Intellectual well-being is the ability to constantly expand upon one’s own knowledge through creative and stimulating activities and experiences and to share what is already known with others. It is the exercising of the mind.
For hundreds of years, there has been a dynamic duo in the hospital setting: the social worker and nurse. A healthy partnership between social workers and nurses is vital as they both provide effective, holistic care. Here are 7 key elements of the partnership between social workers and nurses that contribute to positive patient outcomes:
1. Partnering in Patient-Centered Ethical Duties
In the National Association of Social Workers (NASW) Code of Ethics (1996), social workers are ethically bound to support the dignity and worth of a patient. In the same way, the American Nursing Association (ANA) Code of Ethics (2015) calls for nurses to protect human dignity and patient rights. Each profession’s training requires a patient-centered focus.
2. Assessing a Patient’s Physical and Psychological Needs
Identifying needs and desires of a patient is one of the first steps of the social work and nursing team. As part of a multidisciplinary team, social workers and nurses contribute to the development of each patient’s treatment plan. The nurse will assess a patient’s medical and psychological needs and provide care to ensure that these needs are met according to their professional scope and standards, clinical guidelines, and best practices. Social workers also complete an evidence-based biopsychosocial assessment early in treatment to inform a patient’s individual treatment plan. This assessment serves as a guideline in discharge planning, where the social worker determines the various environmental, social, medical, and family supports that a patient will need upon discharge.
3. Advocating for Patient’s Autonomy and Rights
Social workers and nurses each play key roles to ensure that every part of a patient’s treatment is ethical, appropriate, and respectful. Both social workers and nurses remain aware of any barriers throughout a patient’s treatment, initiating investigations for abuse and neglect (as needed), informing a patient of their treatment options during care, maintaining confidentiality, and including them in all decisions regarding their treatment.
4. Answering Questions for a Patient or their Family
With a multitude of factors which require consideration in a patient’s treatment, it is natural for a patient and family to have questions concerning timeline, the treatment plan, medications, and long-term care. In this dynamic duo, nurses take the lead on conversations concerning a patient’s diagnosis, treatments, and medication management. In turn, the social worker takes the lead on conversations about long-term care plans, providing counseling in challenging situations, and connecting the family to needed resources. As such a dynamic duo, both the social worker and nurse ease a patient and their family’s minds, which can lead to better health outcomes. In fact, when patients are educated about their diagnosis and treatment plan better health outcomes can be expected (Fernsler, J. I. et al, 1991).
5. Individual and Group Counseling
Diagnosis and treatment plans can be challenging for patients and families. Making lifestyle changes to improve wellness can often seem overwhelming. A nurse's rapport with a family can create opportunities to offer emotional support and referral to a social worker if needed. A social worker may counsel patients and families individually to process these feelings and challenges in behaviors and skills to achieve recovery. In addition, patients and families may participate in group counseling sessions. Group counseling is an evidence-based practice that allows individuals to receive treatment together in a group with others who may be experiencing similar life stressors.
6. Providing Financial Planning and Assistance
In addition to concern for their loved ones, families frequently endure financial stress related to healthcare and hospital stays. While the nursing team works to ensure proper medical treatment and recovery, the social work team is tasked behind the scenes to address the financial situation with the family. As recovery is underway, social workers may refer patients to legal aid, federal financial assistance programs, community-based resources, and payment plans provided by the healthcare institution.
7. Developing Discharge Plans
Nurses and social workers alike are proponents of a patient living their best life after hospitalization. However, the social worker and nurse assist a patient and family leading up to discharge in different ways. The nurse will provide timely communication with a patient and family regarding medical assessments and ongoing care needs. This includes explaining to a patient and family regarding all necessary health information, medications, and other health needs. In a complimentary manner, the social worker’s role for discharge planning focuses on securing housing (or other accommodation) placement, financial resources, and social support. The social worker may coordinate ongoing patient and family assessment and counseling, follow-up, and community resources needed to ensure continuity of care after discharge.
Conclusion
The collaboration between social workers and nurses in hospital settings creates a dynamic duo. Together, they have the common goal of providing care to patients in ways that enhance patient outcomes. Partnering in ethical duties, assessing patients’ physical and psychological needs, advocating for patients’ rights, providing individual and group counseling, financial planning and assistance, and developing discharge plans are all ways that social workers and nurses work together toward providing excellent care.
