Best Of

To clarify: After the patient is permanently accepted, there is push back from staff about the patient's behavior?

Once the patient is accepted after 30 days they are a permanent placement.

Transportation issues are common and could be mitigated with some changes to the patient's schedule if it is reoccurring. The AVF placement is encouraged, but it is the patient's right and if they are not ready/able to change at this time it is not a reason for IVD.

Perhaps a training on the CFCs, patients rights and facilities obligations related to patient care.

Hello
Our unit has recently experienced some significant complications resulting from overstepped boundaries between staff and a patient. This nearly resulted in an involuntary discharge due to the ongoing behavior of the patient and will likely have serious consequences with the staff members involved.
Social workers are trained to have a strong sense of who we are with our clients and who we could be to them in spite of our actual actions or intentions; we learn about transference and counter-transference, and maintaining a helping stance at all times. We see it as the only way to keep the focus on their needs so that they can be empowered to help themselves.
I feel based on my experience in the dialysis unit that for other disciplines boundaries and professionalism may be taught or practiced as an ancillary skill rather than the core of the helping professions. I see some who have also very strong professional boundaries and others who really, really, do not. I don't know how other professions are trained, but I do know that in my own experience at the master's level, understanding one's role, function, and purpose as a social worker was the essence of the entire learning experience. The possibility of dual relationships and blurred boundaries (even with the best intentions) causing harm to a client was regularly addressed and explored during those two years post-grad. I was taught that self-disclosure and client privacy were essential to the helping relationship.
Here's two things I'd like to chew on with you all:
I'd love to hear what other social workers have to say about how you "stick to your guns" when it comes to pushing through a culture full of blurred boundaries, especially if you are also rural as is our unit. I'm holding a "discussion/Q&A" session available to all staff next month, but it isn't mandatory, so I'm concerned those most at risk of violating boundaries may not attend.
Secondly, I'm hoping this group might be another way to support each other as social workers to do what we know is right in the face of so many others in the unit pushing or crossing the limits. It's a tough job to be telling people how to behave when you are not the boss, but also tasked with being a kind of ethical conscience/patient advocate for the unit! Help and ideas on what has worked for you, or even just sharing your experiences with this would be supportive!
Thanks to all and Happy Summer!

The trial program provides a previously Involuntarily Discharged patient the ability to treat in a facility for 30 days. At the end of the 30 days the facility would advise the Network if they need more time, or if they will be accepting the patient permanently. The Network obtains approval for the program from the Department of Health prior to the patient starting at the facility.

Let me know here if you have any questions on how the program works.