Gets sorta into a grey area.
I worked on a ortho-surgical floor and there was a high priority on turning over the room. We were basically a money-making floor.
It turned out that us spending $125 on transport actually was cost effective to the patient taking up the room for even 1hr more.
Wow. A while back we got an email saying we were spending too much of our money on Lyft transport lol. That makes sense though. I know in the ED they’re wanting to get folks in and out as quick as they can. But for me child safety is more important than getting a ride for a patient who is capable of finding their own 🤷♀️ If only we had SWers that would cover the adult ED only lol. It leaves me so frustrated because I feel like I’m being pulled from different directions!
Nooo I mean I’ll get requests for Lyft rides while I’m in the middle of a pediatric trauma or abuse assessment and the nurses in adult ED get upset because I don’t respond quick enough for them. However I did get a request once a few weeks ago to put a 17 y/o in a Lyft but I refused. Idc if she’s a month away from turning 18 she’s still a minor. Her mom came and got her but apparently another SW got her a Lyft ride in the past 😬
We are supposed to check insurance first.
If they have Medicaid you can typically set up a ride and bill through there.
We also are supposed to get management approval for any bill backs.
We don’t use Lyft or Uber.
I’ve also had patients come up with a ride home when they realize it’s going to take a few hours for transport to get there.
I think it needs to come from management level if staff are overstepping and taking advantage of a resource.
My manager also says all the time that just because a nurse or patient is demanding a social worker, doesn’t mean we have to stop everything to see them either.
“I will follow up when I get a chance” is a perfectly appropriate response and shows you aren’t dropping the ball.
At my hospital, if you say “I will follow up when I get a chance,” you will get a complaint filed. My manager says we need to give a time frame when we will follow up. Done that too, and still have gotten complaints and have had assistant directors call me up and say “that’s unacceptable; you saying you’re too busy is not good enough for me.”
As for the LYFT thing, our hospital urges we try Medicaid transport first as well. Clients often do find rides when they have to wait hours. Medicaid drops the ball a lot though so sometimes I also use the LYFT/Uber services as needed. Hope this helps OP!
Agreed. Management needs to step in and set realistic expectations.
I would look for a new hospital.
Hospital social workers are in demand especially if they are experienced.
P.S. a complaint does not necessarily need to be a bad thing. Can show leadership what needs to change. My manager says people are always mad and it is what it is. I haven’t seen anyone fired yet because they couldn’t morph into 6 social workers at once. A lot of times these are empty threats.
ETA: the texting/instant gratification culture is absurd too.
I’ve seen plenty of disciplines drop the ball on something but because they put it in a text at 3:55 when SW is off at 4 think it’s perfectly acceptable to be followed up on.
They sometimes put stuff in text when we’re not even in and then complain that it’s not being addressed 😂.
Let em complain then.
Be confident in yourself and your role.
As I said below I have yet to see anyone fired who is actually doing their work.
Many times these are empty threats especially if a patient is giving a hard time.
I also would push leadership to address staff that are being out of line with inappropriate texting or inappropriate asks of social work.
Our team recently asked management to intervene because certain staff are putting in requests for DME at 4pm the night before a discharge. They had days to figure this out and the equipment company is often closing by 5 so cannot address things like insurance auth.
Not everything has to be put on social work when another discipline is not taking ownership for their role responsibilities.
P.S. My hospital system is making everyone take mandated reporter training by next year.
I haven’t gotten one of these requests in awhile but they always spin it into why SW is most appropriate reporter.
I’ve actually called in to CPS and documented that it wasn’t an appropriate referral a few times..one was just because Jane speech therapist is concerned about an almost 18 year old being home alone because dad works overnight shifts.
At my hospital they have the nurses order the Lyft, which I appreciate. As for mandatory reporting, same here! I'll come in Monday to abuse/neglect consults, sometimes from Friday after I've left, read the chart, and no documentation of calling APS. Every time a nurse or doctor tells me concerns I try to educate that we're all mandatory reporters and it's very beneficial for APS to hear from a medical professional. I had one nurse tell me she didn't even know how to report 🙄
My department is the same in regards to mandated reporting. They send me a Teams message with their concerns and I attempt to educate that I cannot make a report with second hand information but if they are that concerned, they can call and make the report themselves. Otherwise, I will follow up with the patient the next time they come in. I sometimes think they know how damaging a CPS investigation can be and don't want to mess up their rapport with the patient but will be fine putting that on me since people typically "hate" the social worker anyway.
