Diary: ‘A never-ending battle to update notes and see patients’

A forensic social worker reflects on a week of balancing paperwork and meetings with time spent with service users

Photo: WavebreakMediaMicro/Fotolia


I come in and realise I have a tribunal report due tomorrow. I know the patient well and I have lots of documentation, but still I could do without it especially as I know it will take up most of today.

The afternoon is full of Care Programme Approach (CPA) meetings and paperwork. It feels a never-ending battle trying to update written notes while also speaking to patients, families and colleagues.

I speak to the patient whose report I need to write. The conversation is short; he does not want to talk to me about it and sees no need for him to remain in hospital.

I receive a call from the local safeguarding team about an assault on one of the wards. I agree to check if the victim wants to report it to the police and to send in a written referral.


I’ve been tying to arrange a visit by a child for the last few weeks. We have very tight child visiting procedures which need to be followed to ensure children are safe when they visit a parent in the hospital. After weeks of missing each other’s calls, I agree a date with the child’s family and book the child-visiting room. I confirm it with the ward and make a note to check the room beforehand to ensure there’s good supply of biscuits and squash.

I speak to a student social worker about a possible placement and try not to put her off. The work is fascinating and rewarding but I’m aware of the stigma around secure work.

I have to race back to the office after grabbing a sandwich, to add the final touches to my report before sending it to our mental health administrator.


Ward round. Our multidisciplinary team works well together and we share the same values. We have one patient who we don’t think is progressing and we discuss different options. It’s difficult because some of us have known this patient for years and we feel torn about the possibility of them moving elsewhere. We discuss ward shortages and how we can cover nursing staff absences.

I visit the ward. This is the most valuable part of my week; spending time with patients and getting to know them a bit better. Often a well-timed game of snap with a patient can improve our working relationship far more than anything else.


I’m summoned to a meeting about carers to discuss how we can better support them on the unit. I come away with a letter to re-draft and a promise to look at carers information in time for the next meeting.  I return to my desk, re-draft the letter and send it to colleagues for feedback.

I visit the ward to talk to a new patient who’s just moved from a young offenders unit. He’s a teenager and new to the area but seems to have settled in well. I ask him about his family and offer to contact them to go though visiting procedures.


Another ward round. This one goes on for several hours because we have a new patient, who’s been transferred from prison and is causing the ward some concern. We discuss the risk assessment for this patient and talk about how the ward will manage potentially risky situations. This patient has a history of hostage-taking which makes all staff anxious.

I visit another ward and speak to a patient about benefits. The ward is happy because it’s Friday which means it’s takeaway night. I plan to do the same and head for home.

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4 Responses to Diary: ‘A never-ending battle to update notes and see patients’

  1. Jim Byrom January 18, 2017 at 2:41 pm #

    WELCOME TO OUR WORLD!!! We in the care home industry are subject to the same pressures of paper work as you are, and then some,
    but most of this was imposed by yourselves. We are subjected to the constant interference and inappropriate intrusion by quality monitoring and by safeguarding taking hours of our time which we would prefer to spend on patient care. It is a pity that although we are alledgedly partners we do not work by and large in collaboration for the benefit of our patients.

    • Ben Glass January 19, 2017 at 9:54 pm #

      Ah the politics of ‘care’.

      Have you thought that we (service users) aren’t collaborated with nearly enough by yourselves (and the SWs/RMNs etc), and might actually be glad that there exists oversight to the decisions you make?

  2. Barbara MacArthur January 19, 2017 at 7:24 am #

    Reminds me of when I was a social worker in the 1960s/1970s etc., lists of referrals were longer, hours longer and pay miserly. I was on 24-hour call with a telephone in my home for emergencies, the number listed in the phone book 4 times under Welfare emergencies, Mental health etc. No overtime or time off in lieu .The Director told me I must keep records ‘up-to-date’ so when I was told that a councillor had made an urgent referral of an elderly man because he was “Dishevelled, Uncouth and unkempt”, I visited and I wrote on the file – “Visited, Mr. so-and-so – found him to be Shevelled, couth and kempt”

  3. Cyrnix January 19, 2017 at 8:59 pm #

    Well, the task of recording has always been fraught with difficulty, when specifically relating to statutory child protection social services. To be candid I feel having served within numerous health care trust departments, the concept of recording’ as it was referred to took on nightmareish proportions for the individual worker concerned. A lot of which was made better or worse by the immediate line managers’ attitude on the subject. There is a most unrealistic expectation by some of the targe occupants of the role of SSW, that you will have your recording sitting pristine in the relevant file, by close of business each day.
    But when placing this task in the context of CP visits, case conference and review, court reports, court reports and court attendances, lac visits, reviews and of course more forms to be completed, you play a game of catch up and thunder and lighting. A shorter home visit so you can sit in your car to record the previous interaction and obs.
    I am not putting down my colleagues at the coal face but trying to convey the extremes of pressure you experience on a day and daily basis where one feels they are the little Dutch boy attempting to plug the hole in the dam. But without success.
    So you have to make informed decisions surrounding home visits, recording and prioritised court work, it is envivitiable that some aspect of your work has to be given lesser importance. Only when a file audit or closer scrutiny of your management does a lack of recording count as a default. Then does this misdemeanour again take on a life of its own. Investigation, interviews, unions and sanction from the ruling professional body.
    Oh dear, until a more abridged form of recording methods are accepted, like the medical profession, with greater reliance on technology to perform these mundane and laborious task, coal face social workers will remain to be subject to the unecessay scapegoating of their management. Remembering of course that your senior management has not been in real life practice for sometimes decades.