Mary Kate Leister

Personal Practice Reflection

Explain your values and what you have learned about empowerment, acceptance, being
non-judgmental, objectivity, self-determination, confidentiality, accountability?
COMPETENCY 2.1.10 bullet 3
I value diversity. I value the chance to learn new things, meet people who are different
than I am, and spend time with people who know things that I may not know. I relish the fact that
I am learning from the people I work with. I believe this helps me in my acceptance process.
Because I am naturally curious, I tend to think that accepting others is not a hardship I
experience. Acceptance is more readily available in my life than others.
I value empowerment. I value the ability to work with clients and give them the tools and
support that they need to feel that they can do things and they have the ability to do the things
they want to do. I love being able to enable my clients to do the good things they have planned
for themselves.
I value the ability to make choices for myself, and I know my clients value this as well.
This, through my experience in home care especially, has been very prevalent. Selfdetermination is a big deal in the medical social work world, as it should be in every realm of
social work. If we cannot meet our clients where they are and allow them to make the choices for
themselves, how are we supposed to make a difference in their lives? Even better, how can we
expect our clients to want to change things if they are not making the decisions for themselves?
Objectivity is hard for me. I want to look at each patient as an individual case. Every case
is different. So its hard to have to follow rules that apply to every situation, in the agencies eyes.
For example, as a home health care medical social worker, there is a whole slew of rules and
regulations that need to be followed, and a very limited amount of resources available to some
patients because of age restrictions or monetary restrictions. This makes it extremely hard to do
my job as a social worker. But then you compare home health care to hospice care, where
hospice has so many more resources to access and they have the ability to say yes to their
patients far more than most home care social workers. I value rules, but sometimes I feel that I
value individuality and I value situational circumstances. This is a conflict I will have to continue
to work through as I develop myself professionally.
Accountability is something that is easier for me when I have other people that are
responsible for similar things working around me. For example, the UnityPoint at Home team of
medical social workers has four field social workers that go out in the field and do
documentation and visits. The four of them are all held to the same standards, and the
performance of each is monitored by their supervisor. This kind of accountability, both from
peers and supervisors, is something I am used to having. As someone who is still in school, I
have classmates who assist me in keeping accountable on things as well as having professors
keep me accountable. I feel that I need to learn to value accountability a little bit more, and build
myself to be accountable from the inside instead of always being held accountable on the
outside.

Confidentiality is something I value. I always look back to how I would feel in my

clients shoes. I wouldnt want my business broadcasted to everyone around me, especially when
it comes to sensitive information like health issues or a criminal history. I also believe that when
it comes to confidentiality, there are certain reasons that should be broken (for example, if a
client told me that they had plans and means to hurt themselves or someone else, I would feel it
ethical and my moral responsibility to alert the proper people of these plans).
Differences may come about between my values and beliefs and the values and beliefs of
my clients. As a professional, it is important for me to recognize these differences and know that
they are normal. It is also important that I never impose my beliefs or values on someone else. I
do not always have to agree with the choices or lifestyles my clients make, but I have to respect
the fact that they have the right to believe how they want and live how they see fit for their own
personal journey.
Were there any policies, procedures, or general practices at your agency which caused you
to have a conflict of values? If so, describe and tell how you resolved the conflict(s). Are
there any policies you believe need to be changed? Give an example and how it would
impact the agency. COMPETENCY 2.1.2 bullet 3
The largest, most constant, conflict of values that came up in my placement was the
difference in perspectives between some of the nurses and the social workers. Social Work Visit
orders come from either a physician or a case manager (which is a nurse) for home care at
UnityPoint. Often times, social workers are ordered to place a patient into a facility. This
brings a huge conflict of both values and a conflict between disciplines. Social workers cannot
magically place patients into facilities, for multiple reasons. Some patients do not have the
funding or insurance to pay for these facilities, some patients do not wish to go into a facility,
and some patients do not qualify for certain types of facilities when we see them. This makes it
hard to go into a visit. For instance, if a nurse went into a patients home and assessed that it
would be safer and better for their overall health to be in a nursing facility, even if the patient
expresses that they do not wish to leave their home, they would order a Medical Social Work
visit for the patient in their home to assess placement. Therefore, a social worker is going to go
into the home simply to write documentation that the patient wants to stay home. The most we
can ever do in these situations is to offer information, education, and support to the patient. Self
determination vs. safety and medical ethics issues is the largest conflict of values Ive seen in this
placement. It was brought up almost on a daily basis by the social workers I spent my time with.
The way that the agency sees taking care of the above issues is through education. The
social work team has given multiple presentations on what the medical social workers role is on
the home health team to the other disciplines that they work closely with. But I still see the
frustrations of the social workers because they still receive orders for things that they cannot
physically do or accomplish for a patient. I feel that it needs to be addressed in another step
(maybe someone should be screening what orders are being made for. Not only would this assist
with better budget for the agency, it would probably ease some of the frustrations between the
nurses and the social workers).