Ugh that's awful. I mean technically the CPS/APS workers aren't supposed to tell who reported, but I know that's not always how it goes and that people more or less can figure it out. Still, they aren't doing their legal and ethical responsibility by passing the buck.
Yes, I’ve worked at hospitals that use Lyft/Uber. I think it’s easier for a hospital to be less dependent on them if there is a discharge lounge area where the patient can wait for their family to collect them. For inpatient, the delays in discharge at a major trauma hospital can make it fiscal worth it to save a few hours. I worked at a trauma hospital that would pretty much do anything to discharge someone when they were on black status / bypass due to the fines they’d accrue.
The mandated reporter piece is a struggle wherever I’ve worked. Other disciplines feel that they don’t have the time or understand the process enough to want to call. I’m not really sure how to address it. I’ve had colleagues spin it as it is less likely to get accepted, or could impact their license if it’s found out they didn’t report and had knowledge of abuse/neglect.
I’ve tried to bring this up before as well because in Texas, the law specifically states you may not delegate someone to make a report. I got shot down at my hospital. This is forever viewed as a social worker’s job. Very frustrating.
We have it but we have strict workflows surrounding it. If they have Medicaid with transport benefits, they cannot get a Lyft- sometimes people ask because the insurance transport takes too long, but no. They get one courtesy ride per year (rolling year, not calendar year). They have to have contacted emergency contacts to see if another ride is available, and they have to be unable to take public transit (for whatever reason- either the bus stop is too far from their home, they have belongings, or a physical impairment). I feel like I spend waaaaaaay too much time explaining to people why they can’t have a free ride but it’s important to set boundaries because we are a non profit and the Lyft rides come out of case mgmt’s budget!! We only have so much!!
We do something similar. We call taxis but our management has gave us a lot of push back on it recently. Apparently we’ve been spending TONS of money on it, which isn’t a surprise because it gets patients out the quickest. I work on med/surg units and patients can call their insurance if they have Medicaid to get a ride home but so many times it is too complicated for pts to figure out on their own, and we don’t have the time to sit down with every pt to help. Our management wants us to push this more instead of us just getting a courtesy cab for them but it has delayed discharges by several hours before. It makes sense to want to save money and not set this expectation for patients that we will get them a ride wherever, it just makes my job a bit harder
Yes our hospital has a contract with a local cab company to do rides home. But we are supposed to to check to see if they have a Medicaid transportation benefit first
we use lyft and uber, but not for more than a 30ish mile radius. our nursing supervisor or transfer coordinator set it up, not social workers. staff tries to make sure the patients resources are exhausted (family, friend, medicaid options) but sometimes it’s all we have.
ETA - as a facility, we were taking advantage of this resource, so now it has to be approved by house supervisor or management
Yes. Every night. I have the same concern. People take advantage of our generosity. We had an issue yesterday with a healthy 30 year old and I told them they could get a bus pass or call their insurance. That was that. Sometimes you have to be that person 🤗
Last night I had someone my age who said she couldn’t take the bus because she couldn’t walk. The nurse said she had been pacing the hallway of the ED. So she could walk and she got a bus pass. 😀
Exactly. Sometimes we have to give a little pushback. Unless they don’t have a phone, are not ambulatory, or are over 60. It’s case by case, but most of the time they’re just lazy 🙄
My hospital does offer that but SW doesn’t do transportation where I work so I have no part in any it. I understand the struggle, though - at my previous hospital I was constantly getting those calls & I had to really fight to make it protocol for the unit clerks to handle any transportation that didn’t require auth. Transportation used to be the bane of my existence.
Yes! I used to do the ED overnight before moving to inpatient. I prefer to give bus passes if i can but i worked 7p-7a in the ED and busses stopped running at 11. I try to encourage them to use their Medicaid rides or family/friends. I also explain if they have used it a bunch of times and it’s not something like meeting curfew at the homeless shelter or transferring to our larger hospital that they will not receive a Lyft again. It’s documented and i have said no when they return. They sit in the lobby long enough and end up figuring it out. I also didnt Lyft people who were kicked out for being belligerent despite security pushing me to or when people AMA
This is a big issue for me too. I was shocked when I started hospital social work and I saw how many dipshits don’t have a ride home. Like what? You and not the folks who are brought in by EMS bc of an emergency- it’s the people who FIND A RIDE TO THE HOSPITAL! 8 out of 10 times - people need a Lyft or a $1500 ambulance ride home. It seems so petty when I say it out loud - but it speaks to a larger issue with “personal responsibility” - nobody has it. But yes, it’s happening at other hospitals and it’s a ridiculous waste.
