Field Practicum Report

Field Practice Agency

Hospital Social Service Department
National Institute of Traumatology & Orthopaedic Rehabilitation
(NITOR)
Sher-E-Bangla Nagar,Dhaka-1207

Course Title: Field Practicum

Course no: 201

Submitted by
Name: Abu Huraira Farsi
Session: 2020-21
Class Roll: 1495
Exam Roll: 81063
Reg. NO: 2016-517-008
MSS 2nd Semester

Institute of Social Welfare and Research

University of Dhaka
Dhaka-1205

Field Practicum Report

 Field Practice Agency
Hospital Social Service Department
National Institute of Traumatology & Orthopaedic Rehabilitation
(NITOR)
Sher-E-Bangla Nagar,Dhaka-1207
Duration: 17 September, 2022 to 26th December, 2022
th

Total Working Days: 60 Days

Submitted to

….………. ….………
Institutional Supervisor Agency Supervisor
Md. Tawohidul Haque Mst.Roushanara Khatun
Assistant Professor Social Service Officer
Institute of Social Welfare and Department of Social Service
Research National Institute of Traumatology
University of Dhaka & Orthopaedic Rehabilitation
Dhaka-1205 (NITOR)

Submitted by
Name: Abu Huraira Farsi
Class Roll: 1495
Exam Roll: 81063
Registration: 2016517008
Session: 2020-21
MSS 2nd Semester

Date of Submission:29/12/2022
 Acknowledgement
At the very beginning, I would like to express my deepest gratitude to almighty Allah
for giving me the strength and the composure to complete my BSS (Honours) courses
and prepare this report within the scheduled time.During the period of my internship
work,I have received generous help from many persons, which I like to put on record
here with deep gratitude and great pleasure.
First and foremost, I am grateful to my supervisor Md Tawohidul Haque, Assistant
professor, Institute of Social Welfare & Research, University of Dhaka. He allowed
me to encroach upon his precious time freely right from the very beginning of this
research work till the completion of my internship. His guidance, encouragement and
suggestions provided me with necessary insight into the research problem and paved
the way for the meaningful ending of the work in a short duration. I have no hesitation
to say that, without his constant support and valuable advice from time-to-time, I
would probably fail to complete the work in an appropriate manner.
My special gratitude goes to Mst. Roushanara Khatun,Social Service Officer,National
Institute of Traumatology & Orthopaedic Rehabilitation (NITOR) for her modern
outlook and meticulous supervision to carry out the job perfectly. Without her
direction, supervision, suggestion and guidance it was almost impossible to finish the
field work.
I am grateful especially to my fellow classmates who helped me while preparing the
report by giving their suggestions, assistance and supply of information, which were
valuable to me. I am also thankful to all other office staff of NITOR for their always
sincere cooperation and support.

Sincerely yours

Abu Huraira Farsi

Session: 2020-21
Class Roll: 1495
Exam Roll: 81063
Reg. NO: 2016-517-008
MSS 2nd Semester
 Preface
Social work is an applied social science as it contains both theoretical and practical
knowledge. Theoretical knowledge reflects when it is being applied through practical
training in the field of practice. However,the practical field is the best medium for
achieving experience, skills, knowledge and also getting the visibility of theory.
As a developing country, we face numerous challenges in the service sector. The
majority of people in our country are impoverished. As a result of insufficient Doctors
and Nurses, as well as their ignorance and unawareness, they are denied health care
services. In a nutshell, Bangladesh has health-care limitations that we must accept.
Our government is currently considering how to address the health-care issues.
Medical social work can make medical care more fruitful and effective in this context.
However, a number of issues impede the effective use of medical social work in
Bangladesh. Human beings benefit from a comprehensive service provided by
modern social work. It encompasses all aspects of human life, including economic,
social, health care, recreational, and emotional settings. The evolution of the social
work profession began in a medical setting. In this field, hospitals are the most
common setting for social work practice. Social workers play a secondary but critical
role in disease prevention. Medical social workers participate in the patient's study
diagnosis and treatment planning process alongside doctors, nurses, and other
therapists.
As a student of Institute of Social Welfare & Research,University of Dhaka,I have
been sent to the Department of Social Service of National Institute of Traumatology
&Orthopedic Rehabilitation (NITOR) for field work with 60 working days. Through
this field practicum session, I came to know so many new things and techniques to
deal with different cases as well as the problem solving-process. I have tried my best
to accomplish assigned duties with purity and devotion. From the field work, I have
gained new knowledge and experience which will help me in my future career and for
society.

Chapter -01
 Introduction to Social Work and Field Practicum

1.1 Introduction
Social work is a professional and academic discipline that seeks to improve the
quality of life and well being of individuals, groups and communities by intervening
through research, policy, community organizing, direct practice, and teaching
accordingly. Social work is a mixture of two aspects. One is theoretical knowledge
and another is practical learning. After enriching theoretical knowledge level with
theoretical study, a student of social work is sent to the practical agency of social
work. As an apprentice social worker, s/he gets an opportunity to practice this
theoretical knowledge in the practical field. Here a social work student tries to solve
the problem of clients using social work knowledge, skills, values, principles and
experience. Moreover, theory and practice, the two aspects of professional social
work are closely related to each other alike the head and body. The students of social
work discipline cannot fulfill their knowledge and skill without field practice. The
government and non-government social and human service agencies give the
opportunity to apply their theoretical knowledge in the practice field. (A, 1993)

Field work brings this golden opportunity to an apprentice social worker to use his/her
knowledge of social work effectively in execution, to acquire certain skills which are
relay learned in the classroom, and thus to bridge the divide between the classroom
and the real world. For this reason, field work has been included in the syllabus of
social work education and I was sent to an agency name the National Institute of
Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka.

Social workers work within a variety of settings: Different NGOs, family service
agencies, children’s aid agencies, general and psychiatric hospitals, school boards,
correctional institutions, welfare administration agencies, federal and provincial
departments. An increasing number of social workers work in private practice. 93% of
those in the social worker occupational category are employed either in the health and
social services or governmental industries, with74% in the former and 19% in the
latter. Relatively few social workers are employed in private practice offices.
(Fakhrul, 2006)

1.2. What is Social Work?

Social work is a helping profession which fundamentally and radically aims to assist
the individuals, groups and community to cope with their complex socioeconomic
psychological problems through enabling themselves so that they can solve their
problem by helping themselves.
 According to NASW: The professional activity of helping individuals, groups, or
communities enhance or restore their capacity for social functioning and creating
societal conditions favorable to this goal.
Current definition is given by Social Scientists Skidmore & Thakery. They said,
“Social Work may be defined as an art, a science a profession that helps people to
solve personal, group and community problems and to attain satisfying personal,
group and community relationship through social work practice including case work
and community organization, administration and research.”
Highlighting the theoretical side W.A. Friedlander said, “Social work is a
professional service based upon scientific knowledge and skill in human relations,
which assists individual alone or in groups to obtain social and personal satisfactions
and independence.

The following definition was approved by the IFSW (International Federation of

Social Workers) General Meeting and the IASSW General Assembly in July 2014:
“Social work is a practice-based profession and an academic discipline that promotes
social change and development, social cohesion, and the empowerment and liberation
of people. Principles of social justice, human rights, collective responsibility and
respect for diversities are central to social work. Underpinned by theories of social
work, social sciences, humanities and indigenous knowledge, social work engages
people and structures to address life challenges and enhance well being”

Characteristics of Social Work

 Social Work is a commitment of social betterment. 
 A goal of enhance social function 
 An action orientation 
 An application to human diversity 
 A versatile practice perspective 

Aims & Objectives of Social Work

 To promote effective & human service system 
 To enhance problem solving, coping & development capacities, 
 To link people with resources, services & opportunities, 
 To develop & improve social policy 
 Caring, curing & changing the society

1.3 What is Fieldwork?

Social work practice consists of the professional application of social work methods,
values, principles, and techniques to one or more of the following ends, helping
people obtain tangible services; counseling and psychotherapy with individuals,
families, and groups; helping communities or groups provide or improve social and
health services; and participating in legislative processes. (Moorthy, 1990) The
practice of social work requires knowledge of human development and behavior; of
social and economic, and cultural institutions, and of the interaction of all these
factors. Fieldwork education is one of the most important parts of social work
education. Without this knowledge professional learning of social work will not be
completed. Here some definition of fieldwork education I would like to mention.

