This year Harlem Hospital celebrated the 100th Anniversary of its Social Work Department. HHC TODAY visited with the director of the program, Mary Caram, LCSW-R, who shared some of her experiences and insights from 25 years as a social worker at HHC.
How has social work changed over the past 100 years?
Social work can trace its origins to Ladies' Auxiliaries founded by hospital volunteers who provided non-medical services to patients. In 1909, Julia C. Stimson, Harlem Hospital's superintendent of Nurses, identified the need for formalized medical social services at the hospital. The Social Work Department was founded to support medical care and help patients address some of the economic and social challenges to their health.
As the profession continued to evolve, Harlem Hospital Social workers contributed to the development of innovative programs like the Harlem Center for Child Study, the first Therapeutic Nursery in NYC, Psychiatric Day Treatment and Rehabilitation Centers, Adolescent Prenatal and Parenting programs and many other pioneering initiatives. In the 80's and 90's social workers played key roles in the Domestic Violence and Rape Crisis programs that were developed at HHC hospitals. Over the years we've become more diversified in our roles and have taken a greater role in patient care.
What are some of the tasks that social workers tackle in HHC hospitals?
Social workers are part of the interdisciplinary team on every service. We provide linkages to community resources and develop safe discharge plans with the rest of the team. For example, a patient may be medically cleared by a doctor for discharge but the doctor may not be aware of the patient's living conditions. What if she lives in a 4th floor walk up and can't climb stairs yet? The team discusses the best treatment plan possible for the patient. That may mean rehabilitation or readying an apartment by making it accessible. We also help patients come to terms with the changes their illness may bring. They may no longer be living alone, or may have difficulty adjusting to having a home health aide come into their home. At every turn, we advocate for patients with community agencies, the hospital and family.
Can you give examples of how social workers advocate for patients?
I had a dialysis patient who fell behind in her rent. We negotiated with her landlord so she wouldn't get evicted. Another woman became disabled and had no resources when it was time to be discharged. She needed to go home with oxygen but Con Ed had turned her power off. We negotiated a payment plan for what she owed and they restored power.
How does the current financial climate affect the services social workers provide?
In the present economy there is a growing need for social workers. We help people who are out of a job or down on their luck access services like food stamps, meals on wheels, senior centers. We provide services both in the hospital and to outpatients who come to our clinics. Referrals come from physicians, nurses, or patients themselves, when they ask to see a social worker.