Another values issue that has come up a couple of times this summer: having a patient or
family member of a patient be promised that the social worker can do something for them, when
in reality that something is not a possibility. In my experience, I have been on a couple of home
visits where a patient or their family gets it in their head that the social worker can do something
for them (such as get their family member placed in a facility or in the hospital to go to a nursing
facility to be paid for by insurance), when in reality these are not things that the social workers
have power to do. It creates a strained relationship between the family/patient and the social
worker, and it creates a hard working relationship for the nursing staff and the social worker. The
nursing staff sees a problem, and they know how to fix it, so they tell their patients to do as they
are asked and everything will work out. That isnt how social work goes, and it makes it hard to
work together sometimes.
I think that misunderstandings drive a lot of the value conflicts in this position. I think
that if UnityPoint continues in the direction they are going (educating the other staff), they might
be able to help alleviate more of the problem. One of my suggestions would be to have new hire
nurses (and even the current nurses who may not know) ride with a social worker to a couple
visits so that they know what social workers are able to do and know the kinds of resources those
social workers have and do not have access to. Nurses that are educated on what the resources
are and how they work and know what the social workers are able to do are the ones who work
well with the social work staff at UnityPoint. I feel that education and attempts at understanding
help dissolve most conflicts in the workplace. It requires open minded people and the ability to
have hard conversations without letting your feelings take over (which isnt always an easy
thing).
A policy for UnityPoint at Home that may help to alleviate some of the issues would be
to have resources and interdisciplinary roles explained at new hire orientation. This should be
readdressed for every employee every 6-12 months so that everyone understands how each role
works together to provide the best care for the patients (because care for patients is really why
our agency exists). I feel that having the knowledge of what each discipline does would be
helpful to everyone, even the social workers. I, as a student, would have loved to have some sort
of informational session or even just a little write-up of what the different roles in homecare are
and what it is that they can and cannot do for our patients. This could impact the way the team
works together and could boost patient care. When the team works well together, they have
better odds at completing their goal more often (Best Outcome For Every Patient, Every Time).
How have your attitudes regarding people/situation/policy changed since becoming a
social work major? How will that change impact how you practice?
I like to think of myself as an open-minded individual. I feel that learning the theories
and practices behind social work has helped me to open my eyes even farther when it comes to
working with people different than myself. I feel so blessed to be able to be part of a field that
allows for diversity and change. I am a curious person and I love to learn about things that are
not always on my radar. I feel that since learning about and majoring in social work, I am able to
put my curiosity to professional use.