 In general, “Fieldwork program is designed to help and guide a student to

develop his/her skill and competence, independent professional functioning
and carrying out appropriate responsibilities”. (Islam, 2008)
 According to R.R. Sing- “Fieldwork is an educationally sponsored attachment
of social work students to an agency or a section of the community in which
they are helped to extend their knowledge and understanding and experience
the impact of human needs.”

 In the words of W.A. Friedlander- “Fieldwork is designed to integrate the

academic knowledge, practical understanding and personal skills of the
student by personal contact and to direct the clients”. (Friendlander, 1982)

 After all, it is clear that Fieldwork education indicates the meaning of learning
as do as possible to speak, think, see, feel and act as a member of its culture
and at the same time, as a trained social scientist from a different culture.
(Islam, 2008)

Major Characteristics of Fieldwork are

 Fieldwork is an educationally sponsored attachment of social work Student to
an institution, agency or a section of the community
 Fieldwork helps the students to extend their knowledge, understanding and
experience gathering
 Fieldwork helps the student to realize the theories, methods, and principles of
social work in practice.
 Fieldwork helps the students to become familiar with real social work practice.
 Fieldwork enables students to apply and integrate previous learning and
current learning.
From the perspective of the above discussion, it can be said that Fieldwork is the
science of practice in where students can relate academic theory with social work
practice and they can solve the problems of silent through the application of social
work methods. So, fieldwork education is a mandatory and integrated part of a learner
for being an expert social worker.

1.4 Objectives and Purposes of Fieldwork

The objective of fieldwork programs in social work education is to provide the
student with actual experience in applying social work methods and enable him/her to
become familiar with real work of practice, that is, to relate academic theory to
concrete reality as found in the agency setting.in details discussion about the purpose
of these activities some are:
First of all, I want to give focus on objectives according to M.A Momen has given
regarding this discipline is.

 To apply social work methods in the solution of given individual group or

community problems. They should be exposed to agency practice in which
there is a planned, systematic, objective approach to problem-solving. The
student should learn to start with factual material as the basis for professional
intervention and through appropriate study and diagnosis to move forward
step by step to the implementation of a plan of action. (Trecker, 1950)

 To develop facility in the use of organizational structure particularly the

committee. He should learn the technology of the committee process
(professional staffing functions) as well as an understanding of the human
dynamic of task-oriented groups (group development, interaction roles,
motivations of individuals, reference group behavior etc.) (Skidmore, 1997)

 To achieve self-awareness and disciplined use of self as a helper and an agent

of change in a variety situation.
 To learn the organizational framework of service. A student has to understand
agency structure arid policy and how to facilitate such policy through his/her
practice. As a result, he would become familiar with the differing institutional
styles tempos of agencies associated with various fields of practice.
(Skidmore, 1997)
 To become familiar with administrative procedures and processes. He/she
should learn how an office is run, what kind of routines need to be
established, how to facilitate administrative arrangements relevant to the
discharge of the responsibilities and fieldwork to give that towards students.
 To offer a purposeful learning experience of students through interaction with
life situations under supervisory guidance for professional growth in terms of
knowledge, skills, and attitudes. (Pawar, 2014)
 To develop in the student the required skills in helping the needy through
organizational work, use of social work methods, that is, listening,
participating, communication.
 To foster attitudes in the student towards professional self-development,
increasing self-awareness, appreciation of both capacities and limitations.

Besides these, some experts also have given other purposes of fieldwork such as

 To develop the skills in problem-solving at the mean and macro levels.

Integration of classroom learning with field practices. (Trecker, 1950)
  To develop the skills required for professional practice at a particular level of
learning.
 To develop professional attitudes, values, commitments, self-awareness and
professional ideas.

1.5 Historical Background of Fieldwork Education: Global and

Bangladesh Perspectives
Though the traditional background of social work was originated in England it was
recognized as a profession emerged from society to assist and reform the poor to a
major professional discipline. Early activities were carried out by volunteers who
acquired their skills and knowledge in an apprentice system. During the early
practical period, the volunteers were facing many problems. (Friedlander, 1974) then
they needed more practical training. Modern social work has originated during the
post-industrial period from the effort taken to make up to date the traditional human
welfare activities by adjusting with ever-challenge able lifestyle in America, social
work started in the world by charity giving activities basically in the European world.
Gradually it spreads all over the world including Asian and African countries like
Bangladesh. From the middle of the 18th century to the end of the 19th century, social
work has

 On the view of fieldwork, social work is a dynamic and updated discipline

than the other discipline of arts and social science faculty. But social work is
not a ready made product of present time. It shows an aged history like social
work education Initial stages of fieldwork was not systematic and organized.
One of the great pioneers of the social work Mary Richmond first introduced
social work practice and she wrote a dramatic and historical book named
“Social Diagnosis”. Whish worth, P.I. Park and has inaugurated field practice
at the Chicago University of America to evaluate and monitor urban poverty
by their students. Dr. Emerson has taken initiatives to send the medical
student to the social agency at the John Hopkins University in 1902. (Islam,
2008)
 This New York school kept a great contribution to professional social work
and training. New York School of Social Work was founded to extend social
work education in 1904. Mainly form that time professional social work
practice education and training courses were started in different universities in
America. (Rahman, 1996).

 In that period, the principal aim of social work education was to prove the
necessary knowledge, skill and training for the social worker to solve the
problem effectively. In terms of time, social work has become a subject of the
higher educational institutions, which aim to give the total human welfare by
developing the standard of traditional services through the light of experience
and knowledge collected from society.
From the mid-18th century to the end of the 19th-century social work has evolved
from societies to assist and reform a year of full-time academic study. Now all over
the world, there are many courses on social work education. After independence from
the British, India, Pakistan was facing many socioeconomic problems and the
government sought United Nations help. After the government request, the UN sent
an expert team. According to their recommendation, a short course of three months
was introduced in 1953 to produce skilled social workers. After the independence
from the British, India and Pakistan were facing many socioeconomic problems and
the government sought United Nations help. U.N. sent an expert team after govt.
request. According to their recommendation, a short course of three months was
introduced in 1953 to produce a skilled social worker. In the meantime, V-AID
program in 1953. Social work education has its journey in Bangladesh during the
period of Pakistan through a short time training course with the help of the United
Nations in 1953 and social work education and training were extended afterward. In
1954 Urban Community Development Project was started at Kaettuli in Dhaka on the
consultation of an expert group. College of Social Welfare and Research was
established in 1958 and is included under Dhaka University. This college started its
educational programs in the session of 1958-59 with 55 students. Afterward in 1973,
it was renamed as the Institute of Social Welfare and Research (ISWR) under the
University of Dhaka. In 1974 social work was included in the curriculum of
graduation (pass) and higher secondary level as an optional course. Shahjalal
University of Science and Technology started this subject as a B.S.S. honors course in
the session of 1993-94. At present this university is providing Honors and Master’s
degree. Rajshahi University is also providing graduation and a post-graduation degree
in this discipline. (Fakhrul, 2006) During 1964-67 academic sessions, the other hand
National University was established in 1992 and from the starting of its establishment
it is teaching the subject by the colleges under it. According to the data of 2010
master’s course is being taught by more than 35 colleges and honors course by 52
colleges under National University, now Rajshahi University & in 1992-93 Shahajalal
University, Jagannath University, Gono University and some other private university
& huge number of colleges under National University started Hon's & Master’s
Degree with compulsory Field practicum. (Islam, 2002).

1.6 Relationship between Social Work and Field Work

Mutual relationship between social work education and practice, Modern social work
education has two dimensions: theoretical and practical. A social worker gains
knowledge about society, social problems, property, social structure, social values,
human behavior, social work process when practical training enable them to use this
knowledge acquired knowledge in this field for real life purposes. Thus, practical
training is required for social worker to solve social problems of human
beings/society for modern social work. Social and Economic Council of United
Nations has recognized social work as a profession in 1951 and formulated the
following decisions. Social Work is a profession based on trained male and female
and who are obtained theoretical and practical knowledge in social work degree from
established and recognized educational institutions is mandatory to fulfill by them.
Therefore, we may say social work education and field work are interrelated concept
just like two branches of a tree.

