Chapter 4 Reflection

Chapter 4 Reflection Chapter 4 entitled, "Social Work in Hospitals" revisits the history of how social work in the hospitals came to be and even how hospitals themselves began to be established in the United States and why. Hospitals, in their infancy were almshouses which were established for the poor and in the early 1700's. The Revolutionary War was one reason the need for private non-profit hospitals was spurred on in order to treat the injured and another was the fact that the middle class found the almshouses environment unacceptable. More and more hospitals were built to accommodate urbanization which brought on epidemics and other public health problems. (Cowles, L.A.F., 2013)Almshouses were still the standard care for the economically disadvantaged and the poor conditions inside these care centers did not improve. Once the germ theory began to be recognized and accepted in the late 1800's, hospitals finally became recognized as the proper place for medical care. In the mid 1800's the social worker emerged to fill the need to coordinate the various charities working within the hospitals and even the "outdoor" relief charities as well as oversight and setting standards of care. Urbanization and immigration caused so much growth that was not prepared for, it in turn caused many health problems related to poverty, poor water and sewage and poor living conditions. Hospitals evolved from "caring" for people to "curing" people. What began as the social worker, some branched out and evolved into the specialized social worker in the health care field as it is known today. (Cowles, L.A.F., 2013) The NASW mission of social work in the medical hospital setting as providing medically related social and emotional services to patients and their families in accordance with their medical condition, treatment and recovery.(Cowles, L.A.F., 2013) Today, policies, high cost of medical insurance, the uninsured, contribute to conflicting the values and ethics of social workers and actually affect the future of social workers in the health care field. Some social workers in the health care field feel their values and ethics are being compromised by the decisions they are being forced to make within the guidelines of the hospitals policies which are dictated in many ways by money or lack there of. Some feel their participation, even the line and intention of helping is going against what they believe and therefore should not be involved. could the social worker in the health care field actually be an "endangered species"? What would the ramifications be and what could be done to make the appropriate changes before this could happen? Major macro work in needed to ensure not only the jobs of the social worker in health care field but the countless people whom they help.