References
Code of Ethics for Nurses. American Nurses Association. (2017, October 26). Retrieved November 17, 2022, from https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
Fernsler, J. I., & Cannon, C. A. (1991). The whys of patient education. Seminars in oncology nursing, 7(2), 79–86.
National Association of Social Workers. (1996). Code of ethics of the National Association of
Social Workers. NASW Press.
Social Workers in healthcare: How they make A difference. Adelphi University Online. (2021, June 10). Retrieved May 18, 2022, from https://online.adelphi.edu/articles/social-workers-in-healthcare-how-they-make-a-difference/
Williams, C. C., Bracht, N. F., Williams, R. A., & Evans, R. L. (1978). Social work and nursing in hospital settings: a study of interprofessional experiences. Social work in health care, 3(3), 311–322.
My life constantly glitches. I often get caught up in one moment and have to repeat things to assure myself that it’s okay to move on with my day. My brain tells me I can’t contaminate anything.
My life constantly glitches. I often get caught up in one moment and have to repeat things to assure myself that it’s okay to move on with my day. My brain tells me I can’t contaminate anything.
If I touch something dirty, I have to wash my hands. Wait... my hand touched the sink, so I wash again. Wait... I touched the sink handle that I touched with my dirty hand. I wash again. The towel that I wiped my hands on also touched my face and snot could have gotten on it. I wash again.
I sanitize the door handle with a disinfecting wipe. Wait... there are chemicals in that disinfectant. I try to move on, but my attention is snagged on that one detail. I wipe off the disinfectant with a paper towel so that no one else gets chemicals on their hands.
Continue Reading Transcript
I sit at my computer, reading something. At first, I try to read it in my head. Wait... did I really get anything out of it? I read it again. This time aloud. Wait... I messed up one word. I have to start over and read it perfectly to get the intended message of the sentence.
I get ready to hop into bed and look over at my desk. A couple of things are cluttered around. I tell myself “It’s okay. Those things can wait until the morning.”. My brain sends a different message: “No, I have to clean it now or else it will bother me, and I won’t be able to sleep”.
Moments like these control my whole day. When I try to move past whatever is bothering me, my mind continues to fixate on it. There’s always a “wait...”. I’m nervous... tense... and distressed. I don’t want to give in to the thoughts because I know that they’re irrational. However, the thoughts persist, and at some point, I can’t take it anymore.
If you can relate to my experiences, there is hope and there is help. Health professionals can provide treatments such as therapy and medications. I used to feel helpless, constantly replaying every moment. Receiving treatment has helped prevent my obsessions and compulsions from controlling my life. Are you experiencing obsessive-compulsive disorder? It’s never too late to ask for help.
References
International OCD Foundation. (n.d.). How is OCD Treated? International OCD Foundation. Retrieved May 10, 2022, from https://iocdf.org/about-ocd/ocd-treatment/
International OCD Foundation. (n.d.). What Causes OCD? International OCD Foundation. Retrieved May 10, 2022, from https://iocdf.org/about-ocd/what-causes-ocd/
International OCD Foundation. (n.d.). What is OCD? International OCD Foundation. Retrieved May 10, 2022, from https://iocdf.org/about-ocd/
International OCD Foundation. (n.d.). Who Gets OCD? International OCD Foundation. Retrieved May 10, 2022, from https://iocdf.org/about-ocd/who-gets/
Mayo Foundation for Medical Education and Research. (2020, March 11). Obsessive-compulsive disorder (OCD). Mayo Clinic. Retrieved May 10, 2022, from https://www.m ayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432
If you or someone you know is experiencing obsessive-compulsive disorder (OCD), there is hope. Contact your health provider or call the National Helpline at 1-800-662-HELP (4357) supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).
People with mental illnesses (MI) smoke at higher rates than the general population. However, few mental health providers (MHPs) deliver tobacco treatment to patients with MI especially within inpatient psychiatric settings. According to evidence, fewer than half of MHPs in the US mental and behavioral health settings provide the recommended evidence-based tobacco treatment interventions to their clients with MI. This paper uses the theory of planned behavior to examine factors associated with provider intentions to deliver and their experiences in providing evidence-based tobacco treatment to clients with MI. Data were obtained from a cross-sectional survey of 219 providers in a state psychiatric hospital in Kentucky. Attitudes, subjective norms, and perceived behavioral control were associated with providers’ intentions to deliver tobacco treatment when controlling for demographic and work-related variables. However, only profession, subjective norms, and attitudes were associated with reported provision of evidence-based tobacco treatment. Given the underuse of routine tobacco treatment for this vulnerable population, understanding factors influencing provider delivery of tobacco treatment is needed to guide strategies for reducing the disproportionate rates of tobacco use and related burden among people with MI.