1.7 Scopes of Field Work Practice in Bangladesh

Field practicum is a discipline which is limited by a number of processes. This is not
an isolated process, within the framework of an administrative practice in the field.
The method is applied to social work practice and field work talking the problem. It’s
a comprehensive and extensive range. Various field of Knowledge, skills, practice
which is to archive to specific case, a social worker who provides the opportunity.
There are some important areas in Bangladesh.
 Medical and Non–Medical Setting
Medical social work is one of the few fields in Bangladesh that applies social
work in providing services to the clientele. On the other hand, medical setting
is none of the largest and oldest in the country for the professional
orientation to the student of social work discipline. The setting comprises
government and non–government hospital, clinics and other health related
agencies.

 Psychiatric Setting
Psychiatric social work is an important part of medical social work. It works
for to resolve the mental health problem of the patients. Mental patients need a
long- term counseling service. That is why mental hospital including
psychiatric section of other hospital social including psychiatric section of
other hospital social workers are working for to help the patients. PG hospital,
mental hospital, mental health unit, medical college and hospitals are practices
field work regularly in Bangladesh.

 Correctional Setting
Patients are provided after completing correction. Any act against the law,
constitution or custom of the society is office. And the offender must be
punished according to the law. But punishment is not the solution. The
offenders should give a chance to resolve their offensive mind, so that they
can be mentally prepared not to do some mistakes. This is called correction. In
social work words no man born as offender, they become offender as the
impact of social environment So the social workers make a positive
environment in which they can overcome their problems with ethical values,
which is called correctional service. The first and last saying of social work
and correctional service and correctional agencies is “take to liability”. The
agencies take all liabilities of the offenders. Social workers communicate
constantly with client.
 Development Setting
Generally field placement is selected in those agencies, which work for the
development sectors of our country. Normally, NGOs are considered as
development agency. These agencies work for the economic and social
development of the country. Micro-credit, self- employment, poverty
reduction, agricultural development, life insurance etc. are the economic
development projects. Now a day’s field placement is given to the developing
NGOs mostly in Bangladesh. BRAC, ASA, PROSHIKA are specialized for
micro –credit, education loan, supply of educational equipment’s, health care
services etc. The social workers who, who are under education, help these
agencies to run field work program.

 Community Setting
Some social organization play vital role to organize the community people.
Voluntary initiatives the most effective way in the world. In community
setting, voluntary initiative leads many government initiatives. Urban
community development program gives the registration to the voluntary
organizations. Such as para, samiti, bazaar and committee etc. Whether the
selection committee after a certain time, being properly implement all
program. In community social service Bangladesh government runs two
activities-(1) Urban community development and (2) rural community
development. Besides GOs and many NGOs are working for community
development like –BIRDEM, USS, RSS etc. Field work is practiced in these
setting.

 Women and child welfare setting

Now a day’s women and child welfare are considered as a very important
sector of social development. Many governments and NGOs are formed for
the welfare of the women and child. Social worker plays an important role in
women child development by attending field work in relevant agencies. Which
agencies work for women development, most of them work to rebuilt conjugal
relationship, women empowerment, control divorce prevent
dowry system, ensure legal aid to women etc. The child welfare agencies work
for education training for children, recreational activities, feeding and
resistance for helpless children. There are many government agencies such as
Day care center, Baby home, child family, child society etc. There are also
many other NGOs such as UCEP –BD, World Vision, Ahsania Mission,
Oporajeo Bangladesh etc. Social workers help to the development of the
children by attending field work practice in these agencies.

 Counseling Setting and Others

 Counseling services is a process to serve the client by giving right direction
and advice according to the problem. Counseling helps to make a client to
solve his / her own problem. It is effective to the people Who are
psychologically ill and frustrated social workers try to solve the problem by
family therapy, group-therapy, client –centered therapy, behavioral therapy,
cognitive therapy etc. In the modern time, child welfare activities are most
preferable for practical field work.

1.8 Limitations of Field Work Practice in Bangladesh

In field practicum social work student have to go different fields. They have to face a
lot of problems which is affecting fieldwork practice. Those are the common
limitations of field practicum in Bangladesh.
 Client oriented limitations: Client and client system is a most important part
of Field work practice. The common problem of field work practice which is
related to clients is given below:
 Lack of knowledge about social workers
 Delivering fake information
 Clients unconscious
 Agency related limitation: Agency plays an important role for field work
practice. There is no scope to ignore agency’s role in field work practice.
Though agency plays vital role. It has some limitations these are given below:
 Limited number of professional social work agency
 Fewer program orient
 Lack of professional supervisor
 Busy with official work
 Inconsistency of communication and co-ordination between
client and social service program.
 Supervisor related limitation: Supervisor is an integral part of practical work
that helps the student to grow and develop professionally, to gain knowledge
and understanding and to assure responsibility for effective service to the
people.
 Lack of social work knowledge by agency supervisor
 Lack of training
 Lack of facilities (e.g., honoree)
 Absence of supervisory conference
 Involvement of student in office work
 Lack of proper supervision

Student related limitation

 The placement problem
 Long distance
 No scope of concurrent fieldwork
 Adaptation problem.
1.9 Necessities of Field Practicum in Social Work
It is known to all that practical knowledge is more effective than theoretical
knowledge, that’s why field practice has lots of necessities and importance to enhance
the knowledge of social work students. Fieldwork is important to help in developing
the attitude and ideas of them to make a connection between study and practice…it is
needed to become professional with proper practice in the field. (Robert, 1995)

The field practicum is a dynamic course that challenges students to apply social work
knowledge, skills & values within an organizational context. It is a vital dimension of
students of graduate & postgraduate level in social work discipline.

In “Fieldwork manual” M.A. Momen has mentioned the following importance of

fieldwork practice:

 Through the fieldwork, the students can learn how to apply social work
methods in the situation of given individuals, groups or communities’
problems.
 They are exposed to agency practice in which they are in a systematically,
preplanned approach to solving problem processes such as study, diagnosis &
treatment.
 The students achieve self-awareness & discipline to use them as a helper & as
an agent of change in an individual & group situation.
 The students develop facility in the use of organizational structure. They come
to know foster & use relationships within a structure & gain insight regarding
his/her network of relationships in the organization.
 It helps the students to apply the theory & principle of social work into actual
practice. The students acquire social work knowledge & are given an
opportunity to try a variety of social work methods, skills & techniques.
(Islam, 2008)
 The students become familiar with the administrative procedures & processes.
They learn how to run an office, what kind of routine needs to be established,
how to facilitate the administrative arrangement, relevant to the discharge of
the responsibilities of their own assignment.

 The students have an opportunity to learn the organizational framework of

services. They understand structure & policy & how to facilitate such policy
through practice. They become familiar with different institutional styles &
tempos of agencies associated with various field practices.
 The students acquire knowledge regarding community structure and process.
They know the kinds of formal & group & force that a community. They
should have to ability to utilize community resources in support of social
welfare. (Work, 1965)
Along with this some other importance for studying field education for social work
students are:
Increasing skills: Fieldwork practice increases the student’s skill in applying
theoretical knowledge into practice.
Building up the theory: fieldwork is helpful to build up the theory. When we
practice fieldwork we can test the social work methods, principles, values, and ethics.
Identifying gaps and limitations in the working process: when we practice
fieldwork education, we will find out the limitation of the social work method.
Identifying the relation with agency: if we identify the agency's method to relate
social work, we must need fieldwork practicum.
Evaluating the performance: fieldwork practicum is the greatest strategy to evaluate
social work.
Working with others: it’s a process of giving opportunity for the students to learn to
work with other professionals and voluntary workers.
Awareness in problem-solving: fieldwork practicum is very important to help the
student to develop a deeper awareness of himself and his party in the problem-solving
process.
Finally, it is clear that the ideal field placement offers students a focus on the methods
of direct practice, policy development and implementation, and overall development
in his practical knowledge.

