E-mail Address: *
Name of Organization
Geographic Region BC Alberta Saskatchewan Manitoba Ontario Quebec Newfoundland & Labrador PEI Nova Scotia New Brunswick Yukon Territories Northwest Territories Nunavut
Number of Full Time Social Workers in your renal program
Number of Part-time Renal Social Workers in your renal program
Number of years working in Renal
Professional designation of Renal Social Workers in your renal program With BSW With MSW Other
Other
(if you clicked other directly above, please specify)
If there is more than one renal social worker in your program, who determines the distribution of workload and how?
Chronic Kidney Disease/Renal Clinic: # of patients stage 3-5 0-250 251-499 500-1000 Other
Other
(if you clicked other directly above, please specify)
In-Centre Hemodialysis: # of patients (include self-care and satellite pts here) 0-250 251-299 300-499 Other
Other
(if you clicked other directly above, please specify)
Home Hemodialysis: # of patients 1-25 26-49 50-74 75-100 Other
Other
(if you clicked other directly above, please specify)
Peritoneal Dialysis Patients: # of patients 1-25 26-49 50-74 75-100 Other
Other
(if you clicked other directly above, please specify)
Transplant Recipient assessments: # per year
Living donor assessments: # per year
Transplant Clinic/Follow up: # of patients 1-25 26-50 51-75 Other
Other
(if you clicked other directly above, please specify)
In-patient Nephrology/Transplant Unit(s); # of beds
Other: please specify
(if you clicked other directly above, please specify)
Patient populations served (ie. Pediatrics, First Nations) please list all:
Are you expected to assess and follow each patient indicated above Yes No
Are there any criteria or protocols that establish when Social Work gets involved with these patients Yes No
If yes, please comment
In your opinion, please rate patients overall access to Social Work. Excellent Good Adequate Fair Poor
Model of Social Work Delivery: Please choose one of the following: Primary Care Model (follow patient through all modalities) Unit Specific Coverage (eg. Hemo only) Other
Other
(if you clicked other directly above, please specify)
Job Responsibilities: Assessment Advocacy Advance Care Planning Supervision of students/volunteers Counseling (adjustment, bereavement, crisis, supportive, resource, trauma, individual, couple) If outpatient program, provide inpatient renal social work service (eg. d/c planning) Locating/Arranging Resources Provide social work coverage in other areas (eg. Vacation) Groups Research Education Committees Quality Initiatives Program Development Sexual Health Staff Education and Community Engagement Other
Other
(if you clicked other directly above, please specify)
How many regular paid hours per week is your position (not including overtime)? 7-7.5 hrs/wk 17.5-22.5 hrs/wk 35-37.5 hrs/wk Other
Other
(if you clicked other directly above, please specify)
Do you have access to clerical support on a regular basis Yes No
Do you have access to social work supervision Yes No
If yes, do you find this to be: helpful/very helpful somewhat helpful not very helpful
Does your organization have a social work professional practice coordinator/lead Yes No
If yes, do you find this to be: helpful/very helpful somewhat helpful not very helpful
In your department I am expected to work evenings or weekends I have control over the scheduling of your hours I regularly work overtime I get compensated in the form of pay if you work in an evening or weekend or overtime I get compensated in the form of lieu time if you work overtime Someone provides coverage for you when sick or on vacation I have had difficulty getting your requested vacation time approved
Do you travel to satellite units Yes No Not Applicable
If yes, how many satelites
If yes, average travel time
If yes I am paid for travel time I have access to program vehicle I use my own personal vehicle, are you compensated for its use
If yes, at what rate per km
Does your employer pay for CANSW Membership Provincial Association/College fees Local conference registrations CANSW conference costs (incl travel/housing) Other ie. Health Spending Account (discretionary)
If Other please explain
(if you clicked other directly above, please specify)
Overall, do you believe that your Renal Program employs a sufficient number of Renal Social Workers to complete the workload to an acceptable standard Yes No Not Sure
Comments on above question
Do you have any other information you would like to provide or comments to offer
* Required
The CANSW Executive welcomes your responses to this questionnaire. All information received will be treated as strictly confidential. Please forward completed questionnaires to aleepaget@hsc.mb.ca or fax attention to Amanda LeePaget at 1 (204) 787-4535. Thank you for taking the time to complete this questionnaire. Your feedback is invaluable and will help to inform CANSW's updated recommended staffing guidelines.