I am such a people person. I love to help others and have conversations with people, even
when they are hard conversations to have. Social work has allowed me to learn new skills and
new interests with working with others.
Through the social work program at Loras, I learned a lot about looking at people from
all different angles. There is not just one part of our lives that defines us; there are many parts of
our lives that define who we are and the things we hope to accomplish. The fact that social
workers really take this into account and look at their clients as a whole person is one thing that
originally attracted me to the program. I hope to continue to keep up to date on the education that
comes with really knowing how to put this into practice so that I can implement it in my work.
Before I entered the social work program, I would have told you that I did not like
politics and that I would avoid anything politics related because they werent my interest. After
spending time learning how important it is to be involved in politics and learning how I can be
involved in politics beyond the scope of just voting, I fell in love with advocacy and lobbying. It
is now my hope to be able to lobby/be an advocate in politics as a profession. Politics and policy
are now two of my favorite things to discuss with others and to research.
The social work program has assisted me in learning about myself in the process of
learning about others. Because of my education, I fully plan to continue to immerse myself in
current events, politics, and policy changes, as these will have effects on many of my client (and
potential client) systems. I feel so at home in my title of social worker and I feel that I have
this level of comfort because of my education and the experiences I had in the social work
program.
Considering your strengths and limitations- what are your plans to utilize/capitalize on
those strengths and improve on those personal limitations? COMPETENCY 2.1.1 bullet 2
I am confident in my abilities to build relationships and trust with clients. I know that as a
social worker, it is extremely important for us to be able to create a rapport with our clients.
Social Workers often have the bad wrap of being the bad news givers and we are often given a
poor public image by the clients that are not happy with our services. Because of this knowledge
that I have, it is one of my goals to be able to work as a social worker that changes the public
opinion of what a social worker is and what we do. I may not change everyones perspective, but
I hope that I can positively affect enough people that I can make some sort of a positive
difference. It is important to me to continue to be strong in this area while I am practicing my
social work.
I am confident in my abilities to document information on my clients in the proper and
professional way. While I am not perfect at this, I hope to keep these skills up and continue to
grow in them. Documentation is beyond important to social work, as it sometimes is the source
of funding for an agency or a position. Documentation also assists agencies in keeping track of
what happens with clients in case a situation were to be questioned after the fact. I hope to
continue to learn new documentation skills as I work and grow in the field. These skills will be
put to use right away in almost every position I work. This is a skill that I have received positive
feedback from my mentor on.

I feel that I lack in some of my interpersonal skills. As a social worker that is very
interested in groups and macro level social work, some of the individual level skills still escape
me. I want to continue to work on allowing silence to happen without feeling extremely
uncomfortable. This has been a goal of mine throughout college and while I feel I have made
some improvements, I know that there are still some improvements I could make. I also hope to
learn and zero in on some of my skills when speaking to different groups of people. I still tend to
get caught up in what I want to say and how I am going to say it. This affects both my listening
and speaking skills when with a client. I hope to continue to work on these skills in the near
future at my new shelter position.
I also want to work on being able to identify what it is I really want to work on when it
comes to my professional life. I have so many goals and hopes for my career, and they are all in
different areas of the field. I want to be able to have a track for each area that I hope to work on. I
feel that this is something that can come with time; I hope that as I have more experience in my
professional field I will learn better ways to achieve my goals.
I feel that one of my biggest obstacles is confrontation. I dont like to confront people that
I work with. I become nervous about losing my job or not getting along with my coworkers if a
confrontation were to arise. I know that a large chunk of what makes an agency great to work at
is the people you work with and for. This is something else I hope that I better my skills with as I
work in the field.
How will the roles you performed at this placement prepare YOU for a career in the field
of social work and other roles you may encounter? (be specific) COMPETENCY
2.1.1.bullet 3
Through my field experience, I was given the opportunity to take on some Social Work
administrative roles. I worked with my field instructor on some hiring processes and the
orientation process for social work students at UnityPoint at Home. I was given the opportunity
to make some tools and information sheets for future students, and I also gave feedback and
suggestions to the supervisory/educational staff on things that would have been helpful for me as
a student to have. I am beyond appreciative of these opportunities because social work
administration is an interest of mine. Because I had the opportunity to explore this kind of a role
through experience, I feel that I have learned a little more about what social work administrative
roles require. I am excited to gain more experience in this area and use my process and policy
skills that I recently acquired to use.
I gained experience on the Front-lines as they are often called, as well. I was placed in
the role of a field social worker for the home care side of the medical system. I learned
assessment tools and strategies for discussions with clients. I learned how to have patience and
remain calm, even in situations that are higher stress. I learned flexibility and patience. All of
these skills are important to someone in the social work field, because we work with so many
different kinds of people. We have to be able to adapt and provide services to all clients,
regardless of the blocks we come across.

