SOCW 6520 WK 2 peer responses

SOCW 6520 WK 2 peer responses 
Respond to the blog post of three colleagues ( They have to be responded to separately) in one or more of the following ways: 
Share an insight from having read your colleague’s posting.
Offer and support an opinion.
Validate an idea in your colleague’s post with your own experience.
Be sure to support your blog posts with specific references to this week’s resources and provide full APA citations for your references.
Intext citation and full references for each peer response
Peer 1:  Sasha Ritchie
An explanation of potential challenges in adhering to confidentiality in your field education experience
Saxon, Jacinto, & Dziegielewski (2006) state that the two social work important values are self-determination and confidentiality. Previous research indicates that many ethical decisions in social work practice are difficult to make, and, many times, decisions are made based on the worker’s values and experiences rather than on written ethics, laws, and agency policy. In my second week of field internship at Infinity Hospice, I have learned from my field supervisor that many hospice care situations will present themselves that require calling staffing and a report to Adult Protective Services. When working with patients at end-of-life care, we have to assess for needs and balance this with patients’ rights to self-determination. With this, the medical social worker will have to report if the client is at risk of not caring for themselves if a caregiver has not been identified. Medical Social Workers disclose to the patient that a report has to make, of course, if confidentiality is broken because there is an at-risk or danger present in the patient’s care.
A description of agency policies or mandates with regard to confidentiality
At Infinity Hospice, the policy to uphold confidentiality is held to a high standard. Patients and their caregivers have notified up the admission of the confidentiality policy and sign the acknowledgment. Patient information is shared during an interdisciplinary team meeting when there is a danger presented to the patient’s care, and APS has to investigate. A staff member (i.e. nurse or social worker) must report it, and lastly, for billing purposes, naturally, hospice services are billed. Information is then shared with hospice companies and healthcare insurance (typically Medicare).
An explanation of potential challenges in communicating with clients within your agency.
Unfortunately, when we file reports to APS due to a danger that has presented itself to the patient’s care, the agency may not have grounds to investigate because of patient self-determination. This occurs when a patient has denied going to a group home, nursing home, and does not have a caregiver, and is often left to care for themselves with a terminal illness. However, APS policy states that this is the patient’s right to decline assistance even if it leaves the patient in a dangerous situation being left alone.
Reference
Saxon, C., Jacinto, G. A., & Dziegielewski, S. F. (2006). Self-determination and confidentiality: The ambiguous nature of decision-making in social work practice. Journal of Human Behavior in the Social Environment, 13(4), 55–72.
Peer 2: LaTiona Washington 
experience. A description of agency policies or mandates with regard to confidentiality.
I am currently interning at a psychiatric hospital. Potential challenges in adhering to confidentiality would include abuse, and when a patient is at risk of harming themselves or others. Informed consent, making the client aware of the relationship and their rights, is part of confidentiality (National Association of Social Workers, 2017). During this process, the client is informed of their rights as a patient. As a mandatory reporter, it is our job to report to DCS if a child is being abused. To inform DCS would be to break the confidentiality of what the client told us in private. This may be challenging, and the social worker might desire not to inform DCS, due to building trust with the client. Especially since the client became vulnerable due to the initial arrangement of a privileged conversation (Wulff et al., 2011).  It is our responsibility to not only inform DCS of the abuse but inform the youth also that we will be contacting them. Another challenge I have seen at my internship is when a patient wants to harm others or themselves. For the safety of the client
An explanation of potential challenges in communicating with clients within your agency.
One huge challenge in communicating with clients within my agency is encountering patients who refuse to talk to you. On my first day, a patient refused the social worker three days straight. Within 72 hours of the patient being admitted, they need to have their treatment plan completed. Due to the patient refusing for three days, their treatment plan is uncompleted. This makes it difficult to initiate the discharge process.
Reference
National Association of Social Workers. (2017). NASW code of ethics. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
Wulff, D. P., St George, S. A., & Besthorn, F. H. (2011). Revisiting confidentiality: observations from family therapy practice. Journal of Family Therapy, 33(2), 199–214. https://doi-org.ezp.waldenulibrary.org/10.1111/j.1467-6427.2010.00514.x
Peer 3: Joyce
An explanation of potential challenges in adhering to confidentiality in your field education experience
Living in a small community has it’s Pro’s and Con’s.  A potential issue is when calling a client back, any others sitting in the waiting room know the capacity in which I am there, connecting the client to be at the Clinic for mental health intervention.  Another scenario is that a client provides a referral to a friend, to the clinic for therapy.  It i snot uncommon for them to attempt to strike up a conversation about the mutual client and friend.  Unfortunately, I have to tell them I cannot confirm or deny who they are talking about.
A description of agency policies or mandates with regard to confidentiality.
Confidentiality is vital and structured to follow the HIPPA laws.  Releases must be signed in order to release anything.
An explanation of potential challenges in communicating with clients within your agency
Potential challenges may be workers in other entities, that are looking for information on a mutual client; however, that line cannot be crossed.
 

 
References:
Saxon, C.,   Jacinto, G., Dziegielewski, Dziegielewski, Sophia (2006). Self-
Determination and Confidentiality, Journal of Human Behavior in the Social Environment, 13:4, 55-72, DOI: 10.1300/J137v13n04_04
 

 
Wulff, D. P., St George, S. A., & Besthorn, F. H. (2011). Revisiting confidentiality: observations from family therapy
practice. Journal of Family Therapy, 33(2), 199–214. https://doi-org.ezp.waldenulibrary.org/10.1111/j.1467-6427.2010.00514.x