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The influence of organizational structure on hospital social work practice and professional identity
Shelley Arrian Fleit
Paperback. ProQuest, UMI Dissertation Publishing 2011-09-03.
ISBN 9781243577078
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Förlagets beskrivning
This qualitative study examined the variability of hospital social work practice and how social workers experience these differences in their day-to-day work. Through the analysis of semi-structured interviews, the findings explore factors influencing the experiences of hospital social workers and how such factors impact professional identity. Participants were forty Masters level social workers from thirteen different hospital settings across Long Island and New York City. Three major interdependent themes emerged: control of role, role clarity and practice value. Control of role is influenced by organizational transitions, nonsocial work management and interdisciplinary relationships and perceptions. The dynamics of who controls the definition of social work and who shapes social work practice varied from setting to setting; most broadly within merged and restructured departments. Social work autonomy was experienced along a continuum of models. Role clarity is functionally linked to how roles are defined and controlled. Fragmentation and interchangeability of practice roles between disciplined; how one's professional identity is individually perceived and projected to others; and varying intra professional perceptions regarding practice roles impact role clarity. Participants more likely characterized their experience as positive when they had control and clarity of their role and felt valued. When patient cases were first assessed by case managers and then referred, their practice role became task driven and was often perceived to be inconsistent with an understanding of social work. Overall experiences were more generally negative. Reporting to a non-social work manager increased perceptions of powerlessness and competition with non-social work colleagues. Professional identity is compromised as non-social workers are increasingly defining social work practice and professional supervision is lacking. The recognition of a clear and unique social work professional contribution to hospital settings is challenged as these themes intersect. The implications of the study findings emphasize the need for educational curriculum and evidence based research to clarify social work definition and effective scope of professional practice. Policies are needed to incorporate the specific expertise of hospital social work into the language of professional licensing and health care accreditation bodies to ensure a continued professional role for social work in hospitals
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The influence of organizational structure on hospital social work practice and professional identity
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