Examine the challenges faced by under resourced client systems and how has social policy
impacted their lives.
The first thing that comes to mind is the healthcare issue we see in the United States right
now. This may be because I have spent the summer in a healthcare system, but this is big news
right now in the US, let alone in Iowa. Medicaid switching over to private insurers has been a
huge deal and has been really hard on a lot of our patients. The Health Care Act and Iowas
Medicaid Privatization has led to a huge gap in assistance. I cannot state how many times I have
seen families who struggle to afford parts of their healthcare because its too expensive to have
the insurance policies they need, but they dont quite reach the requirements for medicaid.
Medicaids requirements are tight, especially since the changeover to privatization in Iowa, and
the amounts of money and assets people are allowed to have in order to receive Medicaid
assistance are so incredibly low, its almost sickening how little someone has to have for the
government to really be willing to assist. Its so hard to watch my families and patients slip
through the cracks because they cannot have the care they need because they simply cannot
afford it. This gap is creating a new wave of clients for social workers because this group of
people not only needs assistance, they need advocacy so that their issues are heard at the state
and federal level. While there are programs that exist to assist patients, there is still a large gap in
the assistance that people are receiving
Another challenge I see, specifically in Iowa and with patients, is the fact that state
assistance programs are so backlogged because of budget and availability due to changes in the
system. The Health and Disability waiver through our Medicaid program is so backed up that
people who applied to receive assistance in 2013 are JUST NOW receiving their slots to have
their assistance. It creates a huge frustration in our patients who need assistance now, but are not
already on the waiting list. It is often that we have to tell our patients that they will not receive
the assistance they hope for for at least two to three years, and some of our patients dont even
have that long to wait. Social workers, again, are needed to be that voice to urge our lawmakers
that a change needs to happen in order to better care for Iowas residents.
What is most challenging for you in the Code of Ethics document? How does this
document play out in the arena of practice?
In further reading and discussion of the Code of Ethics over the last few months of field, I
feel like the hardest part of the code for me is the responsibility to co-workers section. Not
necessarily because I feel it will be hard to respect and assist my co-workers, but because I feel
that it is so extremely hard for me to confront people. I feel that when issues of holding my coworkers responsible for what they are doing that may not be ethically correct come about, it will
be hard for me to confront that co-worker instead of just going to someone else. I have a hard
time confronting people that I respect. Im not sure if its a fear of hurting their feelings or
seeming like I have my nose in business that isnt necessarily mine (maybe its both!). I know the
right way to handle those situations, but its the going about doing it part that is hard on me. I
know that not performing my role as a responsible co-worker and confronting someone could

hurt my clients, but I also know that confronting someone could hurt my work environment, and
both of those are important to my ability to do my job well.
If I am being honest, I would also point out that the research portion of the document is a
struggle for me as well. I know how to create research questions and how to look for
information, but the math and statistics part of research is one of my weaker points. I have never
been strong in math. I feel that this is a skill I will have opportunity to understand a little more
once I am in the field practicing this section of work.
As for the Code of Ethics in general for practice, I feel that the document is important to
drive the way we, as professionals, develop a sense of who we are as professionals. The ethics
were built to assist social workers in their practice, not only to work well with their clients, but
also to work well with one another and to pay attention to the values that all social workers
share. The ethics, I see, is a way to bring social workers together, because it is something that
every social worker knows (or should know) and should be holding themselves up to. The ethics
document should shape a social worker through their entire career, not just when they first start
their careers. As we change and grow as professionals, the ethics should mean different things to
our practice.
How have you become more culturally competent through field and what are the
challenges you still face in your impending practice?
Cultural competence is something that is important to me. I am a very curious individual
and I am attracted, if you will, to finding things and people that are different than I am. I feel
that I have a lot to learn from people who are not in my own cultural framework. In working with
the homecare system for the last few weeks, I have met so many people who lived lives that are
different than mine.
I feel that I have become more comfortable around older adults with my field experience.
My field experience in home care allowed me to visit many different people in their home
settings. I used to be very concerned and nervous about spending time with older adults, but
through the practice of working with so many patients that are considered that age group, my
comfort level has become so much broader with them.
Through my time at UnityPoint at Home I have met so many different people that come
from so many different places and perspectives. I am so appreciative of the fact that I live and
work in an area that allows me to have this opportunity and experience. Everyday is different at
the office and on home visits. I never know what all I will be walking into. But thats what makes
me excited to be a social worker. Not every day or every client will be the same. Every situation
I encounter will be unique. Through my home visits as a social worker, I have met people who
have moved to Des Moines from other countries (such as the Philippines) and I have met people
who have different religious beliefs than myself (such as Jewish and Buddhist). I also have met
people of different skin color with different styles than mine. I believe the fact that this position
allows me to feed some of my curiosity is what makes it so incredibly interesting to me.
I know that there are still situations I will be uncomfortable with. It is still hard for me to
feel comfortable visiting a home that is dirty and unkempt. I grew up in a home that was always