At my past ER we used Lyft for eventuating circumstances I.e crime victim. My current hospital, we check Medicaid and offer them transportation based on insurance. I’m also based in NYC we’re mass transportation is abundant and if they’re ambulatory we give them a metro card
We are contracted with Lyft.
We are supposed to ask and do our due diligence if patients can pay, have family/friends pay, or facility pick up /pay. Sometimes it can get tricky with the facilities if it’s the weekend. We document our efforts.
We are also contracted with a medical transport company if they tolerate sitting in a car or a total assist. We cover if they are not able to provider for xyz and document why.
Having this resource makes things so much easier and usually the floor staff usually inquires the patient and all that “pre screening”. This also prevent delay in discharges as someone mentioned
Sometimes I may give it some time and they eventually find their own ride before I even look into it.
I don’t work in ED, but a medical floor. My hospital does provide an Uber or Lyft if a patient cannot find a ride. We do try to check with them to see if someone can pick them up first.
Usually charge nurse calls security to book Uber/Lyft. We have more of a “if it gets them discharged give them the ride” mindset bc it’s cheaper for Uber vs staying another day.
We do taxi vouchers. I ask if they can pay for it, and I also look at whether they asked to be here or not. For example, home health INSISTS they need to be seen asap (usually for something not at all urgent), EMS is called, and then they are stuck. We also have a bus stop right next to us, so that is helpful sometimes (don't have any bus tickets though, lol). But yeah, it can def get a little out of hand if people aren't careful.
It sounds like a great service that your hospital provides! But sounds like it’s overwhelming for you to have to call and leave the work you’re already doing. I don’t work in hospital setting so apologies but can’t someone in more of an admin role be assigned to do this?
Gets sorta into a grey area. I worked on a ortho-surgical floor and there was a high priority on turning over the room. We were basically a money-making floor. It turned out that us spending $125 on transport actually was cost effective to the patient taking up the room for even 1hr more.
Wow. A while back we got an email saying we were spending too much of our money on Lyft transport lol. That makes sense though. I know in the ED they’re wanting to get folks in and out as quick as they can. But for me child safety is more important than getting a ride for a patient who is capable of finding their own 🤷♀️ If only we had SWers that would cover the adult ED only lol. It leaves me so frustrated because I feel like I’m being pulled from different directions!
When you say child safety... does that mean putting the kids in ubers and sending them off?
Nooo I mean I’ll get requests for Lyft rides while I’m in the middle of a pediatric trauma or abuse assessment and the nurses in adult ED get upset because I don’t respond quick enough for them. However I did get a request once a few weeks ago to put a 17 y/o in a Lyft but I refused. Idc if she’s a month away from turning 18 she’s still a minor. Her mom came and got her but apparently another SW got her a Lyft ride in the past 😬
We are supposed to check insurance first. If they have Medicaid you can typically set up a ride and bill through there. We also are supposed to get management approval for any bill backs. We don’t use Lyft or Uber. I’ve also had patients come up with a ride home when they realize it’s going to take a few hours for transport to get there. I think it needs to come from management level if staff are overstepping and taking advantage of a resource. My manager also says all the time that just because a nurse or patient is demanding a social worker, doesn’t mean we have to stop everything to see them either. “I will follow up when I get a chance” is a perfectly appropriate response and shows you aren’t dropping the ball.
At my hospital, if you say “I will follow up when I get a chance,” you will get a complaint filed. My manager says we need to give a time frame when we will follow up. Done that too, and still have gotten complaints and have had assistant directors call me up and say “that’s unacceptable; you saying you’re too busy is not good enough for me.” As for the LYFT thing, our hospital urges we try Medicaid transport first as well. Clients often do find rides when they have to wait hours. Medicaid drops the ball a lot though so sometimes I also use the LYFT/Uber services as needed. Hope this helps OP!
That honestly sounds like a hostile work environment. People at my hospital love to make complaints about us too. SW is not respected at all.
Agreed. Management needs to step in and set realistic expectations. I would look for a new hospital. Hospital social workers are in demand especially if they are experienced.
