Source: US State of Connecticut
Broadly defined, sometimes overlooked and often misunderstood, social work is a crucial component in health care.
It can even be life-saving.
“I had a patient who wrote a message in [UConn Health’s patient portal] MyChart to their physical therapist saying, ‘I’m not coming in today, because I think I’m going to end my life,’” says Rachel Boxwell, a licensed clinical social worker who supports many of UConn Health’s outpatient practices. “The physical therapist lets me know, and I’m able to call the patient. They’re sitting in their car, we have a conversation, try to figure out what’s going to be the next step to keep them safe.”
It’s possible that intervention prevented a suicide, and is an example of how social workers can support patients even outside of scheduled face-to-face interactions.
UConn Health employs 35 social workers. Collectively they work with patients in both inpatient and outpatient settings.
Boxwell works in tandem with Eleanor Szmurlo ’17 MSW to cover more than 50 of UConn Health’s outpatient practices as part of UConn Health’s population health team.
“I previously worked as a substance abuse counselor and have seen first-hand how stigma can prevent people from getting appropriate care,” Szmurlo says. “In my role supporting the outpatient clinics, I have the opportunity to show compassion and care to our patients and to connect them with the supports they need to live happier, healthier lives.”
Amanda Mundo works with hospitalized patients, primarily on the fourth floor of UConn’s John Dempsey Hospital, a medical-surgical floor.
“I go through the entire floor and look at every single patient and familiarize myself with those I’m not familiar with yet,” Mundo says. “In this setting, social work is a universal service available to all patients where we offer both ‘case finding,’ where we’ll review patients’ charts, see if there’s anything documented in an area that we feel we could help, and we also get consultations from the team. Once I go through the list in the morning of the whole floor, I triage to see who might need to be seen first, and build my day from there.”
Five stories below her, in the Connecticut Children’s Neonatal Intensive Care Unit at UConn Health, Brittney Niro works with every parent whose child is admitted to the NICU.
“I assist families with psychosocial needs and community resources,” Niro says. “Parents don’t anticipate a NICU stay, even if they are counseled on it or prepped. The reality hits once their baby is admitted to the NICU. I value being a part of a multidisciplinary team and providing emotional support and resources during their baby’s NICU stay.”
Niro also facilitates a support group for NICU parents.
Many of the inpatient social workers report to Lori Pawlow, UConn Health nursing director who oversees case management.
“Social work services span from birth to end of life,” Pawlow says. “They are present to provide support during the most vulnerable times in patients’ and families’ life experiences. They help by supporting them and guide them in difficult life choices. One very important aspect of the work that social workers do is that they approach all situations in a holistic manner that supports individuals and the whole family. We are very fortunate to have such a talented and dedicated team of social workers here at UConn Health.”
How patients find their way to a social worker will vary. In the outpatient setting, providers can refer patients to social workers. When that happens, Szmurlo or Boxwell will contact the patient and evaluate their psychosocial needs.
“If you’re having a housing challenge, that could really be exacerbated if you are wheelchair-bound or you need certain levels of accessibility,” Boxwell says. “Or you might need home care, and in theory that sounds simple, but if you can’t self-direct your care due to mental health or cognitive decline, those have additional barriers. So I really can assess all of those, help identify what resources are available to our patients, and really talk it through and help them make an informed decision. Sometimes a resource can sound great, but it’s not a great fit for our patients for reasons like medical complexity, their cognitive ability, maybe a familial relationship, where they live and who they live with.”
Anne Horbatuck is chief operating officer of the UConn Medical Group and vice president for ambulatory operations.
“Social workers play a vital role in our outpatient clinic settings,” Horbatuck says. “They address social, emotional, and environmental factors that impact patients’ health. They provide counseling, connect patient with community resources and support care coordination to improve treatment outcomes. Their involvement helps reduce barriers to care, enhance patient well-being and promote a more holistic approach to health care. Rachel and Eleanor cover our UMG clinics along with many others that are department-based. We thank them for all for all they do.”
