Hospices have lost social worker staff at a faster rate than any healthcare facility across 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 Tracking System. As of October 2021, dropout rates exceeded pre-pandemic levels by 35%.
As recently as 2006, the hospice industry left more social workers than any other health care sector, according to a study by the National Association of Social Workers (NASW) and the Center for Health Workforce Research at the University at Albany. Leaving social work was most commonly reported as a common occurrence in hospices (18%) compared to other settings such as health clinics (9%), the survey found
The reasons mirror those for nurses and others in the hospice workforce who have left the field — burnout, stress, higher-paying opportunities, lack of a career and retirement.
But a lack of employer engagement poses 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 say in company decisions,” Levy told Hospice News. “I’ve heard this from social workers in a variety of settings, including hospices.”
A supportive culture is attractive to job seekers
Social workers who participated in the NASW survey cited a lack of respect, support, wages, and opportunities for career development or education as reasons for leaving the field.
At the same time, hospice social workers were more likely to be dissatisfied with supervisor guidance (29%) than those in other settings, such as health clinics (19%) or hospitals (15%), according to the NASW survey.
When asked about potential factors influencing job turnover, the majority of hospice social workers told NASW that supervisors were a top concern.
Workplace culture greatly affects staff retention, according to Susan Ponder-Stansell, president and CEO of Florida-based Alivia Care.
Across health care, the pressure on social workers is increasing. This includes an inability to take time off without causing a “huge backlog of work” 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 said in an email to Hospice News. “A growing trend is to have work boundaries, so having time off and being able to have some reasonable schedule expectation is a factor in attracting and retaining staff, especially younger staff.”
Salary issues and thin career paths
The health care sector has become a battleground when it comes to workers’ compensation — one where hospices are often at a disadvantage compared to large, well-capitalized health systems.
Some providers have used benefits beyond increased wages to attract and retain workers, including telecommuting options, flexible schedules and ways to accrue compensation over the course of their work.
Hospice providers need to be creative when it comes to compensation, according to Ponder Stansell.
“Retention really requires moving away from a one-size-fits-all approach to compensation and job location,” Ponder Stansell said. “We’re finding that younger workers aren’t connecting to the bi-weekly check. They want a daily pay arrangement where they get paid closer to the time they work. Many are not so interested in full compensation; they’d rather have a higher salary now and worry about retirement savings later.