Why I HATE Medical Social Work: Discharge Planning

After wrestling with myself about whether or not I wanted to post this, I decide you all deserve to know the truth about discharge planning. As a travel social worker, I pushed and encouraged others to join me on the road. However, that was before I knew what most social workers actually did in this role. For three and a half years I had been lucky to have assignments that were strictly social work but for six months I got to experience the other side of discharge planning. Initially, I wanted a per diem job in the hospital but after reading this back-I’m so good on that.

Today is December 7, 2025. By the time I post this blog it may be the new year, but I really wanted to document these emotions in real time. I’m currently on assignment at a hospital where social workers do both RN case management duties and social work duties. The long and short of it is—I HATE IT.

When I was active on TikTok, I posted a video asking medical social workers what they did in the hospital setting. About 99% of them said they do both roles. In my last assignment, I was strictly a social worker, so I couldn’t understand how they did both. Some days were chill, while others were very busy. We did great social work. All of the social workers were strong and they gave everything they had—plus a little bit more. The social workers I worked with pushed back on doing RN CM duties. They pushed back so much that management had to create a Venn diagram of what duties belonged to whom and which tasks were shared.

I’m personally trying not to “rock the boat” because this assignment has truly been a blessing at a time when I couldn’t secure a permanent role. And honestly, if permanent staff aren’t speaking up, who am I as a traveler to say anything?

RN CMs only focus on their assigned patients, while social workers tend to our assigned patients plus any social work consults. I truly feel like social workers are boxed in and limited in the “social work” we can do because discharging patients trumps everything. There’s more I want to say about that, but I’ll come back to it.

Let’s not even talk about the financial aspect of the different roles! RN CMs on average make more than social workers, even though we’re all doing the same work—and social workers do a bit more. Crazy work! Right now, I’m considered “local,” so I don’t receive any stipends. I’m making about $1,000 less per week than I was before and doing more work. But again, I’m thankful for the income.

I’ve been told it wasn’t always this way, but after COVID-19, things changed. I’m very frustrated in this role because I don’t feel like a social worker at all. During multidisciplinary rounds, my eyes gloss over when the medical terminology gets too thick. I’m grateful for the things I’ve learned, but every day I’m Googling words I don’t know. Every day is pure chaos, and I feel tethered to my phone or computer. Some days I don’t even eat lunch, but we’re told we MUST take it. How???

My phone is literally blowing up all day with calls from family members, bedside RNs, skilled nursing facility marketers, and insurance case managers. I’m happy to support patients in getting home and ensuring they have everything they need for a safe transition, but it’s chaotic as hell.

The best part of this assignment is working with a supportive, amazing team and meeting great patients. Every day I show up, I’m happy to see my team and excited to support my patients. The worst part of the job—besides everything I’ve already mentioned—is the pressure to discharge patients because the hospital is a business and the push is REAL… uncomfortable and doesn’t feel good to me personally. Considering discharging patients is the priority, on weekends social work consults are low on the priority list unless they’re urgent.

The silver lining in this kind of hospital social work is that I feel very respected as a social worker, which hasn’t always been the case. Whether or not a patient on my caseload discharges on time determines if the hospital will lose money. It’s a different kind of power for sure.

Overall, this type of social work is not my happy place. Honestly, some people are cut out for this job and others aren’t. It’s me. I’m others.

On the bright side, I recently interviewed for a nephrology social work role at a dialysis clinic, and I’m very excited about the possibility. At one point in my career, I applied for nephrology roles, but the pay wasn’t sufficient. Before COVID-19, I worked as a pediatric nephrology social worker, and end-stage renal disease is no stranger to my family. I think this could be a great fit for me. If you’re reading this… I got the job! =)

UPDATE: I did not get that job, but I got something better.