Social workers leaving hospice, health care in record numbers

Hospices have been losing social worker employees at a faster rate than any health care setting in the continuum of care.

Social workers have left the health care field at record high rates during the pandemic, according to data from the Peterson-Kaiser Family Foundation Health System Tracker. As of October 2021, the rate of decline exceeded pre-pandemic levels by 35%.

As recently as 2006, the hospice industry saw more social workers leave than any other health care sector, according to a study by the National Association of Social Workers (NASW) and the Center for Health Workforce Studies at the University at Albany. Dropouts from social work were more often reported as common in hospices (18%) versus other settings, such as health clinics (9%), the study found.

The reasons mirror those for nurses and others in the hospice workforce who leave the field—burnout, stress, opportunities for higher pay, lack of a career path and retirements.

But a lack of employer engagement represents the biggest problem when it comes to curbing social worker burnout and turnover, according to Rachel Levy, assistant clinical director at The Help Group.

“A big risk factor for staff burnout and turnover is feeling disconnected from their work and not having a voice in company decisions,” Levy told Hospice News. “I’ve heard this from social workers in a variety of settings, including hospice.”

Supportive culture a draw for job seekers

Social workers who participated in the NASW study cited a lack of respect, support, pay and career advancement or educational opportunities as reasons for leaving the field.

At the same time, social workers in hospices were more likely to be dissatisfied with their supervisor’s instructions (29%) than those in other settings, such as health clinics (19%) or hospitals (15%), according to the NASW study.

When asked about possible factors influencing a job change, most hospice social workers told NASW that supervisors were a major issue.

Workplace culture greatly affects staff retention, according to Susan Ponder-Stansel, president and CEO of Florida-based Alivia Care.

Across the healthcare space, pressure has been mounting on social workers. That includes an inability to take time off without a “heavy workload” and increased stress levels that reduce their quality of life, Ponder-Stansel said.

“Staff are increasingly making decisions based on whether the workplace culture expects them to consistently work long hours,” Ponder-Stansel told Hospice News in an email. “One trend that is intensifying is having boundaries at work, so time off and being able to have a reasonable expectation of a schedule is a factor in attracting and retaining staff, especially younger staff.”

Salary problems and few career paths

The health care sector has become a battleground when it comes to workers’ compensation — one in which hospices are often at a disadvantage compared to large, well-capitalized health systems.

Some providers have used benefits outside of increased wages to attract and retain workers, including telecommuting capabilities, flexible schedules and ways to build compensation over the course of their employment.

According to Ponder Stansel, hospice providers need to get creative when it comes to compensation.

“Retention really requires that we reject the one-size-fits-all approach to compensation and job location,” Ponder Stansel said. “We are finding that younger workers are not connected to the two-week check. They want some kind of pay-per-day arrangement where they get their money closer to when they work. Many are not so interested in total compensation; they’d rather have a higher salary now and worry about retirement savings later.”

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