Name: Laura Gaughan

education: Master of Social Work, Loyola University, Chicago; Bachelor of Science in Sociology, Creighton University, Omaha, Neb.

title: Director of social services
workplace: Brightview Care Center
location: Chicago, Ill

Laura Gaughan

The role of a social worker varies depending on what type of setting you work in—hospitals, schools, non-profit agencies and nursing homes are just a few of the possibilities. Prior to my current position as director of social services at Brightview Care Center in Chicago, I worked with mentally retarded adults in a vocational setting, pregnant and sexually active adolescents in a hospital clinic, elderly patients in the Chicago community, and dialysis patients in a hospital and outpatient clinic. Despite the diversity of these settings, there was one common theme: I always enjoyed helping patients cope with their medical problems in a health care setting. Brightview Care Center has allowed me to continue this vocation; I currently work with individuals who are facing medical setbacks or require end-of-life care.

Brightview has a diverse population of residents, and the goal of the center is to increase the quality of life of the residents and to help them maximize their level of independence. Some residents are at the center for a short-term stay while they recover from a stroke, amputation, surgery or infection. These patients might receive physical therapy, occupational therapy, speech therapy, amputation adaptation therapy, post-stroke care, bone fracture recuperation, IV antibiotic therapy or wound care treatment in order to gain the strength and skills they need to ensure a safe and successful return home.

My role with this patient group is to provide counseling to help them adjust and cope with their limitations. Many of these individuals will experience a wide range of emotions during their adjustment process such as grief, anger, depression, denial, fear or concern until they come to terms with their situation. When residents are ready to return home, I assist them with the discharge process. I make any necessary arrangements for home services, such as home physical or occupational therapy, home nursing, meals on wheels, home health care or homemaker services.

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For those residents at the center for a long-term stay, my role is to help them with the adjustment process as well. Adapting to a new environment takes time. Careful consideration is taken when making room assignments at Brightview. I work closely with the director of nursing to take into consideration the resident’s medical condition and personality to make a compatible roommate match. We always consult the resident and the family during this process as well.

When any new resident arrives, I meet with him or her to begin the orientation process. I usually start by taking the resident on a tour in order to familiarize them with their new surroundings. During our initial meeting, I also get an extensive social history so that I have an understanding the resident, and I find out who is part of their support system. We discuss in detail their rights as a resident of Brightview and the various policies at the center. New residents often have questions about obtaining personal belongings or financial considerations. The maintenance department retrieves any desired belongings to be transferred and Brightview has a bookkeeper on staff to answer any questions pertaining to insurance coverage or finances. Despite the question or need, I make sure to connect residents to the appropriate service or department.

Over the course of the next few weeks, I conduct a thorough psychosocial assessment on the patient. I look closely at their thought processes, communication abilities, mood, behavior, interpersonal relationships (including family, friends and other individuals), spirituality, interests and hobbies. I bring all this information to the care plan meeting, and the care plan coordinator (RN), rehab director (ADON), activity director, dietary supervisor, social service director and social service case manager also bring their assessments of the resident to the meeting. Involved family or friends and the resident also attend this meeting, which takes place within 14 days of admission and then every 90 days thereafter.

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The purpose of the care plan meeting is to determine the residents’ goals and what the staff can do to assist him or her. Typical resident goals are increasing independence and quality of life or achieving a better level of comfort. Department representatives have a specific area to focus on to help the resident achieve their desired goal. My role varies; for some residents I focus on discharge planning while for others I may help with a vocational program. I also do one-on-one counseling to address a particular problem or refer a resident to a specific group that may help them.

Generally my daily activities vary but each day usually includes pursuing guardianship or surrogacy for residents as needed; handling resident or family complaints, grievances and suggestions; coordinating and supervising the Social Service Department, which includes four case managers; and preparing quality assurance and safety committee reports.

I enjoy my position at Brightview; I find it both challenging and rewarding. Each resident is different and finds a way to touch me in their own special way, which brings me opportunities for personal and professional growth.

