社工師值機工作探討－－以某醫學中心為例

The Discussion of Social Workers' On-Call Work: The Case Study of a Medical Center

本研究係以北部某醫學中心於2012至2017年之社工師值機工作紀錄作為研究資料，對案件來源、問題分類進行統計，並對出勤的問題類型、必要性、社工師的角色功能進行分析。對於值機的定義是指社工師在非上班時間、非特定場合配戴公務手機，對於來電提供諮詢與處理，必要時需到院加班。2012至2017年夜間假日值機總計接獲525件照會，照會來源以急診照會最多、占50%，其次是病房照會占38%。來電內容前兩項照會原因分別是家庭暴力個案及性侵害個案之相關問題，合計183件、約占34.9%。值機社工師接到來電，並依個案判斷後出勤處理的案件計106件、占20.2%。針對這106件夜間假日出勤案件逐案審視處理內容，大致歸納出4類狀況，分別是陪同驗傷就醫的法定職責64件、安全性評估／安置或照顧需求評估22件、有精神狀況／情緒激動14件、其他特殊案件6件。根據上述分析，本研究建議出勤指標包括性侵害個案陪同就醫及驗傷採證；個案有安置需求或有人身安全問題，需立即評估處理；未成年個案獨自就醫，需進行驗傷採證；其他緊急特殊事故（例如大量傷患）。最後，強調建立支持性環境的重要性，在善加發揮醫務社工師角色功能的同時，也需要注意減少值機工作帶來的身心耗損。 This study focused on the on-call work record of social workers in a medical center in Northern Taiwan from 2012 to 2017. Statistics of case sources and problem types were collected, and the types of cases that led to on-call social workers' attendance, the necessity for such attendance, and social workers' roles and functions were analyzed. Being on call means that social workers carry an official cell phone in their off time in nonspecific occasions to respond to calls and handle the situations; they may be required to return to the office and work overtime when necessary. Of all the 525 nighttime or holiday on-call records from 2012 to 2017, most were from the emergency department(50%) , followed by those from ward management(38%) . Regarding the content of the calls, domestic violence and sexual assault ranked as the two most frequent causes of notice, accounting for 183 cases in total(approximately 34.9%) . Moreover, among all the 525 notices, social workers attended work to handle 106 cases(20.2%) after judging the situations when they remained on call. After close examination of these 106 cases that required social workers' nighttime or holiday attendance, the authors identified the following four main types of situations:(a) the social workers' legal duty to accompany clients to receive medical examinations(64 cases) ;(b) safety evaluation or evaluation of placement and care need (22 cases) , (c) clients with mental disorders or agitation(14 cases) ; and (d) other special cases (6 cases) . Based on the aforementioned analysis, this study suggests that the attendance indicators for on-call social workers include the following situations: accompanying victims of sexual assault to visit the hospital and receive medical examinations for evidence collection; immediate evaluation and intervention is required when clients have placement needs or safety concerns; medical examinations for evidence collection is required when accompanying clients who are underage and visit the hospital alone; and supporting in other emergencies and special occasions(e.g., an excessive number of patients) . Finally, a supportive environment must be built for medical social workers, which ensures they fulfill their roles and duties while preventing them from experiencing mental and physical exhaustion caused by on-call work.