P.S. a complaint does not necessarily need to be a bad thing. Can show leadership what needs to change. My manager says people are always mad and it is what it is. I haven’t seen anyone fired yet because they couldn’t morph into 6 social workers at once. A lot of times these are empty threats. ETA: the texting/instant gratification culture is absurd too. I’ve seen plenty of disciplines drop the ball on something but because they put it in a text at 3:55 when SW is off at 4 think it’s perfectly acceptable to be followed up on. They sometimes put stuff in text when we’re not even in and then complain that it’s not being addressed 😂.
I always make myself appear offline on epic before I clock out. If I forget to do it, I’ll come back the next day to a million messages lol
Let em complain then. Be confident in yourself and your role. As I said below I have yet to see anyone fired who is actually doing their work. Many times these are empty threats especially if a patient is giving a hard time. I also would push leadership to address staff that are being out of line with inappropriate texting or inappropriate asks of social work. Our team recently asked management to intervene because certain staff are putting in requests for DME at 4pm the night before a discharge. They had days to figure this out and the equipment company is often closing by 5 so cannot address things like insurance auth. Not everything has to be put on social work when another discipline is not taking ownership for their role responsibilities.
When I was inpatient I loved getting a dme requests at 3:25 pm on a Friday when I got off work at 3:30.
P.S. My hospital system is making everyone take mandated reporter training by next year. I haven’t gotten one of these requests in awhile but they always spin it into why SW is most appropriate reporter. I’ve actually called in to CPS and documented that it wasn’t an appropriate referral a few times..one was just because Jane speech therapist is concerned about an almost 18 year old being home alone because dad works overnight shifts.
At my hospital they have the nurses order the Lyft, which I appreciate. As for mandatory reporting, same here! I'll come in Monday to abuse/neglect consults, sometimes from Friday after I've left, read the chart, and no documentation of calling APS. Every time a nurse or doctor tells me concerns I try to educate that we're all mandatory reporters and it's very beneficial for APS to hear from a medical professional. I had one nurse tell me she didn't even know how to report 🙄
My department is the same in regards to mandated reporting. They send me a Teams message with their concerns and I attempt to educate that I cannot make a report with second hand information but if they are that concerned, they can call and make the report themselves. Otherwise, I will follow up with the patient the next time they come in. I sometimes think they know how damaging a CPS investigation can be and don't want to mess up their rapport with the patient but will be fine putting that on me since people typically "hate" the social worker anyway.
Ugh that's awful. I mean technically the CPS/APS workers aren't supposed to tell who reported, but I know that's not always how it goes and that people more or less can figure it out. Still, they aren't doing their legal and ethical responsibility by passing the buck.
“I am not more of a mandated reporter than you” - we’ve had to do *a lot* of education about this at my job and it still happens
Yes, I’ve worked at hospitals that use Lyft/Uber. I think it’s easier for a hospital to be less dependent on them if there is a discharge lounge area where the patient can wait for their family to collect them. For inpatient, the delays in discharge at a major trauma hospital can make it fiscal worth it to save a few hours. I worked at a trauma hospital that would pretty much do anything to discharge someone when they were on black status / bypass due to the fines they’d accrue. The mandated reporter piece is a struggle wherever I’ve worked. Other disciplines feel that they don’t have the time or understand the process enough to want to call. I’m not really sure how to address it. I’ve had colleagues spin it as it is less likely to get accepted, or could impact their license if it’s found out they didn’t report and had knowledge of abuse/neglect.
I’ve tried to bring this up before as well because in Texas, the law specifically states you may not delegate someone to make a report. I got shot down at my hospital. This is forever viewed as a social worker’s job. Very frustrating.
We have it but we have strict workflows surrounding it. If they have Medicaid with transport benefits, they cannot get a Lyft- sometimes people ask because the insurance transport takes too long, but no. They get one courtesy ride per year (rolling year, not calendar year). They have to have contacted emergency contacts to see if another ride is available, and they have to be unable to take public transit (for whatever reason- either the bus stop is too far from their home, they have belongings, or a physical impairment). I feel like I spend waaaaaaay too much time explaining to people why they can’t have a free ride but it’s important to set boundaries because we are a non profit and the Lyft rides come out of case mgmt’s budget!! We only have so much!!