7:20 a.m.
I arrive at work and check if there are any new admissions. There is one new patient and one readmission. My first order of business is to check on the resident that returned from the hospital last night. She is 40 years old and was sent to the hospital for complications related to lung cancer, which required surgery. She indicates that she is happy to be back and is feeling better. She has received all of her belongings from storage and has no immediate concerns.

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I then visit with a newly admitted resident and welcome him to Brightview. He is in his mid 60s and was living alone when he suffered a stroke. He is paralyzed on the left side and has come to Brightview to receive physical and occupational therapy; he hopes to eventually return to his apartment. The resident is in his room eating breakfast when I meet him. He says that his first night went smoothly; he feels comfortable in his room and says that his roommates have not caused him any problems. “They’re cool. He’s my bud (pointing to the gentleman in front of him); he reminds me of George Burns.” We make a plan to meet later in the morning, and I leave him to finish his breakfast.

8:10 a.m.
I head back to my office and take care of some charting before the day gets away from me. I also get my handouts ready for general orientation, which is later in the morning. I get interrupted a few times, once by a resident with a question and twice by the phone.

8:59 a.m.
I head downstairs to the care plan office for our daily “house report” meeting. This is a daily meeting with all department heads. It starts at 9:00 a.m. Monday through Friday. Those in attendance include the administrator, director of nursing, rehab director, care plan coordinator, dietary supervisor, activity director, bookkeeper, maintenance/housekeeper supervisor, medical records director, human resources supervisor and the social services director (myself). This is an opportunity to discuss any issues that may be pertinent to the various departments, potential admissions or discharges and other resident issues. The meeting ends at 9:40 a.m., and I meet with the director of nursing to briefly discuss a possible room change.

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10:00 a.m.
Now I meet with the new resident again, as promised. He says that he was not able to tour the facility when he arrived the night before, so we start off by taking a tour of the home. We end up in my office where we discuss his rights as a resident, and I orient him to Brightview’s programs, services and policies. I then conduct an extensive social history assessment. The new resident would like to retrieve some of his personal belongings from his apartment and also go to the bank to take of some financial business. The meeting concludes at 11:15 a.m. I make arrangements with the maintenance department to retrieve his belongings from his apartment the following morning. I then arrange with a rehab aide to accompany him in a cab to the bank because he cannot get in and out of a cab by himself due to paralysis. Next I call the bookkeeper and see if she can stop by and see him. The resident signs a consent form with a list of all the items he would like moved from his apartment to Brightview.

11:30 a.m.
I head to the conference room for a new employee orientation. Each department head orientates new employees in their area of expertise. We discuss resident rights and patient privacy, abuse/neglect prevention, employment policies and procedures, communicating with residents and managing difficult behaviors. When I am done, I call the next person to let them know it is their turn to present.

12:50 p.m.
I grab a quick bite to eat and enter reports. (I try to eat with co-workers several times per month and not always eat at my desk!) My lunch is over faster than planned, although, when I receive a call from a resident’s guardian. Then a case manager comes to me with a concern over a patient who refuses to take his IV-antibiotics. We discuss strategies as to how we can gain the cooperation of the resident.

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1:30 p.m.
I head to the care plan office. We have five residents to review today—one new resident and four current residents who are scheduled for quarterly meetings to review their current situation with their care providers and family members. Goals for residents are established. The goals of these residents include, rehabilitation to gain more mobility, personal hygiene (taking more frequent showers and changing their clothes regularly), medication compliance and wound care (allowing the treatment nurse to do dressing changes). One resident has progressed to the point where discharge is in sight and another is working on increasing their socialization by getting involved in facility groups and activities.

3:00 p.m.
The care plan meeting is not quite over, but I need to attend a resident council meeting. These meetings take place every month, and they are an opportunity for the residents to get together with an elected board of officers to discuss issues and ideas for the center.

4:25 p.m.
I gather my things and get ready to head home for the day. I am on call on evenings and weekends for emergencies, but typically I do not get paged more than once or twice a week. Usually these calls pertain to resident or family issues or guardianship/power of attorney questions, but they can be about any issue that comes up. I say goodnight to residents and staff as I leave and let the receptionist know that I am leaving for the day.

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