This is the story of John. John is 45 years old and has recently experienced numerous substantial life changes. Watch the video below to hear John’s story and identify some risk factors and warning signs that increase the risk of suicide for John.
Patient Background
Meet John
John is 45 -years old.
After 10 years of marriage, he recently went through a divorce and is now living alone. He has visitation with his 10-year-old daughter every other weekend.
John was recently fired from his factory job of over 15 years and is unemployed because of his increased drinking.
John acknowledges feeling increasingly depressed and hopeless since his divorce and the loss of his job.
Over the last two weeks, he has had insomnia and loss of appetite, leading to weight loss and loss of interest in hobbies including hunting and going to the shooting range with friends. His use of alcohol has also increased considerably in the past 2 weeks.
John has a few close friends but has little contact with his family. He has expressed his hopelessness and while drinking with his friends he’s said things like, “My family might be better off without me.”
His increased drinking led to being pulled over by the police and charged with DUI, one week ago.
Can you identify some risk factors and warning signs that increase the risk of suicide for John?
According to the National Institute of Mental Health (2021) and the American Psychological Association (2019), warning signs for suicide include the following.
Talking
Talking about wanting to die, experiencing guilt or shame and/or being a burden to others.
Feelings
Feelings of emptiness, sadness, hopelessness, feeling trapped and/or feeling unbearable emotional or physical pain.
Changes in behaviors
Changes in behaviors such as making a plan or researching ways to die, preoccupation with death and dying, has recently experienced serious losses, withdrawing from family and friends or social activities, loss of interest in school, work or hobbies, saying goodbye, giving away important items, or making a will, taking unnecessary or dangerous risk, displaying extreme mood swings, eating or sleeping more or less and/or increases in drug or alcohol use.
Lee Anne Walmsley, Ph.D., EdS, MSN, RN, is an Assistant Professor in the UK College of Nursing. She is also a part of the BH WELL faculty team. Her life's work is about mental health and well-being. In this brief video, she shares her thoughts on feeling stuck.
We all want to stay healthy, happy, and resilient. So, how can we do this? Health and happiness require checking in with yourself to assess your needs. Think: “Am I eating well? Exercising? Stressed? Needing to say ‘no’ to some things?”. Stay tuned for a prescription to REST.
We all want to stay healthy, happy, and resilient. So, how can we do this? Health and happiness require checking in with yourself to assess your needs. Think: “Am I eating well? Exercising? Stressed? Needing to say ‘no’ to some things?”. Stay tuned for a prescription to REST.
Why do we fail to take care of ourselves? Haven’t we learned our limits by now? Our lives are impossibly busy. We balance jobs, family, and never-ending daily agendas. But self-care shouldn’t feel like a burdening To-Do list item. It’s a GIFT to yourself and helps you love those around you better. And it doesn’t take a lot of time!
Here are 12 tips to beginning your journey of practicing self-care:
Sleep well.
Your nightly routine can train your body to know it is time for bed. Being aware of what you consume close to bedtime is important. Sugar, caffeine, and distractions like television tend to keep you awake. Checking your email may also awaken stress and a work-mode mindset that can make it hard to fall asleep.
Heal your gut.
While this includes eating healthy, it is even more. This is being aware of your body’s reaction to certain foods. Stomach aches, digestive troubles, fatigue, brain fog, skin issues, headaches, emotional issues, weight changes, and food intolerance are all examples of gut health issues. There are many important elements to this process but knowing your food triggers is a great place to start.
Exercise daily.
We don’t want to sound like a broken record, but exercise has physical and mental benefits. It boosts mood, reduces stress and anxiety, and helps you gain muscle and strength. Exercise doesn’t have to take place at the gym. You can go for a walk while listening to a podcast, dance to your favorite playlist, play tennis with a friend, or practice yoga.
Eat a clean nourishing diet.
