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IMPORTANCE OF EFFECTIVE Nurse-social worker TEAMWORK IN THE COMMUNITY EXAMINED IN NEW BOOK BY BOSTON COLLEGE PROFESSORS
CHESTNUT HILL, MA (9-30-97) -- By the year 2000, an estimated 98 percent of Americans with health insurance will be involved in some sort of managed care program, according to Boston College Graduate School of Social Work Associate Professor Nancy Veeder. The hallmarks of managed care program--reliance on HMOs, walk-in treatment at health centers, and preventive medicine regimens (fitness clubs, etc.) to promote healthy lifestyles and avoid illnes--have placed a major portion of modern health care delivery squarely in the community. In response, nurses and social workers are increasingly called upon to practice together in the community.
In their forthcoming book, Nurse-Social Worker Collaboration in Managed Care: A Model of Community Case Management (Springer, 1997), Boston College School of Nursing Professor Joellen Hawkins, Veeder, and University of Massachusetts at Lowell Assistant Professor of Nursing Carole Wieland Pearce, examine innovative ways in which nurses and social workers can blend their skills effectively in this new era of community-based care. The authors interviewed nurses and social workers in the field, as well as executives of hospitals and home health care agencies.
As an example, the authors cite a case of a diabetic woman suffering from debilitating depression who had not been keeping her medical appointments, and whose case was referred to a nurse and social worker at a home health care agency. Working together, the two were able to address the patient's needs in a more comprehensive way than if either had tried to handle the case alone.
"The case of a patient with depression who can't get out of bed in the morning has physical and psychological aspects," explains Veeder. "While the social worker assesses the psycho-social situation in the family, the nurse on the team will manage the health aspect, taking care of the woman's diabetes and urging her not to eat foods that are potentially harmful."
Beyond their individual skills, Hawkins points out, nurses and social workers also have access to services which can provide a broader range of care. A nurse might be able to help treat a depressed mother of a pre-school child, she says, but "nurses don't have the connections social workers do to get the child into Head Start."
Veeder and Hawkins have teamed in the past to research the nurse-social worker collaboration in turn-of-the-century settlement houses like Hull House, founded in Chicago by pioneering social worker Jane Addams to serve the moral and physical health of the city's immigrant workers. The authors see similar challenges facing nurses and social workers today who are increasingly called to combine in non-traditional ways to treat both the physical and emotional needs of patients in the community.
"Here we are at the turn of another century and health care is returning to the community," says Veeder. "People are staying in the hospital for shorter periods. More surgery is on an outpatient basis. Lengthy hospital stays are reserved for the most extensive, and expensive, treatment.
"We need to find the ways to deliver the very best service to the community, efficiently," continues Veeder, and interdisciplinary cooperation to that end "is the hot topic in health care."
Although nurses and social workers often have found themselves as competitors in traditional institutional settings, say Veeder and Hawkins, now they are joining forces to care for "the whole person."
"The combination of the nurse-social worker should not be competitive, but collaborative," Hawkins says. These collaborations can bring forth more innovative approaches to health care, the authors conclude, including "true prevention"--resolving individual or family problems without having to use the expensive resources of the health care or social services systems.
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