Why Social Work
Boxwell, who arrived at UConn Health in 2022, has been a social worker since 2016. She found her way to the profession after a year of teaching high school English in Malden, Massachusetts.
“A lot of my students were living in shelters, were teenage parents, were in foster homes, and getting them to the point where they’re even in a spot where they could actually be present in class was social work, was connecting them to resources, was meeting their psychosocial needs,” Boxwell says. “And I realized I had a passion for it, and there was such a need for that.”
Niro has been a social worker since 2009 and joined UConn Health in 2018 as an inpatient social worker on the sixth floor of John Dempsey Hospital. She moved to the NICU in 2022.
“What draws me to the profession is helping families navigate during a vulnerable time,” Niro says. “I knew I wanted to be in the helping profession; I was involved as a peer advocate during high school. The peer advocate program allowed me to be a peer support for younger peers, and I had a mentor who suggested, ‘You’d be a great social worker, you really should look into social work.’”
Mundo joined UConn Health two years ago and has been a social worker since 2016.
“I like relating with people and really being able to build relationships,” Mundo says. “Being able to be there for someone in a moment of need or vulnerability is an honor and not something that everyone has the opportunity to do. You can really make a big difference even with seemingly smaller gestures or tasks.”
She says every day on the job is different.
“It ranges from smaller tasks such as helping a patient to get clothing, helping to coordinate transportation home, to helping them make a phone call that they’ve been really struggling to make, to more serious matters such as substance use, safety issues, crisis intervention, and end-of-life hospice,” Mundo says.
Szmurlo, who graduated with a Master of Social Work from the UConn School of Social Work in 2017, has spent her nearly three years at UConn Health in an outpatient role.
“The social and medical systems we work with can be overwhelming and complicated to manage when things are going well — even more so when people are undergoing a health crisis,” Szmurlo says. “By helping patients navigate services, we can make this less overwhelming and reinforce to patients that UConn Health is here to treat the whole person.”
Misperceptions
Boxwell and Mundo both say it’s common for people to associate their profession with child protective services and people whose job is to separate children from their families.
“Of course, part of our role is to assess for safety, but our job is so much more than that,” Mundo says. “It’s very multifaceted. It can range from smaller, simple tasks to really intense clinically, emotionally draining, and taxing interactions. A lot of people don’t know what we do day-to-day. A lot of it is behind the scenes, but it does make a really big difference, for the medical team and for the patients.”
She says it’s about an even split between those who understand the social worker is there to help and those who would rather not have an interaction with a social worker, as they may not understand a social worker’s role in this setting.
Niro points out that patients or families may not always realize that social workers are independently licensed clinicians.
“We can diagnose and assess mental health needs,” Niro says. “A social worker can be an autonomous, independent mental health professional. Sometimes the term ‘social work’ is used to explain many different roles and responsibilities. Being a medical social worker is a rewarding career.”
What I find most rewarding about being a social worker is being able to be there for people when they’re at their most vulnerable. — Amanda Mundo
‘An Honor’
Niro says she appreciates the multidisciplinary team approach, working with nurses, physicians, advanced practice providers and others, and the comradery that naturally comes with it.
“I find my job to be rewarding in the sense that families need someone to be in their corner,” Niro says. “I truly enjoy being a constant support and advocate to each family during a challenging time.”
“What I find most rewarding about being a social worker is being able to be there for people when they’re at their most vulnerable,” Mundo says. “It’s really an honor to be there for someone when they need it the most and to be that support when oftentimes a lot of patients don’t have any support.”
Similarly, Szmurlo says, “It’s an honor to be a social worker and to be able to support people through some of the most difficult times in their lives.”
Boxwell says what may seem like a small thing can make big difference in the lives of patients and families who have been struggling.
“It can be life-changing for them, and knowing the ripple effect that that then can have on their life — not just their quality of life, but their relationships with others, their ability to be financially solvent, to then be able to have a solvent retirement, to not be concerned about what’s going to happen with their disease process because they know they have a team to support them, being able to relieve folks of that — it’s a great feeling,” Boxwell says. “You have changed that person’s life for the better, and that will continue having a ripple effect.”
March is National Social Work Month.