Chapter -02
Hospital Social Work
2.1 Concept of hospital social work:
Hospital social work is the application of method and philosophy of social work in the
field of health and medical care. It makes selected and extended use of those aspects
of social work knowledge and methods which are particularly relevant for the patient
to use the available health service most effectively.
It is the application and adoption of the method and philosophy of social work in the
field of health and medical care. Hospital social work is the branch of social work and
deals with the social, physical and psychological aspects of patient-ail work is based
on the assumption of the individual's dignity.
Hospital social work is a sophisticated method of modern social work by which social
work methods and strategies are used in hospital sector where social worker plays a
vital role for combating the psycho-social disease. Collaboration with nurse and
doctor and other therapist hospital social worker take part in the study of diagnosis the
process of treatment plan.
According to, Robert L. Barker (1995: p-229) has defined, hospital social work as
"The social work practice that occurs in hospital and other health settings to facilitate
good health, prevent illness, and aid physical ill patient and their families to resolve
the social and psychological problems related to illness."
The Social Work Year Book-1957 (1957: p-356-58) it has stated,
"Hospital social work practiced in programs of medical care and public health."
According to Friedlander W.A and Apte R.Z, (1997:p-387)
"Hospital social work is an important field of practice for social workers, who play
significant roles facilitating the delivery of hospital service at the individual,group and
community level".
According to,R.A. Skidmore and M.G. Thackeray (1964: p-21) have defined,
"Hospital social work is the application of social work knowledge, skills, attitudes,
and values to the field of health and medicine."
The Social Work Year Book-1957 (1957:p-356-58) It has stated,
"Hospital social work practiced in programs of medical care and public health."

Hospital social work has five essential functions:

 The practice of social case work.
 Participation in program planning and policy formulation of the agency.
 Participation in educational program.
 Participation in community organization.
 Participation in studies, surveys, or research.

Hospital social work, a powerful weapon to realize comprehensive and qualitative

health care is used only in a few limited fields and less used. It needs boosting up and
revitalization,particularly among the medical students, doctors and health planners.

2.2 Historical background of hospital social work:

The root of hospital social is deeply rooted in the past like any other branch of social
work. Actually,this branch derived for helping people both mentally and physically.
Though the medical social work has been developed in the last century but it gets its
complete features in 1905.The initiatives which play an effective role for developing
the medical social work.
Global perspectives:
In 1980: There introduced a special service to pre-test of re-attack of mental diseases
of psycho-social problematic patients in England because many patients could fall in
these type of mental diseases.
In 1890: Sir Charles S Loch along with the former students of English Hospital
introduces an institution named Lady Almoners in London.
The works of these institutions are as follows:
To consider the application of the patient who are eager to admit into hospital.
To make a list of people who are eager to get free medical service.
To observe the social economic conditions of them Select the people who are get help
and what kind of service they want.
To take decision what types of organization should be considered for helping them.
In 1893: merry Brewster and other members of Henry street settlement house start to
visit the poor patient they identify the actual needs of the poor patient.
In 1902:Dr.Charles P. Emerson includes the different types of emotional learning in
syllabus as a part of medical education.
In 1905: a doctor named Richard Cabot of Massachusetts general hospital of Boston
in America realizes that the socioeconomic condition of a patient is also responsible
for their disease.
To know the socioeconomic factors of the patient hospital social worker were
appointed in Massachusetts general hospital.
In 1917: Mary Richmond explains the necessites of hospital social work in her book
of "social Diagnosis". She shows both physical and social factors are responsible to
disease by giving different examples in her book.
In 1918: Hospital social work gains its institutional features in USA through
establishing the medical social work association.
In 1948 National Health Service introduces in England in that time.
The appointment of social worker starts and their work are related to:
Child guidance.
Mental health care
Observation work
Research on the psychiatric patient.
Hospital social work is now practiced in many developing countries and training in
hospital forms part of the field work curriculum of social work courses all over the
world.
Bangladesh perspectives:
In 1954:In Bangladesh Hospital social work introduces at the middle of twentieth
century.The UNO and the RED CROSS helped to run an experimental hospital social
work program, in Dhaka medical college (DMC).
In 1959: After the formation of national council of social work the pace of speediness
of hospital social work continues.
In 1958: At the initiative of National Council of Social Welfare of East Pakistan.
Hospital social work formally introduced with developing two hospital social workers
in Dhaka Medical College Hospital.
From 1961 to 1981: With the success, the program was extended to Chittagong
Medical College and Hospital (CMC), Rajshahi Medical College (RMC) and Hospital
and Sir Salimullah Medical College and Hospital (SSMCH) and Chest Disease
Hospital at Dhaka in 1961. After the liberation war this project had been extended to
11 hospitals. Twelve social workers had been recruited in 12 hospitals during 1979-
81.
From 1991: onward 44 hospitals have been taken under this program. Now this
program is going on in 84 hospitals. (Islam, 2007)

2.3 Aims and objective of Hospital social work:

Hospital social workers work in hospitals, community clinics, and other healthcare
settings to support patients and their families, and to assist the larger medical team in
the co-ordination of patients' care.
They play an essential role in many of the non-medical aspects of patient care,
including helping patients and their families navigate the hospital system, assessing
and monitoring patients' and family members' mental and emotional health, providing
short term counselling and therapy, and communicating patient needs and concerns to
the larger hospital team. Hospital social work provides support for the vulnerable
patient with the basis of this aims and objectives aspect: ---
Aims of hospital social work:
I. Helping people facing illness, trauma-related crises, or disability to understand
and manage the psycho social impact on their lives and on significant
relationships and to make decisions and plan for the future.
I. Facilitating adaptive coping patterns and adjustment to chronic illness or
disability and assisting with reintegration or adaptation to new environments.
II. Participating in multidisciplinary teams and providing insight and understanding
of the psychosocial dimensions of the hospital circumstances affecting particular
patients and families.
III. Identifying and arranging community supports and practical resources to
facilitate discharge from hospital or transfer to alternative care facilities.
IV. Assessing the needs of selected patient populations, planning and implementing
appropriate programs, networking with community organizations, and developing
services to meet these needs, including support and psycho educational groups,
educational forums,socialization, and reintegration activities.
V. Identifying potential neglect, abuse, and exploitation in vulnerable populations
and involving authorized agencies.
VI. Supporting institutional goals and purposes and encouraging institutional
responsiveness to patient needs.
VII. Assisting with anticipatory grief and mourning,counseling people facing death,
and providing other bereavement-related services to members of the family,
including making practical arrangement.
Objectives of hospital social work:
A. To build up rapport and collect socioeconomically and related to information to
assist doctors full cure the patients.
B. To identify the poor and outdoor patients including them within services the
medical social services.
C. To send/transferred the patients to the related department and doctor chamber.
D. To admit the patient by the basis on prescription.
E. To building relationship among the patients, doctors, nurse and caretaker. To
assist the poor patient by giving them medicine, blood, artificial parts of the body
and creche etc.
F. To follow up the treatment and rehabilitation process of the patients.

2.4 The role of Hospital social worker:

Social workers play a critical role in hospital settings by helping patients and families
address the impact of illness and treatment Social workers, as part of the health care
team,provide assessment and appropriate interventions to aid the patient in achieving
optimum recovery/rehabilitation and quality of life.
In hospital Doctors and nurses care for the patients are not sufficient both mental and
physical needs aspects. That's why a hospital social worker can come in.
Hospitalization and dealing with a medical condition creates unique needs among
patients. In some situations, patients may already have issues. Such as homelessness
or addiction, and a medical condition only complicate things further.
Role of Social Worker in Hospital
 Counseling
 Cara planning
 Assessment
 Advocacy
 Legal assistance

2.5 Responsibilities of a Hospital social worker:

Hospital social workers will not see every patient that comes into the hospital.They
will usually receive a referral from a doctor or nurse for social work services. The
medical social worker responsible for these aspects:
To work as a team member in the multidisciplinary team consisting doctors,nursing
and staff. To coordinate and help the patients, family and other team members.
Maintain liaison with the hospital team.
To make the patient and his family understand the hospital problem or disability he is
suffering from, in a language the patient and his family can understand. To help the
patient cope with the disability/illness and make him adjusts to it emotionally.
To assess the social condition of the patients and provide appropriate counseling.
To help the patient to find the ways and means to financially manage with the
illness/disability. Making the patient manage and tap resources for carrying out his
treatment and support the family.
To help arrange financial support, for carrying out patient's treatment where needed
from Governmental and Non-governmental organizations. In addition suggest ways to
the patient and his family to reduce economic burden on the family.
To advice the patients/persons with disability on available disability benefits from the
government and help them to get those benefits.
To help the person with disability/illness to adjust to his environment, including
issues of removal of architectural barriers and encouraging independence in patients
To assist with the doctor in the discharge planning, making protocols, and to involve
patient and family members in the social work.
To help the patient in smooth transition from hospital to the community and maintain
the link with the patient, the community and the health services.

