MSW post-graduation MSW scope-of-practice concerns

[Jpuppy]

Hello. I’m an MSW with my mid-level license (LMSW). I worked the past several years in various healthcare settings but only recently got my license and began working in a small hospital.

However, at my current position my role is the only social work position. I work mostly with nurses and do discharge planning, care coordination, and a little bit of counseling.

The problem is that NONE of my education prepared me for some parts of this job. For example:

1. I was asked to discuss the medical risk/benefit intricacies of one medication v. another as the patient navigated which charity program to pursue (you can only pursue one)
2. I have been asked to coordinate IV antibiotics with infusion specialists and answer questions about the class of antibiotics for the pharmacy reps
3. I was urged to explain the medical risks of choosing to leave the hospital without a scan for a specific injury
4. I can get most insurance authorizations, but some of them depending on insurance, procedure, and patient needs require a lot more advanced clinical feedback such as questions about medical history and diagnosis than I feel comfortable with
5. On some pre-admission screenings for placements I am asked to directly assess whether patients meet various nursing/medical criteria such as ability to walk safely, perform various occupational tasks, and so on—these make me very uneasy

I have spoken to my supervisor (who is an RN) and another department supervisor (who is also an RN) as well as an administrator (whose background I don't know) and they say this is within the scope-of-practice of social work. I have also reached out to other social workers at other hospitals, who say these are constraints they deal with all the time--being asked (or forced) to work outside our scope-of-practice. Not a single social worker told me their education prepared them for this, but not a single one has resigned their jobs (which I am becoming more inclined to do). I feel like I am either over-reacting or taking this way more seriously than other people, but it really does worry me.

I called the State Board and they said this is an internal workplace situation and they couldn’t help. However, I went to school out-of-state so they were not sure if this information was part of my education and I somehow forgot all of it.

My questions:

• Am I really over-reacting?
• Should I have been trained to do this stuff?'
  
• If I should do this kind of work, how do I get trained in it competently?
• Should I contact the NASW about this? If so, what do I even say?

My concern:

• Harming a patient by making a nursing/medical mistake I don’t even recognize.

If nothing else, I hope somebody can offer some feedback. I like my job overall, but I feel like I am being asked to do nursing and medical work. It's not all the time (it's not even the majority of my work) but if I were a patient and understood the scope of an MSW education and license the way I currently do, I would not feel safe having an MSW doing some of this work for me.

Thank you.

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[MAClinician]

You seem to be describing medical social work.

https://www.socialworkers.org/LinkClick.aspx?fileticket=o7o0IXW1R2w=&portalid=0

Might be worth reaching out to NASW for guidance on how to navigate your concerns. I am not an MSW so there might be other ways to handle your concerns. Good luck.