Managing Volunteers or Providing Clinical Services? a Mixed Method Study Among Medical Social Workers in China

Background and Purpose

A growing number of hospitals in China have gradually established social work departments as part of integrated medical care practice (Zhou, 2016). Medical social workers are expected to manage volunteers and provide clinical services (Wang et al.,2017). However, medical social workers spend most of their working hours and energies on recruiting and managing volunteers, which is sharply contradictory to their professional training on providing clinical services to patients and their families. This phenomenon may increase medical social workers’ role conflict and role ambiguity. Thus, this study aims to (1) understand medical social workers’ expectations on their roles in providing clinical services and managing volunteers; and (2) examine the relations between multiple tasks and their role conflict and role ambiguity.

Methods
This was an exploratory study using a mixed method concurrent nested design. The quantitative phase included a survey about medical social workers’ expectations on volunteer work and clinical services and their role conflict and role ambiguity. The semi-structured interview was to explore their job expectations and experiences of being medical social workers. A total of 109 participants were included in quantitative analyses, while nine qualitative one-on-one interviews were analyzed. For quantitative data, descriptive analyses and bivariate analyses using SPSS 22.0 were conducted. A thematic content analysis was conducted using NVivo 12.0 for qualitative interviews.

Results
Quantitative results found that medical social workers had moderate levels of role conflict and role ambiguity. Their most frequent work task in the hospital was volunteer management, followed by providing clinical services to patients and their families and other administrative work. Volunteer management and direct services were correlated to social workers' role conflicts and ambiguity. Qualitative results showed that two factors influenced medical social workers' understandings of the relationship between providing clinical services and managing volunteers. Two factors were (1) the working environment and department of social work's resources and (2) medical social workers' personal cognition, attitude and professional ability. The comprehensive results also revealed medical social workers' negative attitudes on volunteer management. However, participating in volunteer management helped integrate social work practices into hospitals' current practice models in the short term. Moreover, different understandings of “volunteer management” work, such as resource-related work or administrative work, caused different outcomes. Treating it as resource-related work increased medical social workers' compassion satisfaction, while treating it as administrative work resulted in their job dissatisfaction, role conflict, and burnout.

Conclusions and Implications

The result suggests that linking stereotypes of “social workers” to “volunteer management” requires more attention and discussion. Minimizing the time spent on volunteer management would help medical social workers have more energy to provide clinical services. It will also reduce medical social workers' role conflicts and role ambiguity and promote their professionalism in the long-term.