To do follow up with family so as to stabilize the gains made during treatment. This
may involve Case Work, one to one counseling method, Group Work and Community
Organization.
To create awareness among the people to stimulate people's participation in health
care program and to educate/interact with the community to help the community
adjust with patients having disability or illness. To make the community adaptive for
the disabled to help them integrate the disabled with them.
2.6 Education and training for Hospital social worker:
Although a bachelor's degree in social work may be enough to obtain an entry level
job, most hospital facilities prefer to hire someone with a master's degree in social
work. After earning a master's degree, social workers can start working towards their
license. Rules for becoming a licensed social worker vary by state. Information on
individual state requirements can be found through the association of social work
boards.
In most cases, license requires working a specific number for hours under the
supervision of a licensed social worker. Some hospital facilities may hire social
workers who are working towards license. Optional certification is also available
through the National Association of Social Workers. After meeting requirements,
social workers can apply to become certified in areas, such as health care, hospice,
and palliative care and geriatrics. Although certification may not be needed to get a
job, it shows additional dedication and knowledge in the field.

Chapter-03

Introduction to Field Work agency

3.1: Introduction of NITOR

The National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR) is an

orthopedic hospital and undergraduatc & post-graduate institute in Sher-e Bangla
Nagar,Dhaka, Bangladesh.It was established in 1972 by the Bangladeshi government
as the Shaheed Suhrawardy Hospital. In October 2002 the name of the institute was
changed to National Institute of Traumatology & Orthopaedic Rehabilitation
(NITOR).
3.2:History of NITOR

The history of Orthopaedic Service Programme in Bangladesh runs somewhat

concurrently with the advancement of the Rehabilitation Institute and Hospital for the
Disabled. With the War of Liberation, the new nation of Bangladesh was left with a
huge number of wars injured. Though a few of the Freedom Fighters from among the
wounded were taken by foreign countries for treatment, the great bulk of the wounded
including the civilians had to be taken care of by the new nation itself. The vast
majority of these patients had orthopaedic problems, and at that time there was only
one skilled Bangladesh Orthopaedist in the country and he left within a matter of
months. In those days, we had to depend mostly on volunteer staff, and they came
forward from all over the world.

There were doctors,nurses,physiotherapists,occupational therapists limb-makers,

brace makers, secretaries, pharmacists and administrators. By July,1973 the
Government of Bangladesh proved true to the promise, and assumed the financial
burden of the hospital, which by that time had mushroomed to 250 beds.

Government appointed staff gradually replaced the majority of the volunteers.It

became apparent,however, that if the Orthopaedic programme was to continue, young
doctors of Bangladesh would need to be trained as Orthopaedic Surgeon. Volunteer
Orthopaedists had been coming from England and Canada,from the onset of the work,
and in 1972 Mr. J.N. Wilson had come under the auspices of the Overseas
Development Ministry of England to study the need and decide the feasibility of
entering into a joint venture of training doctors in Bangladesh. Mr. Geoffry Walker
followed soon after Mr. Wilson who had recommended that the O.D.M. be actively
involved in securing highly qualified Orthopaedists to work along with us in the
training program. With the help of Mr. Walker, formal requirements were drawn up.

3.3:Founder of NITOR

Some human being are larger than life. Prof.R.J. Garst was one of them. He was a
friend of Bangladesh. His name is synonymous with the dedicated care of the
wounded freedom fighters of the war of liberation and with the birth of National
institute of traumatology & orthopaedic Rehabilitation(NITOR), the then RIHD.Dr.
Garst was working in Ludhiana, India as a missionary surgeon in 1971.In Bangladesh,
we attained victory from Pakistani occupation but at the cost of 3 million deaths and
thousands of freedom fighters wounded in the war apart from other miseries. During
that time we hardly had any orthopaedic surgeon to take care of our wounded freedom
fighters. Bangabandhu Shiekh Mujibur Rahman was deeply concerned &
worried about how to arrange proper treatment for the brave sons of our nation. On
his personal initiative, some of the wounded freedom fighters were send to Germany.
Many more were left for treatment in Bangladesh. Bangabandhu Sheik Mujibur
Rahman at that time found Dr. Garst to help them out. Dr. Garst came to Dhaka and
started his journey of dedication and sacrifice for the people of Bangladesh. Initially
he gave his services in DMCH and then from the makeshift wards in the veranda of
Shahid Suhrawardi Hospital Complex. Within a short period of time the demand for
his services grew immensely both among the freedom fighters as well as the civilians.
So,with the blessings and active support of Bangabandhu he went for a large and
ambitious project that would help to mitigate the suffering of orthopaedic patients and
injured freedom fighters.

3.4:Patient Service Overview

National Institute of Traumatology & Orthopaedic Rehabilitation is a 500 bed tertiary

center, receiving referral patients from all over the country. Among 500 beds, 40% is
paying and 60% is non-paying. In the paying bed seat rent is taka 225/- per day. At
present NITOR has 10 air-condition cabin which rent is taka 1000/- per day. The
investigation cost is taka 20/- to 300/- for each test and X-ray of normal variety is taka
55/- to 70/- and digital X-ray is taka 250/- Operation charge for minor procedure is
taka 500/- and for major procedure is taka 1000/-.

All these services are increasing day by day in quantity as well as in quality. Many
specialized operations like spine surgery, replacement surgery like total hip and knee
replacement and plastic & reconstructive surgery of limbs, which require at three to
four hours to operate, are done at a minimum cost on routine basis.

Emergency Department

Round the clock an orthopaedic team is available for management of orthopaedic

trauma patients. There are shifting duties of 12 hourly rotations. In each shift there are
two senior residents. Assistant Registrars, Registrars and Consultants are on duty.
Professor, Associate Professor and Assistant Professors remain on Call.

3.5:Goals & Objectives of NITOR

 Provide treatment of patients.

 Provide free treatment to the poor patients.

 Assist poor people with medicines, foods, cloths,blood.

 To rehabilitate poor patients.

 To facilitate such an environment is favorable to the patients.

 Help the poor patient with crutch, surgical shoes, and brail presses.

3.6: Aims & Objectives of Social Service Department

Hospital social work or hospital social service is the application ofsocial work
knowledge, skills, attitudes and values to the field of health and medicine.Hospital
social service is a helping programmed which gear up to accomplish to meet patient's
needs. Hospital social service provides lot of tremendous service for the wellbeing of
patients in following style:

1. To help the patients to get admission in hospital and provide important directions.

2. To help patients to adjust with hospital's environment.

3. To provide medicine,blood, cloths, crutch, artificial organ, spectacles and other

treatment materials to the poor and helpless patients.

4. To provides financial support and help to do required pathological test to the poor
and helpless patients.

5. To provide/supply nutritious food to the poor and helpless patients.

6. To provide rehabilitation facilities to the band one and disdained child.

7. To assists the patients to come or lead a normal life who are passing horrible time
because of diseases.
8. To give priority to provide treatment service and to get admission in organization
which are run by social service department those who are old and disabled persons.

9. To arrange recreational facilities for the patients those who are staying in hospital
and to refer the patients to other hospital if necessary.

3.7. Administrative Structure

Head of Administration

Administration Hospital Institution

Personnel OPD Emergency Orthopaedic training

program

Account Artificial limb

General Store Blood Bank Library,postgraduate

nursing

Laundry,Medical Store Pathology and X-ray Limb makes training

and pharmacy program

3.8:Faculties of NITOR

Yellow Unit I

One of the oldest and busy unit of NITOR, started functioning since the beginning of
NITOR as the directors unit till 2000. Since 2001 Prof. R R Kairy is in charge of this
unit.Although this unit is designated as hand surgery unit the doctors of this unit is
also proficient in all sorts of general orthopaedic, pediatric orthopaedic surgery, spine,
tumor surgery, interlocking nail, ilizarov and flap reconstruction of limbs. This unit
runs a separate hand OT and Hand Clinic.
Yellow Unit II

Yellow unit is one of the oldest part of NITOR. It was headed by some renowned
orthopaedic surgeons of Bangladesh, including Prof. A.F.M. Ruhal Haque,
Honourable Minister, Health and Family Welfare. The government of People's
Republic of Bangladesh,Prof. Abdus Samad Sheikh,Prof.A.K.M.Eshaque,Prof. M.A.
Hannan. In August 2002, Prof. R.R Kairy took charge of yellow unit. Which was
there known as hand surgery unit. In 2007,there was a charge from 9 units to 12 units,
and hence yellow unit was subdivided into yellow unit I and yellow unit II.Prof. R.R
Kairy has been continuing as the unit chief of both yellow unit I and II.

