"We Are Essential" : Health Care Social Workers' Perspectives on Being Designated Essential Workers during the COVID-19 Pandemic

Background and Purpose: During the acute stage of the pandemic, “health care workers” were named an essential category across the United States (NCSL, 2020). Consequently, many social workers in health care settings were expected to report to their workplaces, rather than isolating at home to avoid exposure to COVID-19 (Larochelle, 2020).

Though the essential designation bears a universal validity, there is very little available guidance on the operationalization of the term and how essential work should be carried out (Stevano, Alie & Jamieson, 2020). This raises questions as to how social workers in health care settings can perform their essential work safely and effectively. This study addresses these questions through qualitative analysis of the perspectives of pediatric hospital social workers on the meaning and operationalization of essential status designation of social work.

Methods: All participants were recruited via email announcements from the social work department of a large, urban, quaternary pediatric hospital located in the northeastern US. Focus groups were conducted asynchronously using FocusGroupIt, a cloud-based focus group solution broadly used for qualitative research (www.focusgroupit.com) and structured to ensure that participation was entirely anonymous. Fifty-five social workers participated in 14 focus groups over the study period. Participants were drawn from five primary work locations/functions: leadership/administration (5), emergency (4), inpatient (13), outpatient (22), and specialty programs (11). Participants were asked to respond to question prompts specifically about essential personnel status.

Data from focus groups were coded using codes generated by consensus, with a particular focus on the essential personnel question prompt as a sensitizing concept (Miles & Huberman, 1994). The constant comparison method (Glaser & Strauss, 2009) was used to ensure consistency within and across coding teams. Coding was conducted using using NVivo 12 (QSR International, 1999).

Findings: Findings revealed themes spanning four main categories pertaining the substance of social work, operationalization of essential status, and implications of the designation not only for the future of the profession but also for the populations who receive social work services. Salient themes that emerged in relation to these different ways of operationalizing the essential designation status included safety concerns, essential does not always have to mean in person, and essential from home. In addition, lack of clarity about the role of social work on interprofessional teams within other disciplines complicated operationalization of essential personnel status.

Conclusion and Implications: Though social workers expressed varying views about how the essential designation should be operationalized, there was little doubt that social work was both essential and uniquely suited to make a critical contribution to pandemic response and recovery efforts. This study demonstrates need for clarity in the operationalization of the essential designation for social workers and suggests that healthcare systems need to engage in ongoing discussions of how to maximize the efficacy of the social work workforce, both in terms of integration with medical teams and recognition of the important roles social workers play in healthcare settings.