The food we eat controls our weight, can cause or prevent disease, and can keep our minds active. The right foods can even prevent memory loss and inflammation which have long term effects on the body. Some of the best foods to eat are fatty fish, blueberries, walnuts, pistachio nuts, green leafy vegetables, and broccoli. Hydration is equally important for your body and brain!
Learn to say “NO”.
In order for you to function at your peak in your job, with your family, or just in your own mental space, you have to be calm and rested. You cannot be your best self if you continue to say “yes” when your plate is too full. You will be irritably working out of stress or obligation and likely find yourself burnt out. Learn how to say “no” politely but firmly and with conviction, and keep practicing until it comes more naturally.
Take a trip.
Even if you’re not feeling particularly stressed, getting away can provide space to disconnect, relax, and reset. This doesn’t have to be far or costly. You can visit a friend, explore a nearby town, or go camping. The goal is to get out of your normal routine and do something that sounds fun to you.
Go outside.
Being outdoors can reduce stress, lower blood pressure, reduce fatigue, and overcome symptoms of depression and burnout. It also helps you sleep better, especially if you do something active such as hiking, walking, or gardening. Nature is one of the best resources for healing. Listen to the birds, notice the trees, feel the wind, and appreciate the changes in the weather.
Spend time with a pet.
From companionship to unconditional love, pets bring huge benefit to our lives. Dogs, cats, and horses especially can reduce anxiety, stress, and lower blood pressure. Often, pets are empathetic to our moods and can tell when we are not feeling well. They are called our ‘best friend’ for a reason!
Prioritize getting organized.
Declutter the things in your mind by writing them in a planner or calendar. Keep a running grocery list or to-do list so you never again have to stress about what you may be forgetting. (Just don’t forget the list!). Another quick organizational habit is to prepare keys, purses, backpacks, briefcases, and coats to be ready to go for the next morning. This gives your mind more room to be creative!
Prepare your own meals.
Make this an event. Cook. Fast food and pre-made meals lack sufficient nutrients and are often more calorie-dense than fresh meals made at home. Even if it’s once a week, try cooking a healthy meal. The recent rise in meal kits and meal delivery services may help you get started.
Read a book on self-care.
Instead of scrolling a news feed for entertainment, try reading a self-help or self-care book. This can help you slow down, improve your mood, and help you be mindful and present where you are. Listen to a podcast on resilience, self-care, and the science of self-care practices.
Schedule daily self-care time like an important appointment.
You wouldn’t cancel breakfast with your favorite author, would you? Then why are we so quick to sweep our self-care aside? Self-care can help you stay grounded and keep goals at the forefront of your mind. Start small. Wake up 15 minutes early to have a cup of delicious herbal or green tea and practice deep breathing. Or take a walk around the block on your lunch break. The more you practice incorporating self-care into your schedule, the better you can grow and prioritize the things most important to you. Aim to take 5 minutes 5 times a day to practice self-care. 5 X 5. It’s like rebooting your brain for better health and performance.
People with mental illness (MI) have a disproportionate tobacco-related disease burden and mortality. Tobacco-use rates in people with MI are nearly twice that of the general population. Reasons for tobacco-use in this population may be a result of diminished tobacco-related disease risk perceptions. The purpose of this study was to examine the reasons for tobacco-use and perceived tobacco-related health risks among psychiatric inpatients. A correlational design was employed to survey a convenient sample of 137 patients from a psychiatric facility in central Kentucky. Information obtained from participants included demographics, psychiatric diagnoses, tobacco-use and exposure history, medical illness history, reasons for tobacco-use, and tobacco-related illness risk perceptions. The primary reasons participants endorsed for tobacco-use were for stress reduction, followed by addiction, then boredom, psychiatric symptom control, social, and negative mood. In addition, about 72% of participants used tobacco to cope with MI symptoms and 52% to manage the side effects of their medications. Participants were most likely to endorse that tobacco-use caused lung disease (83.2%), heart disease (79.6%), cancer (77.4%), and premature mortality (79.6%) but were less likely to admit that it may cause addiction to other drugs (39.4%) or MI (23.4%). Given the high endorsement of tobacco-use for stress reduction and psychiatric symptom control, it is important for mental health nurses to properly educate consumers on tobacco addiction and evidence of its effects on mental health. Strategies to incorporate our study findings into routine mental health services may address the tobacco-use disparities experienced by people with MI.
