Many dialysis clinics are undergoing cutting staff. Social workers are expected to take on more patients than they had previously.
Can any social workers offer supportive guidance on how to deal with management's goal of placing more patients on the shoulders of social workers, over working the social worker, and taking away quality of care from the patient? Can anyone offer some facts/ideas on how we can advocate for ourselves in the face of management???
Our mission is to help meet the patients psychosocial needs; this mission can't be accomplished with more patients.

I'm not sure what your caseload is, but in many corporations and private clinics, caseloads are higher than is optimal. I've heard of people with caseloads of around 80 and I've heard of people with caseloads of 300! What probably won't work is saying your overworked. Everyone in dialysis is nowadays.

Review the Social Work Advocacy manual that CNSW developed and provided free to members. This may give you some ideas. There are job descriptions for social worker, social work supervisor, financial counselor and social service aide. These latter two positions are intended to reduce the clerical tasks many social workers are doing that are taking them away from federally mandated responsibilities (and the things that MSW social workers are trained to do), such as assessment, counseling, team care planning, resource finding/recommendations.

Find out what the community standards are for social worker/patient caseloads and look at the social work staffing formula in the advocacy booklet. Be sure that you're not doing things for patients that they can be doing for themselves. If you are, teach them how to do things for themselves.

Be sure that your administrator understands what you can do and what benefit there is to the clinic of having you do more clinical things. For instance, depression is linked with higher mortality and hospitalizations. Rather than saying you want to help depressed patients have better quality of life (too warm and fuzzy), say you want to develop a program targeting patients who are depressed as identified by administration of a standardized survey to determine if you can increase employment, reduce hospitalizations, and increase survival. In financial terms, your administrator should hear -- better revenue stream. Good luck!