To telework or not to telework: Perspectives from inpatient and outpatient social workers at the Veterans Health Administration

Abstract: The COVID-19 pandemic has forever changed the way social workers provide care to their clients (Walter-McCabe, 2020). Before the onset of the pandemic, telework opportunities were limited for social work staff (Ashcroft et al., 2022). Research has shown that social workers’ observation of their clients’ body language and facial expressions allows them to provide quality care, utilizing clinical skills like active listening and paraphrasing to convey empathy and compassion for their clients (Wagaman et al., 2015). Virtual care often makes it difficult for both social workers and clients to read nonverbal cues, which can make it challenging for social workers to effectively communicate with their clients (Nordesjö et al., 2022). However, many social work agencies shifted from an in-person care model to a virtual care model, as the spread of COVID-19 raised safety concerns for the public (Mishna et al., 2021). This change ensured that clients were able to continue receiving therapeutic care, while social workers and staff could work from home to minimize the risk of exposure to COVID-19. To address safety concerns and minimize staff shortages, telework became a viable option. The U.S. Department of Veterans Affairs (VA), the largest employer of social workers in the United States, was recognized as a model for other social work agencies because of its high-speed technological innovations and quick transition to telework (Matthieu et al., 2022). Among clinical and nonclinical employees, teleworking minimized staff shortages and burnout at the VA (Brower et al., 2022). Recent research (Kranke, Kranke, et al., 2024) shows that outpatient social workers remained employed at the VA during the COVID-19 pandemic because they were able to telework. In fact, their non-VA social work colleagues desired to work for an agency that would afford them the opportunity to telework as well (Kranke, Kranke, et al., 2024). However, inpatient VA social workers did not echo the same feelings about teleworking, as they desired in-person peer interactions and office support (Kranke et al., 2023). Outpatient social work is considered more conducive to effective telework (Kranke, Milligan, et al., 2024) than inpatient social work, because the latter depends on working with a multidisciplinary team of providers, which requires frequent meetings and providing in-person treatment to clients. Since the COVID-19 pandemic is no longer considered a national emergency (U.S. Department of Health and Human Services, 2023), there has been an increasing push by congressional leadership for federal agencies to require their employees to return to in-person work (Tausche, 2023). However, some positions are more suited for teleworking because of employees’ capability to work productively and effectively at home (Abrams, 2019). There is limited research that examines VA social workers’ perspectives on teleworking, specifically comparing inpatient and outpatient social workers’ perspectives. As research demonstrates (Kranke, Kranke, et al., 2024; Kranke et al., 2023), there are major contextual differences associated with conducting inpatient and outpatient social work duties. Previous findings demonstrate that perspectives of VA social workers may have parallels with non-VA social workers (Yuma et al., 2019). Therefore, this case study strives to build on the literature by disseminating perspectives about engaging in telework among VA inpatient and outpatient social workers.