue: The Self-described Roles of Social Workers in Urban Hospitals.Health & Social Work, 38(1). doi: 10.1093/hsw/hls064