Here is a post by Christine Guenther, DVM at Pittsburgh Veterinary Specialty and Emergency Center on the ACVECC (American College of Veterinary Emergency and Critical Care) listserv:
Recruitment: We started the process of finding a veterinary social worker (VSW) for our practice by contacting Sandra Brackenridge, a veterinary social worker at the University of Tennessee. [INCORRECT: Texas Woman's University] She came out and evaluated our practice and we ultimately determined through her assessment and our growing needs as a hospital with over 400 employees that our practice, employees and clients would greatly benefit from a full time onsite social worker. She helped us with the interview process because none of us practice owners felt qualified to interview a social worker. We had about 40 applications which she narrowed down to 10 candidates. A small committee, including myself, went over the interviews and resumes and narrowed it down to 3 people for in person interviews with the board and clinical managers, including a presentation of which the topic was chosen by the candidate from a list of topics recommended by Ms. Brackenridge. Per a recommendation from Ms. Brackenridge we only interviewed social workers with a masters degree. The thought process behind that was that social workers with a masters degree can take masters students as working interns. From there we hired Lori Harbert, a social worker with over 10 years experience working with high risk traumatized children. As part of our contract with Ms. Brackenridge she remained a consultant and worked with Lori via phone and email for the first 6 months to help develop our program. In Pittsburgh the average salary of a social worker with a master’s degree is around $50-65K per year depending on years of experience, plus benefits.
Cost Justification: Prior to hiring a VSW we (the Board) had extensive conversations regarding compensation and justification of their salary and benefits. From my perspective, if hiring a VSW saves one life it’s worth the cost, but the Board likes more solid numbers than that. J In our cost analysis we included both doctor time and employee retention as our speaking points. We had the doctors who tend to see a higher number of terminally ill or critical patients and high maintenance clients (oncology, critical care, emergency, internal medicine) estimate the number of hours per week they spend with clients for euthanasia counseling and end of life conversations. We were also having a problem with employee retention, especially with our technicians and front desk staff. Exit interviews which are conducted for all employees when they leave our practice indicated burnout and compassion fatigue were in the top 3 reasons for leaving. We proposed that having a VSW on staff would decrease our employee turnover thus saving money on recruiting and training and allow doctors more time for patient procedures and appointments. After a year the response from our doctors indicated a huge time savings to them by having the VSW get involved in end of life/difficult discussions thus freeing up the doctor to see appointments or to deal with other patients. We also saw a decrease in the turnover rate of our techs and front desk staff. In exit interviews the number of employees leaving for reasons of burnout and compassion fatigue decreased considerably. Based on the success of our first VSW and being able to justify her salary and benefits we hired a second full time VSW in order to expand coverage into the evening and weekend hours. As an aside, we initially thought that we could have one full time master’s VSW and have master students as interns covering some evening and weekend hours. That didn’t work out due to the rules of the programs at the universities in our area in that interns have to be supervised at all times by a VSE on site. Other VSW programs nationwide have a little more leeway with what their interns can and can’t do.
Implementation: Lori spent the first 4 weeks on the floor rotating through the different departments and stepping in as needed. Her goal for her first 30 days was to mostly observe and see where the most need was. From there she set up protocols for getting her involved with pretty much anything – euthanasia, upset clients, mediation with employee issues etc. After witnessing a particularly heart wrenching code in the ICU and the stress and grief observed she implemented a decompression plan for when events like this unfold, to quickly, in a 10 minute time period, regroup and discuss the situation focusing on the positives (it actually really helps).
She met with employees at first as groups to discuss their concerns and needs and was able to provide a lot of insight to the Board and the clinical managers as to some of the issues they were dealing with. From there our program has expanded to weekly grief counseling meetings for clients, one on one employee meetings, mediation at disciplinary/termination sessions, mediation with upset clients, follow up with clients the doctor perceives is ‘at risk’ and employee workshops on a variety of wellness topics. They meet with the interns and residents as a group twice a year and their door is open throughout the year for individual discussions. Their interaction with owners who are euthanizing their pets is, for me as doctor, invaluable. In the past I’ve had owners who need hours of my time to come to the realization that their pet is going to die – hours I don’t have. I’ve always felt incredibly guilty not being able to spend the time my clients need and sometimes sending clients out the door after a euthanasia and being worried that the client is going to harm themselves. The VSW handles all of this – it’s not that I’m not involved but I’m able to hand over the counseling to the professionals. They will stay with the client as long as takes (often hours), stay during the euthanasia, make sure the client gets home safely and follows up with them by phone. For off hours the ER docs can email the VSW if they feel they have a client at risk and the VSW will call them the next day to touch base. To say that having a VSW at the hospital has improved my quality of life is an understatement.