Pink Unit I

Pink unit come into emergency in the year 2001 with the expansion of 4 units to 8
units. Prof. Siraj-ul-islam, ex Director of NITOR,was the first unit chief. This unit
again was divided into Pink I and Pink II in August 2007, with further expansion of 8
units to the present 12 units. Prof. Siraj-ul-Islam continued to be the Unit Chief of
Pink I, till his retirement in June 2008, when Prof. AKM Eshaque the next Director
become the Unit Chief.

After retirement of Prof. AKM Eshaque in Oct. 2008,Assoc.Prof.MM Bari became

the Unit Chief of Pink unit 1,till April 2010, when Prof. Md.Iqbal Qavi became the
Unit Chief of Pink I. This Unit takes special interest in SIGN Interlocking nail and
Arthroscopy.

Pink Unit II

In 2004,12 units separately started their activities in NITOR. On that time Blue-2 was
headed by Dr. M. M. Bari with emphasis to do ilizarov technique in addition to
normal traumatology & orthopaedic management. By the course of time, Dr. M.M.
Bari was advised to take charge of pink unit instead of Blue 2 with his entire team.
Later on Pink 1 was replaced by Pink 2.

Green Unit I

Green unit was one of the oldest units of this institute. Green is a symbol of life,
vibrance and dynamism. Many renound professors of orthopaedic of orthopaedic
surgery was in charge of this unit. In 2006 this Green unit was divided in to two units
like Green I & Green II. Since its inaption in 2006 Prof. M.A.Samad was the
Green Unit II

Green unit started working at NITOR under the supervision of Prof. Abdus Samad SK
in the bear 1992. then Prof. Amzad Hossain was the Chief of this unit in 1997. After
that 1998 Prof. M.A. Samad was the head of the green unit. From July 2006 the green
unit was divided in to two units like Green I and Green II.

Red Unit I

Red Unit is one of the old unit in NITOR. It started its journey during inception of
RIHD. This unit was previously headed by veteran orthopaedic surgeons like Prof.
Shamsuddin Ahmed, Prof. Faruque Reza Aolad, Prof. Ayjaz Ahmed Khan and Prof.
SK. Nurul Alam and we are the descendants. This unit excels in Arthroscopic
Reconstruction of Knee ligaments, Meniscus, Spine, Arthroplasty, Pelvic &
Acetabular Reconstruction, UMEX and Ilizarov External Fixators. Recently we got to
establish the subspeciality of Paediatric Orthopaedic in our unit.

Red Unit II

Unit is performing routine daily activities and engaged in managing trauma &
orthopaedic patients. Weekly working routine is as follows OPD Sat, ward round Sun,
Tues. Routine OT on Mon, Wed. Emerge Admission/operation on Thus day. Total
unit bed 40 and special bed- 3 spine patients. All the members of this unit is
committed to ensure patients care, taking part in academic & scientific activities of
hospital. Unit chief is also in charge of spine unit. Unit all members have keen interest
in spine surgery and we are doing spine surgery regularly. Spinal stabilization &
fixation fusion,spinal decompression,disectomy,spine deformity correction etc.we
planned to start" Saturday pain clinic" very soon which will create window to enhance
spine care service and will speed up the force of activities of enthusiastic surgeons of
this unit.

Violet Unit I

The concept of twelve units in NITOR resulted in the emergence of violet unit I in the
year November, 2007. This unit is headed by Professor Sajjad Hussain. This unit has
special interest in locking Plates and interlocking Nailing of long bone, but manages
efficiently all sorts of trauma and orthopaedic patients.

Violet Unit II

The violet unit of NITOR was first started in the year 2001 under Professor Dr.
Ramdew Ram Kairy. On July 2002 this violet unit was designated as SIGN and
interlocking nail unit under the supervision of Prof. Dr. Shahiduzzaman upto June
2006. After the Prof. Dr. Md. Sajjad Hosain continued till October 2007.Thereafter on
November 2007. this unit was divided into violet I and violet II. Violet II was headed
by Asso. Prof.Dr. M.A. Awal Since November 2008 Asso. Prof. Dr.Md. Shah Alam is
continuing the unit in charge. From December 2010 this unit has declared as Spine
Unit.

3.9:Department of Social Services at NITOR

Hospital social work is an important wing of social work which is practiced in public
hospital. Social service program has been started in NITOR in 1984. To implement
this program smoothly a client welfare organization has been established in
1985.Since it has been working for the welfare of vulnerable clients.Administrative
structure of Social Service Department:

Social Service Officer(One)

Office Assistant(One)

M. L.S.S(One)

3.10: Functions of Social Service Department

The main functions of social service department are to mitigate with the economic,
cultural, mental and personal problems which hinder the accomplishment of treatment
of poor vulnerable patients. It assists the clients by giving below materials and
immaterial aids.

Food, Blood, Wheel Chair, Provide material and Transport,allowance,Brace

Artificial Limb, Surgical immaterial aid from the , Funeral of dead body,
Shoe, Medicine social services department Crutch.
3.11Financial Sources of Social Service Department
The National Institute of Traumatology & Orthopedic Rehabilitation (NITOR)
department of social service of hospital has two sources of collecting funds. Such as:

1. Government yearly donation

2. Donation from the donor person (businessman, politician and others)

Besides these, there are also some other source

1.General member's contribution

2.Life-time member's contribution

3.One time donation

Name of the institution

1. Rotary club of Dhaka (Down Town): Medicine,operation materials, wheel chair,

scratches.

2. Rotary club of Dhaka :Artificial limb, scratches, wheel chair, medicine.

3. Lions club of district government: Wheel chair.

4. Inner wheel club of Dhaka: Wheel chair, food, clothes, artificial leg.

5. Annual donation national social welfare perished: Donation=50000 per year

6. Rotary club of Shere-E-Bangla Nagar: Wheel chair, medicine, scratch.

7. Medical company: Supply medicine.

8. Client welfare smithy: Medicine, surgical shoe, book.

9. Inner wheel club of Dhaka metropolitan: transport D. A Wheel chair, medicine,

scratch .
3.12 Role of Hospital Social Worker in NITOR
 To aware the patients and families about family planning, nutrition diet,
education and cleanliness etc.
 To supply medicine, food and other medical supports to the poor patients.
 To help the new patients to introduce and adjust with the hospital environment.
 To analyze social, economic, mental cause behind the discussion of the patients
and to supply necessary information and advice accordingly.
 To discuss with doctors and nurses to ensure improved medical services for the
patients.
 To give mental support in order to turn out their internal problems.
 To rehabilitate the destitute and unknown patients.

3.13 Fund Collection

PWC provides financial help to the helpless, destitute and underprivileged poor
patient in 91 Public Medical College and Hospital along with 419 Upazilla Health
Complex across the
Bangladesh. In general, every association raises a fund from 100000 to 150000. The
sources are following:
1.Annual donation from Bangladesh National Council of Social Welfare. Blood
donation from Bangladesh National Council of Social Welfare.
2. Financial and from the philanthropic rice, grants and Jaquat is the main source of
income.
3. Annual grants from district Council.
4.Medicine, garments, crutch, wheel chair provided by various organizations.
5. Blood donation by Red-cross.
6.Patients Welfare committee collects fund from various government and non-
governmental organizations. They help by providing money, wheel chair for disable
patients and free medicine. Many private agency and organization also help for fund
collection. Individual person also helps for patient's welfare. For example: Akiz group
helps by providing money for Muslim patients.
3.14 Member of PWC
The executive body of PWC consists of 15 members. Now I depict a feature of the
executive body in below:
President -1 person is director of hospital. He was selected by priority based.
Senior vice president -1 person selected.
Treasurer -1 person is selected.
Member -1 person.
Vice president -1 person is social service officer.
Secretary -1 person is selected.