clean and well cared for. I believe it is important to ones mental, physical, and emotional health
to live in a home that has some sort of cleanliness and order to it. This has been hard for me to
get past sometimes when I sit in a home that looks as though it hasnt been cleaned in years. I
cant help but sit there and wonder if that has something to do with why my patients have such a
hard time getting healthier. I also feel a tinge of guilt when I visit these homes because I become
frustrated and irritated and uncomfortable and I dont believe I am very good at keeping that
hidden from my body language and facial expressions. This is something I hope to become
stronger at. Not necessarily being comfortable in a place that does not fit into my personal
standards, but being able to remain strong and keep that hidden from my outward expressions
and discussions with people. Im not sure if I will continue to do home visits in the future, but
this is certainly something I am glad I am aware of now so that I can work on it.
I also find it hard to be in a situation with someone who is extremely evident in their
Catholic faith and beliefs. Although this might not be a super cultural thing, I feel that it partially
is. I grew up in a Catholic home and in Catholic schools and I had many negative experiences
with teachers and priests and other parents in our school systems that made me very
uncomfortable with Catholicism. I wont even claim Catholicism as my religion anymore
because I have been pushed away from it by the way I see others act on their faith. Now,
whenever I encounter people who are very aggressive with their Catholic beliefs, I shut down.
I get angry and overwhelmed because I feel that sometimes, this can come off as pushy and
judgemental. I hope that I can continue to find some balance with this as I continue my work as a
social worker.
I dont necessarily know if this is a challenge, but it is a goal I have posed for myself. I
love to learn about other people. And I absolutely adore other cultures because I feel that I am
bettering myself and my world view by listening to and learning about other groups of people. I
have imposed a goal upon myself to never lose that curiousness. I hope to continue to learn about
other cultures and systems as a Social Worker. I have access to resources that allow me to have
the ability to find information that knows no limits. And it makes me excited that this is a
possibility for me. This is something I hope to never lose.
Describe the value of your Loras education in relation to your future career, leadership
and/or graduate school goals.
I value my education from Loras. There is something to be said about receiving a liberal
arts degree from a well-recognized school. While Loras was not the big university feel, it was
a family feel. And that was important for my learning options and capabilities. I felt like I
mattered on campus, that my teachers cared about me, that I had the opportunity to know most of
my classmates and fellow Duhawks, and that I was able to recognize almost every face on
campus and know that we were all part of a great network of people. This gives me peace of
mind as I enter the working field, because I know the chances of me running into a fellow
Duhawk are pretty good.
I feel that Loras has prepared me to take on both my career and my future education
goals. I plan to work full-time while finding an option for graduate school, even if it means I take