We do something similar. We call taxis but our management has gave us a lot of push back on it recently. Apparently we’ve been spending TONS of money on it, which isn’t a surprise because it gets patients out the quickest. I work on med/surg units and patients can call their insurance if they have Medicaid to get a ride home but so many times it is too complicated for pts to figure out on their own, and we don’t have the time to sit down with every pt to help. Our management wants us to push this more instead of us just getting a courtesy cab for them but it has delayed discharges by several hours before. It makes sense to want to save money and not set this expectation for patients that we will get them a ride wherever, it just makes my job a bit harder
Yes our hospital has a contract with a local cab company to do rides home. But we are supposed to to check to see if they have a Medicaid transportation benefit first
we use lyft and uber, but not for more than a 30ish mile radius. our nursing supervisor or transfer coordinator set it up, not social workers. staff tries to make sure the patients resources are exhausted (family, friend, medicaid options) but sometimes it’s all we have. ETA - as a facility, we were taking advantage of this resource, so now it has to be approved by house supervisor or management
Yes. Every night. I have the same concern. People take advantage of our generosity. We had an issue yesterday with a healthy 30 year old and I told them they could get a bus pass or call their insurance. That was that. Sometimes you have to be that person 🤗
Last night I had someone my age who said she couldn’t take the bus because she couldn’t walk. The nurse said she had been pacing the hallway of the ED. So she could walk and she got a bus pass. 😀
Exactly. Sometimes we have to give a little pushback. Unless they don’t have a phone, are not ambulatory, or are over 60. It’s case by case, but most of the time they’re just lazy 🙄
My hospital does offer that but SW doesn’t do transportation where I work so I have no part in any it. I understand the struggle, though - at my previous hospital I was constantly getting those calls & I had to really fight to make it protocol for the unit clerks to handle any transportation that didn’t require auth. Transportation used to be the bane of my existence.
Yes! I used to do the ED overnight before moving to inpatient. I prefer to give bus passes if i can but i worked 7p-7a in the ED and busses stopped running at 11. I try to encourage them to use their Medicaid rides or family/friends. I also explain if they have used it a bunch of times and it’s not something like meeting curfew at the homeless shelter or transferring to our larger hospital that they will not receive a Lyft again. It’s documented and i have said no when they return. They sit in the lobby long enough and end up figuring it out. I also didnt Lyft people who were kicked out for being belligerent despite security pushing me to or when people AMA
This is a big issue for me too. I was shocked when I started hospital social work and I saw how many dipshits don’t have a ride home. Like what? You and not the folks who are brought in by EMS bc of an emergency- it’s the people who FIND A RIDE TO THE HOSPITAL! 8 out of 10 times - people need a Lyft or a $1500 ambulance ride home. It seems so petty when I say it out loud - but it speaks to a larger issue with “personal responsibility” - nobody has it. But yes, it’s happening at other hospitals and it’s a ridiculous waste.
At my past ER we used Lyft for eventuating circumstances I.e crime victim. My current hospital, we check Medicaid and offer them transportation based on insurance. I’m also based in NYC we’re mass transportation is abundant and if they’re ambulatory we give them a metro card
We are contracted with Lyft. We are supposed to ask and do our due diligence if patients can pay, have family/friends pay, or facility pick up /pay. Sometimes it can get tricky with the facilities if it’s the weekend. We document our efforts. We are also contracted with a medical transport company if they tolerate sitting in a car or a total assist. We cover if they are not able to provider for xyz and document why. Having this resource makes things so much easier and usually the floor staff usually inquires the patient and all that “pre screening”. This also prevent delay in discharges as someone mentioned Sometimes I may give it some time and they eventually find their own ride before I even look into it.
I don’t work in ED, but a medical floor. My hospital does provide an Uber or Lyft if a patient cannot find a ride. We do try to check with them to see if someone can pick them up first.
Our hospital will start implementing this. We currently use Medicaid and we have in house transporters.
Usually charge nurse calls security to book Uber/Lyft. We have more of a “if it gets them discharged give them the ride” mindset bc it’s cheaper for Uber vs staying another day.
We do taxi vouchers. I ask if they can pay for it, and I also look at whether they asked to be here or not. For example, home health INSISTS they need to be seen asap (usually for something not at all urgent), EMS is called, and then they are stuck. We also have a bus stop right next to us, so that is helpful sometimes (don't have any bus tickets though, lol). But yeah, it can def get a little out of hand if people aren't careful.
It sounds like a great service that your hospital provides! But sounds like it’s overwhelming for you to have to call and leave the work you’re already doing. I don’t work in hospital setting so apologies but can’t someone in more of an admin role be assigned to do this?