3.15 Rogi Kalayan Samiti of NITOR

Hospital social service is an important program among numerous programs of social service
department under social welfare ministry and it is directly related to the service of the
patients. In order to integrate private venture with public venture, there is voluntary
organization in every hospital with project named Rogi Kaylan Samiti. According to the 46th
ordinance, 1969 Rogi Kaylan Samiti debited under voluntary social welfare agency with the
registration no. Dha-09116 on 2nd august, 1969. The core objectives of this organization are
to raise fund and create various opportunities for providing financial support of the patients.
The organization raises fund from Jaquat, Charity and government aids. The hospital social
service officer implements all the decision by ex- officio.
 Chapter-Four
Roles,Responsibilities and Performed Duties during Filed Work

4.1 Roles and Duties by me

During my field work at NITOR in Department of Social Service,there are some

professional like doctors,psychologists, therapists, nurses and social workers.I was
being a trainee social worker,following responsibilities that I have performed during
my field work period.

4.1.1 Duties from the Internal Supervisor

 To go the agency in time and obey the agency supervisor.
 To maintain rules and regulations of agency.
 To be oriented about background, structure aims and objectives, principles, nature
and programs of hospital social work.
 To participating weekly supervisory conference.
 Keeping process recording book in daily basis.
 Listen and attend the supervisory conference.
 Writing process recording paper with social work methodology and psychological
terminology.
 Participated in experience sharing and brainstorming session.
 Reading several books related to field work, medical social work, and so on.
 Search Internet.
 Take at least 3 cases for the final field work.
 Prepare a final field work.
 Use the social work and skills effectively in the knowledge problem solving
process.
 Practicing social work knowledge.

4.1.2 Duties from the External Supervisor

Regular attendance in agency (not a single missing) during 50 days. I was present 50
days out of the duration.
 Create the good relation among the working stuff and make rapport with the
client.
 Learn about the different unit and department of agency.
 Help the client to have their services, by taking their interview.
 Learn he structure,objectives,goals and programs of the agency.
 Collect data about the social, economic condition of the patients.
 Helping the outdoor and indoor patients.
 Helps patients and his family to get help from social service department.
Counseling with the patients and guardians.
 Take the case history effectively.
 Make follow up with full attention to the client.
 Volunteering in social service department.
 Rapport building with patients.
 Deal with cases.
 Short research/study on socio-demographic aspects of outdoor patients.
 Follow-up the patients.
 Participated in experience sharing and brainstorming session

4.2 Key Responsibilities I performed in the Agency

As an apprentice social worker, I was assigned both in indoor and outdoor department
of Social Service, NITOR involve myself to assist the patient as an element of patient
care system. I have tried to assimilate my theoretical knowledge into practice.

The following tasks, I have done may be stated below:

4.2.1 Performed Duties in the indoor at NITOR

 I have learned the structure, objectives,goals and programs of the agency.
 Learn about the different unit and department of agency.
 Create a good relation among the working staff and make rapport with the client.
 Help the client to have their service, by taking their interview.
 Collect data about the social,economic and psychological aspect of the patients.
 Counseling the patients and guardians.
 Go different wards to provide medicine, injection, operational instrument,
bandage,cross match,wheel chair etc.
 Take the case history effectively.
 Make follow up with full attention to the client.
 Advocate for the clients or patients to the client.
 Collaboration with other professionals to evaluate patient's medical or physical
condition and to assess client needs.
 Refer patient, client,and family to the doctors or related diagnosis center to assist
in recovery from mental or physical illnessand to provide access to service such
as financial assistance, free test,free medicine facilities or accesses to get
admission into hospital.
 Counsel clients and patients to help them overcome dependencies recover from
illness and adjust to life.
 Organize support groups or counsel family members to assist them in
understanding, dealing with, supporting the client or patient.
 Modify treatment plans to comply with changes in clients status.· Monitor,
evaluate and record client progress according to measurable goals described in
treatment plan.
 Identify environmental impediments to client or patient progress through
interviews and review of patient records.
4.2.2 Performed Duties in the outdoor at NITOR

 I have performed many duties in outdoor at NITOR. The duties which I perform
are:

 Help to meet doctors in the outdoor.

 Help to collect medicine…

 Help to collect blood.

 Help to do various test.

 Help to make test fee free by communicating with the doctors.

 Act as a referral social worker to the patient.

 I record all my outdoor work in the record book of Social Service Department,
NITOR.
 Chapter-Six
Applied techniques, methods and principles and my learning
6.1 Methods and Techniques used in performing the Duties

Being an Apprentice social work,I have used different method and techniques of
social work during my field work.Major of these are mentioned following

 Establishing rapport.
 Recording.
 Observation.
 Interview (to patient and his attendants, doctors, therapists).
 Listening.
 Talking.
 Active participation.
 Maintaining case work principle.
 Use of support treatment technique of case work.
 Clarification,
 Directing.
 Interpretation
6.2 Application of social work knowledge and methods in field work
Social work is professional activity of helping individuals; group or communities to
enhance or restore their capacity for social functioning and creating societal
conditions favorable to that goal. In hospital problem is client centered. So I used
social case work method to solve the problem and I also try to apply all over the basic
method and auxiliary method in my field practicum.

6.2.1 Basic Method

Basic methods are that systematic and planned way of performing an activity, which
is fundamental to social work. These are just like roots of social work which gave
birth to other branches. Three basic methods are
1. Social Case Work
2.Social Group Work
3. Community Organization and Development
6.2.1.1 Social Case Work
Social Case Work is an important basic method of social work. in field work practice,
I had to perform hospital social work as the agency does so. So in the case study,1
applied social casework method of social work. Social case work is a proces of
helping individuals or groups materials or non-materials in their social set up for
better adjustment. Social case work is essentially a problem solving process. Life is
not a rose without thorns. It is full of so many hazards and difficulties which hinder
our social functioning. From the moment of birth every individual goes on trying to
solve all these problems and to make good adjustment with the social situation of
which he/she is a part. Sometimes he/she succeeds, sometimes he fails.

When he fails to cope with the problems independently, he comes to is referred to the
social worker agency for help. The case worker through the problem solving process
of the social case work, help the clients solve his own problems and adjust to the
society.

As an apprentice social worker, I applied social case method.I followed following

steps:

Study
Study in social case work refers to gathering of facts,regarding socioeconomic
conditions of the client and the assessment and observation of the psychological
characteristics of the individual. In the study phase I collected relevant data for
understanding the client and his problem in order to assess the help required by client
for adjustment and better social functioning.

Psycho-social Study

Psycho-social study is one of the important steps in problem solving process of case
work. Psycho-social study denotes to the stage of social work in which necessary
information concerning problem stricken person is helped up. It is a technique of
undertaken to take in necessary Information with a view to tracing out nature of the
problem and designing treatment plan,

Diagnosis

Diagnosis is a continuous process,When the nature of the problem is traced

outboasted on the analysis made in light of the data collected through psychoanalyse
study. followed this step. It is a mental and intellectual process.
Treatment

The process of treatment differs from agency to agency and from client to client.1
followed my agency rules.

Evaluation

Evaluation is one of the phases involved in problem solving process in case work
where strength and weak points of activities undertaken are determined and
reassessed. I followed this step.

Follow-up

Since treatment doesn't mean total cure and susceptibility of the problem remains,the
cases need to follow up with a view to giving supplementary support to have
improved treatment

6.2.1.2 Social Group work

Social group work is an activity which helps to participate in the activities of a group
for their intellectual, emotional, physical growth and for the attainment of desirable
goals of the groups. Though I got little scope to apply this method during the period.

6.2.1.3 Community Organization

Community organization is the process of planning and developing social services in
the order to meet the health & welfare needs of a community or larger unit. During
Field work, I tried to help patients to get community services from Social Service
Department

6.2.2 Auxiliary Method

Auxiliary methods are secondary because it facilities the primary methods,.These are
also the derivatives of primary method.Three Auxiliary methods:

1.Social Action

2.Social Work Research

3.Social Welfare Administration

6.2.2.1 Social Action

It is an organized group process solving the general social problems & furthering
social welfare objectives by legislative, social, health or economic progress.