a couple years off of school to save the money for graduate school. Loras is very centered on
shaping well-rounded individuals who excel academically, professionally, socially, spiritually,
and even personally. These goals of Loras are instilled in students before they ever set foot in
their first classroom. As a freshman, it was hard to understand why I was required to write a
paper before I even entered the school or why I had to prep myself to be part of the colleges
community, but looking back I fully understand why Loras implements this process. It allows
students to be aware of the high expectations and to challenge themselves in ways that they may
not have done before.
I believe that Loras academically pushes its students to learn beyond the realms of their
interests and their career/major choices. While I personally did not love every single class I sat
through (Democ, anyone?), I am glad that I was pushed to learn outside of my comfort zone. I
was pushed to question my values and take them one step further. I was pushed to take my
knowledge one leap higher.
Loras, I feel, has given me so many opportunities. Not only did I have classroom
opportunity to excel, but I was involved in different groups on campus where I could hold a
leadership position (as I did in Alpha Sigma Alpha) and I took advantage of the programs and
opportunities the CEL office had (such as paid internship positions, AmeriCorps, and resume
workshops). I was given enough opportunity that I was able to build a great resume while still in
college, and my hard work was recognized when I made it to the Deans List a few times during
my last couple years at Loras. I cannot help but be thankful for everything I had the opportunity
to do and learn at Loras, because I know that not all schools allow for these opportunities with
their students.
What constructive feedback can you offer the Program for ongoing improvement in the
Social Work Program as a whole for future students.
I want to start this section off by stating that the Loras Social Work Program was a home
away from home for me at school. I remember going into my initial interview with Nancy and
stating that Social Work makes me feel more like me than anything else, it makes me feel like
Im at home. I love the fact that the professors take the time out of their busy schedules to be
available resources for both Alumni and current students. They take an active interest in their
students learning paths and they work to connect students with as many resources and
networking options as humanly possible. I feel confident that I can come to Brad, Nancy, or
Michelle whenever I need to for questions or assistance, even though I am not going to be a
current student for much longer.
I am also extremely thankful for the many independent study/internship opportunities I
was given while earning my degree. I feel that I have a lot of experience to draw upon in my
field placement, and I feel that my experiences have helped to prepare me to work full time when
I am available to do so. I also feel that I have been shaped into a more prepared student and
social worker entering the field. I feel truly blessed and thankful for the many opportunities I
had. I may not have loved all of my internship placements, but I was able to take something
away from each placement that allowed me to learn and grow as a professional. At all worst

costs, I was able to learn the things that I should not do as a professional. I would not have
changed any of my opportunities or options for anything. More students should be using this
option at school.
I may have a slightly different perspective than some students, simply because I switched
into the Social Work Program after two years in the Education Program, so my real experience
with the program is only about two years worth (which feels so incredibly short!). Some of the
things that I feel I missed out on may be due to my switching so late, or the fact that I had to
prioritize all of my required courses before the things that I was interested in so that I could
graduate on time. Some things I wish that I had had the opportunity to do include: learn more
about professional lobbying/meet more connections with Loras that have experience in lobbying.
As a macro-level interested social worker, lobbying and activism and advocacy are HUGE to me.
I love the idea of being able to go to the state capitol and petition for the laws that will benefit
clients.
I wish that there had been more offerings of Career Options for social work majors.
Every semester it was offered, I was required to be in another class. Im not sure if this is a
feasible request, but I feel it would have benefitted me in many different ways.
If I had any one thing that I would push to change about the Social Work Program, I
would suggest adding information to the curriculum on finding a field experience that can be
paid, even if that means students have to work with grants or other programs that allow Social
Work students to be paid for their field experiences. As a summer field student, it has not been
easy to work part time and have some money to live off of while working a basically full time
job with no pay. I know resources are limited and that there may not be anything to offer
students, but at least giving students the information and even ideas of field placements that
allow students to be paid or work part time on the side at their placement to earn some cash
while completing their field hours would have been extremely helpful.
Another suggestion I would have is to expose students to licensure practice questions
prior to taking field. Even if that means giving students a copy or two of practice tests to look at.
Allowing students to see practice questions and know about the available resources to assist in
preparation for the test also allows them to know their options. I have been able to find different
resources by asking around (there are apps on iPhones...not sure about Android because I do not
own one, there are also books and classes to take in person or online). Knowing the resources
and associated costs of those resources would have helped me to better prepare to begin that
process.
Overall I am so beyond grateful for my education at Loras with the social work program.
I met some amazing people and I have learned both in and out of the classroom. This journey
that I am completing is something that I would not change for anything.