台湾急诊科社会工作员的岗位职责与专业发展

The Responsibilities and Career Development of the Emergency Department Social Workers in Taiwan

急诊科社会工作员的服务从早期处理街头流浪汉病患和协助无家属案主申请医疗补助,已逐渐发展到以独居老人、家暴受害者、儿童及老人虐待保护、自杀、酒药瘾、到院前死亡、紧急意外事故等个案为主,富弹性的处遇计划是急诊科社会工作员重要的专业能力。从人道关怀与协助支持层面,急诊科社会工作员弥补了医护人员在忙碌中对患者疏于心理照顾的不足,扮演着重要关怀角色,包括对病患与家属情绪安抚、联系寻找家属、安排衣食住行或紧急转院服务等,对促进病患、家属与医疗团队三方沟通起到莫大帮助。本文先从急诊科社会工作员与一般医院社会工作员的职务进行区分,探究处在医疗、司法、社会救助最前线的社会工作员最需要具备的专业知识与能力,再从全球各大医院急诊科委外经营趋势,与院领导层碍于医院评鉴法规各项要求,对无法创收获利的社会工作员所出现的职务期待,来进行综合分析急诊科社会工作部门的人力配置、岗位职责与角色困境;另一方面,在医疗团队不一样的待遇底下,社会工作员在制度面、职责分工、伦理价值观与一般医护人员对社会工作员职务期待的落差与医患关系的冲突来深入探讨。近年来,各国政府为了加强社会管理与构建社区安全网络,要求医院相关人员必须密切关注因不寻常受伤入院的患者是否符合法定通报责任制的规定,本文对此举是否会提升社会工作员在医院的专业地位进行了阐述。本文最后以急诊科社会工作员离职主因是来自于高强度的工作特性与压力。必须在极短时间内进行个案评估、处遇、资源链接、转介与通报,要协调解决个案和医疗团队沟通与矛盾,高压多变、立刻结案、弹性处遇计划、院方与医疗团队不尊重,这些都是让社会工作员产生职业倦怠的重要因素。

With the development of the Social Work of Emergency Department, the services provided by the emergency social workers were changed. From helping the patients who were tramps or have no family members in the early years to mainly helping the patients such as who were elderly living alone, victims of family violence, children or the elderly who were abused, suicides, drug or alcohol addicts,meeting with an accident. Making an elastic emergency disposal is a very significant competence to an emergency department social worker. In the aspect of humanity, emergency department social workers to make up for the busy medical staff caring for patients with mental neglect, playing an important part in appeasing, communicating patients and their relatives, which is promoting the communication among patients, relatives and the medical staff. The paper firstly distinguishes the difference of the duties between emergency department social workers and general medical social workers, explores the es-sential professional knowledge and competences which are necessary for the social workers who are at the forefront of medical treatment, justice and social assistance. And then discuss the personnel arrangement, position responsibility and the role dilemma of emergency department based on the tendency that many hospitals around the world authorize their emergency department to some medical institutions.Furthermore, social workers are different form the general medical staff in benefits, systems, occupation division, professional ethics, and they also have conflicts with patients. In recent years, in order to strengthen social management and public safety, many countries have stipulated that the medical staff have the responsibilities on circulating a notice of the patients who get hurt unusually. And we discuss whether this measure can promote the professional status of social workers in the hospital. Lastly, we conclude that emergency department social workers tend to resign or get job burnout is owing to their intensive work and heavy pressure which including they should have do case evaluation, referral resources and circulate a notice in a very short time and also should coordinate the relationships between patients and the medical staff. They can't get enough respect from the hospital.