Social Workers Leaving Hospice, Health Care in Record Numbers

Hospices have lost social worker employees at a faster rate than any health care setting in the care continuum. 

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 Tracker. As of October 2021, attrition rates exceeded pre-pandemic levels by 35%.

As far back as 2006, the hospice industry saw more social workers leave than any other health care sector, according to a study from the National Association of Social Workers (NASW) and the Center for Health Workforce Studies at the University of Albany. Social work departures were most frequently reported as common in hospices (18%) versus other settings, such as health clinics (9%), the study found

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The reasons mirror those for nurses and others in the hospice workforce who have left the field — burnout, stress, opportunities for higher wages, lack of a career path and retirements.

But a lack of employer engagement represents the largest issue when it comes to curbing social worker burnout and turnover, according to Rachel Levy, crisis clinician at Oregon-based Lines for Life.

“A big risk factor of burnout and staff turnover are feeling disconnected from their work and not having a voice in company decisions,” Levy told Hospice News. “I have heard this from social workers in various settings, including hospice.”

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Supportive culture a draw for jobseekers

Social workers who participated in the NASW study cited lack of respect, support, wages and career advancement or education opportunities as reasons for leaving the field.

At the same time, social workers in hospice were more likely to be dissatisfied with supervisor guidance (29%) compared to those in other settings, such as health clinics (19%) or hospitals (15%), according to the NASW study.

When asked about potential factors influencing a job change, the majority of hospice social workers indicated to NASW that supervisors were a leading issue.

Workplace culture factors heavily into staffing retention, according to Susan Ponder-Stansel, president and CEO of Florida-based Alivia Care.

Throughout the health care space, pressure has been mounting for social workers. This includes an inability to take time off without incurring a “huge work backlog” and increased stress levels that diminish their quality of life, said Ponder-Stansel.

“Staff are increasingly making decisions based on whether the culture in the workplace expects them to constantly put in long hours,” Ponder-Stansel told Hospice News in an email. “A trend that is intensifying is having boundaries on work so that time off and being able to have some reasonable expectation of a schedule is a factor in attracting and retaining staff, especially younger staff.”

Wage woes and slim career paths

The health care sector has become a battleground when it comes to employee compensation — one in which hospices are often at a disadvantage compared to large, well-capitalized health systems.

Some providers have leveraged benefits outside of increased salaries to attract and retain workers, including remote work capabilities, flexible schedules and ways to build up compensation over the course of their employment.

Hospice providers need to get creative when it comes to compensation, according to Ponder Stansel.

“Retention really does require that we throw out the one-size-fits-all approach to compensation and location of work,” said Ponder Stansel. “We are finding younger workers don’t connect with the bi-weekly check. They want a daily-pay type of arrangement where they get their money closer to the time they are working. Many aren’t as interested in total compensation; they would rather have a higher wage now and worry about retirement savings later.”

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