Recruitment: We started the process of finding a veterinary social worker (VSW) for our practice by contacting Sandra Brackenridge, a veterinary social worker at the University of Tennessee. [INCORRECT: Texas Woman's University] She came out and evaluated our practice and we ultimately determined through her assessment and our growing needs as a hospital with over 400 employees that our practice, employees and clients would greatly benefit from a full time onsite social worker. She helped us with the interview process because none of us practice owners felt qualified to interview a social worker. We had about 40 applications which she narrowed down to 10 candidates. A small committee, including myself, went over the interviews and resumes and narrowed it down to 3 people for in person interviews with the board and clinical managers, including a presentation of which the topic was chosen by the candidate from a list of topics recommended by Ms. Brackenridge. Per a recommendation from Ms. Brackenridge we only interviewed social workers with a masters degree. The thought process behind that was that social workers with a masters degree can take masters students as working interns. From there we hired Lori Harbert, a social worker with over 10 years experience working with high risk traumatized children. As part of our contract with Ms. Brackenridge she remained a consultant and worked with Lori via phone and email for the first 6 months to help develop our program. In Pittsburgh the average salary of a social worker with a master’s degree is around $50-65K per year depending on years of experience, plus benefits.
Cost Justification: Prior to hiring a VSW we (the Board) had extensive conversations regarding compensation and justification of their salary and benefits. From my perspective, if hiring a VSW saves one life it’s worth the cost, but the Board likes more solid numbers than that. J In our cost analysis we included both doctor time and employee retention as our speaking points. We had the doctors who tend to see a higher number of terminally ill or critical patients and high maintenance clients (oncology, critical care, emergency, internal medicine) estimate the number of hours per week they spend with clients for euthanasia counseling and end of life conversations. We were also having a problem with employee retention, especially with our technicians and front desk staff. Exit interviews which are conducted for all employees when they leave our practice indicated burnout and compassion fatigue were in the top 3 reasons for leaving. We proposed that having a VSW on staff would decrease our employee turnover thus saving money on recruiting and training and allow doctors more time for patient procedures and appointments. After a year the response from our doctors indicated a huge time savings to them by having the VSW get involved in end of life/difficult discussions thus freeing up the doctor to see appointments or to deal with other patients. We also saw a decrease in the turnover rate of our techs and front desk staff. In exit interviews the number of employees leaving for reasons of burnout and compassion fatigue decreased considerably. Based on the success of our first VSW and being able to justify her salary and benefits we hired a second full time VSW in order to expand coverage into the evening and weekend hours. As an aside, we initially thought that we could have one full time master’s VSW and have master students as interns covering some evening and weekend hours. That didn’t work out due to the rules of the programs at the universities in our area in that interns have to be supervised at all times by a VSE on site. Other VSW programs nationwide have a little more leeway with what their interns can and can’t do.
Implementation: Lori spent the first 4 weeks on the floor rotating through the different departments and stepping in as needed. Her goal for her first 30 days was to mostly observe and see where the most need was. From there she set up protocols for getting her involved with pretty much anything – euthanasia, upset clients, mediation with employee issues etc. After witnessing a particularly heart wrenching code in the ICU and the stress and grief observed she implemented a decompression plan for when events like this unfold, to quickly, in a 10 minute time period, regroup and discuss the situation focusing on the positives (it actually really helps).
She met with employees at first as groups to discuss their concerns and needs and was able to provide a lot of insight to the Board and the clinical managers as to some of the issues they were dealing with. From there our program has expanded to weekly grief counseling meetings for clients, one on one employee meetings, mediation at disciplinary/termination sessions, mediation with upset clients, follow up with clients the doctor perceives is ‘at risk’ and employee workshops on a variety of wellness topics. They meet with the interns and residents as a group twice a year and their door is open throughout the year for individual discussions. Their interaction with owners who are euthanizing their pets is, for me as doctor, invaluable. In the past I’ve had owners who need hours of my time to come to the realization that their pet is going to die – hours I don’t have. I’ve always felt incredibly guilty not being able to spend the time my clients need and sometimes sending clients out the door after a euthanasia and being worried that the client is going to harm themselves. The VSW handles all of this – it’s not that I’m not involved but I’m able to hand over the counseling to the professionals. They will stay with the client as long as takes (often hours), stay during the euthanasia, make sure the client gets home safely and follows up with them by phone. For off hours the ER docs can email the VSW if they feel they have a client at risk and the VSW will call them the next day to touch base. To say that having a VSW at the hospital has improved my quality of life is an understatement.