3 Keys to Hospice Social Worker Recruitment and Retention

Three important considerations can help hospices recruit and retain social workers: a respectful workplace culture, reasonable workloads and continuing education opportunities.

Workforce shortages remain the industry’s most damaging headwind, and that includes social workers. During the pandemic, those professionals have left the health care field in record numbers. Attrition rates exceeded pre-pandemic levels by 35% as of October 2021, the Peterson-Kaiser Family Foundation found.

Moreover, data going back to 2006 show that hospices have lost more social workers than any other health care sector, according to the National Association of Social Workers (NASW) and the Center for Health Workforce Studies at the University of Albany.


Ensure social workers have a voice

To keep social workers on staff, hospices should focus on creating a respectful workplace culture in which all members of the interdisciplinary team can feel heard, according to Vickie Leff, a palliative care consultant and interim director of the Social Work Hospice and Palliative Care Network.

“The respect that they get from their colleagues on a team helps them tremendously to feel valued in their work and heard,” Leff told Hospice News. “Team meetings are sometimes organized in such a way where certain voices are heard very loudly and others are not. But for hospice and palliative care to be truly interprofessional, you need to give space for people’s voices to keep people feeling valued in their work.”

Leff is the co-presenter of a 10-hour intensive social worker training program tailored to the hospice and palliative care fields with Terry Altilio, a palliative care educator and retired social work coordinator formerly with the Division of Palliative Care at New York City’s Mt. Sinai Beth Israel. She is also editor of the Oxford Textbook of Palliative Social Work, second edition.


The pair will launch the most current iteration of this intensive at the Louisiana-Mississippi Hospice and Palliative Care Organization Conference in July. In time, they expect to roll out the program as a national model.

Offer continuing education, career paths

The intensive will “go beyond the basics,” Leff said, including modules on communication with patients, families and colleagues; pain and symptom management, ethics and health equity, among others.

In addition to potentially drawing more social workers to the hospice field, or helping them improve their skills, continuing education opportunities can themselves be an important recruitment and retention tool, according to Altilio.

“We now know from a ton of research, that the availability and organizational support of professional education for social workers is paramount to them finding satisfaction in their job and keeping them in the job,” Altilio told Hospice News. “So the ability to offer continuing education at their locations will reduce their turnover. If you give folks an opportunity to be able to practice to the top of their license and opportunities to learn enriches their experience, they’re less likely to leave a job.”

Keep workloads manageable

Another important factor is workload. When social workers have a large caseload of patients, it can contribute to burnout or dissatisfaction based on the limited time they are able to spend with each patient.

In part due to their scarcity, social workers often care for higher numbers of patients than other members of the interdisciplinary team, according to the 2022-2023 Hospice Salary & Benefits Report, published by Hospital & Healthcare Compensation Service (HCS) in cooperation with the National Association for Home Care & Hospice (NAHC).

Nationally, medical social workers in the hospice space had an average caseload of 29.15 patients compared to 14.12 for nurses, the report indicated.

“This is something that institutions need to be working on and thinking about because it’s really hard to encourage social workers to take jobs in organizations where the caseload and the workload is so high, whether it’s a hospital setting or hospice setting,” Altilio said. “Hospices, health systems and so forth need to reflect on the kinds of environments that they are creating for social workers. They need to look at themselves and think about what they can do to not only help social workers be more comfortable there, but to feel that they are actualizing their potential.”

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