As the part of social action method I was participate a rally with a view to minimizing
the financial problem off poor patient on behalf of Department of Social Service,
NITOR.

6.2.2.2 Social Welfare Research

Social welfare research systematic critically investigation of question in the social

welfare field with the purpose of yielding answers to problems of social work & of
extending generally social work concept. I along with my group mate conducted a
research work on socio demographic issues of outdoor patients.

6.2.2.3 Social Welfare Administration

Social welfare administration process is to organize & to direct a social agency.1 dealt
with administration while dealing with patients.

6.3 Applied Principles in field practicum

In my field practicum I also applied some principles. These are given below:

1.Principle of individualization
2.Principle of communication
4.Principle of confidentiality
5.Principle of participation
6.Principle of self awareness and consciousness
6.4 Experience obtained from NITOR
By randomly of the mature of my fortune,I was placed at Department of Social
Service NITOR as an apprentice social worker. Within this short period of time (50)
working days,I learned and obtained lots of experiences and obtained my skill in
certain fields of hospital social work.I have very high hope that in near future I may
use these to enhance and my capacity to place better.

The skills & experience gathered by me are mentioned below

 Knowledge of Medical social work.

 Different dimensions,approach,scope,professional trend of medical social work
profession.
 By giving information and facts about the disease and thereby removing his
misconception about the disease and its effects.
 By giving an emotional support to overcome his emotional tensions caused by
worries and anxieties about the disease, family or other matters
 By securing material resources of the community for the maintenance of his
family during his illness and for his rehabilitation after his cure.
 By giving needed information to his family regarding his care and treatment
during convalescence and thereby removing danger of relapse.
 Importance of Medical social work in hospital.
 Rapport building.
 Recording & reporting.
 Study,Diagnosis and Treatment.
 Experience about etiology and symptoms of diabetic patient.
 Gathering skills to challenge patients.
 Growing more confidence.
 Removing some unexpected situation.
 Experience about manage of patient need.
 Knowing typical format of medical case presentation.
 Knowing about physical health & existing laws.
 Acquiring consciousness.
 Knowing the number of patient & their problems and prospects.
 By giving necessary health guidance,knowledge.

I was engaged in the following activities which have added an experience of my

career:
a. Helping terminally ill patients and their family needs.
b. Counseling people who are so depressed.
c. Counseling patients who are apprehensive about undergoing surgery.
 Chapter -07

Limitations,recommendations and Conclusions

7.1 Limitations of Field Practicum Agency

I completed a 60-day field practicum as an apprentice social worker in the hospital

social services division of NITOR. I ran across a lot of issues when working in the
field. Some of them are associated with the agency, others with medical social work,
others with clients, and still others are associated with my work as an apprentice
social worker. The following details such issues:

The department of social services at NITOR has a small amount of human resources.
Only three (03) people make up this department's staff. This staffing level is
insufficient given the size of the duties and the range of the interventions.

There are limited resources of hospital social service compared to the beneficiaries
Every day near about 20-25 patients come to seek financial & material aid from the
agency.

The doctors, nurses and other concerned persons of the hospital in most cases are not
well aware of the professional social work practice; so I received less cooperation
from them. Sometimes the clients didn't want cooperate from me as they aren't aware
of the role of a medical social worker.

7.2 My limitation being an Apprentice Social Worker

As an apprentice social worker, I faced some sorts of limitations during field
practicum. Remarkable limitations are mentioned in following:

 Conceptual and theoretical idea of field practicum are not clears to agency.
 Primary it was tough to cope as it was not being my choices, of course later l
 felt interested and enjoyed.
 Lack of proper knowledge about the management of patient.
 Lack of training on the basis of field practicum.
7.3 Recommendations to solve these problems
During the completion time of my field practicum in the department of social services
of NITOR, I experienced a few problems related to the agency, government policy,
and existing service delivery system. And some of the problems I faced were because
of novice social workers. The experiences that I have gathered from my field
practicum period, some recommendations are suggested to overcome these problems
which are stated below:

 If the manpower of the social services office is increased, the chances of success
will be increased.
 The current fund of the social services department can provide free medicine and
materials help on an average 8-10 patients that cost in an average 15,000 taka.
Where daily members of help seekers are an average 20-25 people. So the
government should increase funds for the agency.
 High society and distinguished personalities need to be encouraged to donate
their assets and cash money to the agency. Government and media can play a
vital role in this regard. -The behavior of third and fourth class staff and the
rehabilitated staff should be helpful and modest.
 The patient who comes from a distance their admission system can be changed.
 The behavior of hospital employees should be helpful and friendly. Doctors
should be aware of their responsibilities. -Need to arrange a training program for
the trainee social workers to enhance hospital staff skills.
 Seminar, symposium, the conference could be arranged in order to create
awareness about the hospital social services and medical social work to the
doctors, nurses, others professionals and general people.
 The government should employ social service officer from the social work
discipline in order to make the service more scientific and fruitful.
 The government should take necessary steps to recognize social work as a
profession in order to ensure services for all and make health service
comprehensive and effective. -To collect blood in an emergency has to maintain
good communication with the Red Crescent, Lions Club, Blood bank and so on.
 Students should be given a written work chart describing the tasks, time frame,
available resources and other related matters at the outset of fieldwork. This will
help in performance evaluation of the students at the end.
 A seminar, symposium, or conference could be organized to educate doctors,
nurses, other professionals, and the general public on hospital social services and
medical social work.
 In order to make the service more effective and scientific, the government should
hire social service officers from the social work field.
 In order to guarantee services for all and create comprehensive and efficient
health services. the government should take the required steps to recognize social
work as a profession.
 To collect blood in an emergency, it's important to keep in touch with the Red
Crescent,Lions Club, blood bank, and other organizations.
 At the beginning of the course, students should be given a written work chart
outlining the - tasks, deadline, resources available, and other pertinent
information.
At the start of the field practicum, students could receive basic information about the
ailment connected to the disease.
The supervision mechanism must be upgraded in order for supervisors to effectively
guide students' performance progression. When assigning projects to the students,
practicing social work should come first. To bring about remedial actions in the
performance of students, midterm evaluation should be ensured. It's possible to apply
"on the spot supervision" regularly.

The social services department would be able to offer better, more efficient, more
gratifying services to those who actually needed them if the recommendations were
implemented properly.
A branch of social work known as "hospital social work" is medical social work. In a
hospital, outpatient clinic, community health organization, skilled nursing facility,
long-term care institution, or hospice are the typical workplaces for medical social
workers. They assist clients and their families who require psycho-social support.
Medical social workers evaluate patients' and families' psycho-social functioning and
take appropriate action.

7.4 Conclusion
Finally it can be said that social work satisfies the criteria for a profession Social
workers have to study the scientific principles of human behavior and the structure
and organization of social institutions. They have to develop, on their own,
knowledge and skill in working with people under specific social, economic and
emotional conditions. Today the proportion of trained social workers is increasing.
There is a growing awareness on the part of social agency boards and public welfare
commissions, as well as among the public, that professionally trained social workers
are needed for the responsible, competent performance of social services. Successful
application of theoretical knowledge highly depends on field work practice. It is
mentionable that as the sometime theoretical knowledge defines the knowledge as
seed and the field work practice is the free plantation and take care of it. It is also
realistic in social work education. Theoretical knowledge of social work becomes
fruitful when this wisdom is implemented in practical situation to cope the problems
through the field work students of social work able to understand how to apply their
knowledge appropriately. During my field work! have worked with the social service
officer doctor, nurses and with some cases. I have gathered a lot of valuable and
precious experiences and knowledge from them. In some cases I have achieved
success and in some cases I have failed to achieve it due to some problems related my
limitation and the fault of the agency. I apologize for my unintentional mistakes and
limitation. Although my little works (report) may helpful for and essential to others
for any jobs then my labor and efforts will be prolific. Again I cannot preserve my
emotion to say that field work in developed, developing and LDC plays a vital role in
expanding and enriching the theoretical knowledge of field worker standing on the
bookish knowledge. I tried with my best effort to do my duties and take my
responsibilities properly. Finally I pray and bless that the social service department,
NITOR may be live long and all activities would be more effective and progress and
development oriented for the patients to run a general and joyful life on the basis of
these improvement social work must get the professional recognition in the upcoming
future.