What I do...

I don't know that I've ever really described in detail what it is that I do for my job (the one that pays most of the bills). I'm a dialysis social worker. I work for a for profit dialysis company (most dialysis centers are run by corporations). The Centers for Medicare and Medicaid Services mandates that dialysis companies provide social workers for their patients, which is probably the only reason we are here since companies largely view social workers as not cost effective. That's a tangent, though, and hopefully a paradigm that is slowly shifting.

So I get to my center at around 7 a.m. I work a 4 10 hour days, which works well for me right now. My desk is a bit messy, but there is a sense of piles in the mess and I generally know what's going on around it.

I don't often have a to-do list, I just attack piles. There is a pile of care plans for me to note in. There is a pile of assessments to do. There is another pile of completed assessments to enter into the computer.

This morning I took a tour of the floor to speak to patients. I inquired about someone's insurance and stressed the need for her to bring me paperwork. I listened to a man vent his frustration toward his caregiving team (from another agency). I had someone else sign releases so that I can help her get dietary supplements that Medicaid won't pay for.

I returned to my office and returned a call about a patient's travel plans. And I went to try to explain the ins and outs of Medicare to another patient. I now have forms for the doctor to sign, notes of my meetings with patients, and still the piles are there.

I haven't opened my e-mail yet. Another part of my job is as Regional Point Social Worker. In that job, I help with coordinating the training of new social workers (and participating in training and follow-up). I help to plan meetings and work with my fellow regional points and divisional lead social worker to educate and advocate to our management team for all the social workers in our division.

At least once a week (often 2 or 3), I participate in in-center clinics for our home patients or care planning meetings for our in-center patients. There are also conference calls for insurance updates or inservices.

The range of my job goes from simple clerical tasks of photocopying or filling out forms to the work that I am actually licensed to do: providing short term counseling to clients to help with mood and adjustment, or to manage crises. My least favorite task involves calling MediCal (our state medicaid)...this almost always means a wait of up to 15-20 minutes until I can talk to someone.

I carry a caseload of patients of about 120...and if you are wondering if that is large, the answer is complicated. It is a heavy caseload compared to other types of social work jobs, and it is actually a fairly normal caseload for dialysis. Sometimes, I feel like I'm being asked to save the world. Sometimes, I wonder if I am a travel agent.

I had a former supervisor (who was also a nun) who's favorite saying was "never a dull moment." This feels particularly true here. There is always something that can be done. I don't always feel particularly drawn to my work, and I can sometimes feel very overwhelmed by it...but it is true that there is nothing dull about it.