CNA vs. PCA vs. HHA

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I just got hired to start training as a PCA (personal care aide) for a home care agency and I'm wondering how this differs from CNAs and HHAs. I know CNAs work more on the medical side and HHAs do a lot with ADLs, so are PCAs somewhere in the middle?

Does anyone here work in home care? Do you like it? (Pros/cons).

Thanks!

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Specializes in L&D.

I'm a home health aide. It's not too hard of a job, and you get to know your clients pretty well. The most clients I've had in one day was two. At least it's not like a nursing home where you have 15 patients! I hope you enjoy your new job. (:

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Thanks.

I'll have 4 clients per day (8 hour shift, 2 hours per client)...

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A CNA is a certified nursing assistant. This is a licensed career. You can call yourself a CNA without this license. CNAs who work in hopsitals are usually called PCT (patient care tech) or PCA (personal care attendant). The hospitals that I have noticed with PCAs, either use the term interchangeably or as "sitters." They use PCTs as PCAs before they have finished checking them off of their skills. Not all PCTs are necessarily CNAs. A nursing student after some period of experience can get a job in a hospital as a PCT/PCA without getting a CNA license first. I do not think that HHA, and know that sitters, do not have to be licensed.

Oh, and I work in a nursing home as a CNA. I take care of anywhere from 4 (uncommon) to 10 "residents" depending on acuity level. On our rehab units I typically take care of 5 or 6. But my place of employment may be an exception.

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I thought CNAs weren't licensed, just certified...

PCT is a term I never heard of until I came to these boards. Sitters are just that. Literally all they do is sit and watch patients (at least where I'm from).

Hmmm....

And in NYS a PCA is a personal care aide which is also a certification.

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From my knowledge and I can only speak from what I know since I'm currently working as a PCA (personal care assistant) at a hospital, is that they use PCA as another term for CNA in hospitals in general. We take care of ADL's and medical also; they train us to assist the nurses in more ways by taking the patients vital signs, I can perform an EKG by myself when asked to by the nurses and they used to train all PCA's in phlebotomy but not so much anymore. Empty foleys, drains, & etc... I was told by my manager that I may be trained on it, later down the line since I work the night shift incase any emergent situations arise in the middle of the night when blood needs to be sent to lab quickly and the phlebotomists aren't in yet (they work 1st and 2nd shifts only). I can observe the nurses perform any procedures that they allow me to watch or assist in. Very helpful since I plan on applying to nursing school in two semesters. I have friends that are CNA's and family members and that's how I was able to compare what PCA's do versus HHA's and CNA's that work home care and at nursing homes. We also are interchangable and if needed to are pulled to do 1:1's watching over one patient that is at risk for whatever reason. To add one more thing depending on what floor you work on and the census my pt ratio can vary from as little as 3(very, very rare) to as much every patient on that floor in which I am on a 24 bed floor O_o depending on staff coverage. Also I'm at a teaching hospital that offers a training program in which I was hired into, so I'm also not a certified CNA. Hope this helps you out some. =)

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Wow...here a PCA is nothing like a CNA. They can't even do vitals!

My instructor said that CNAs and HHAs are essentially the same but CNAs work in hospitals and nursing homes and HHAs work in home health.

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I have worked in home health care for over 3 years now, and I have worked in LTC facility for 2 years before working in home health care. I thought I would like HHC better than LTC because of the flexibility of hours and one-on-one attention to clients. When I first started with HHC I really liked it, even though I wasn't getting stable hours. Now I am getting to the point that I don't like it as much. If you luck up and get a regular client, great. I have gotten lucky a few times with wondeful clients that treated me like family. I have also been stuck with a very unpleasant person's house while they slave drive you for 8 hours. God forbid you sit down to eat lunch or anything of that nature. I only like going to client's homes where they live by their self because I have been to clients homes where all their family lives and you have to try to work around them to try to get your work done. Sometimes the family can be helpful but mostly they get in my way. Not to mention you end up having to clean up after the family, even though I am there for the client and not to be a maid to the family. If I can help it, I try to only go to client's homes that are at least semi-mobile (where they can walk and have to deal with a wheel chair minimally). I find out what kind of neighborhood they live in and if they live in a dangerous part of town, I will not go to that client's house.

I thought I would mention also that I am a younger caucasian female and I have no problem going to African-American clients. I have had some good experiences with some but sometimes they do have a problem with me especially the older generation in this part of the country (I am in the southeast). They have animosity towards me for no apparent reason other than because I am white. This has happened to me a couple of times at different homes. Some of them have a chip on their shoulder and believe that it is an opportunity for them to work me to death while showing no appreciation for my efforts. I try to be as sweet and kind as I can be and perform all the tasks on the care plan as thoroughly as I can. They also want me to do way more than what is on the care plan. I actually went to one black lady's house and she took one glance at me when I walked in her house and before I could even introduce myself she said "I don't know why they keep sending these WHITE girls out here, they don't know how to take care of BLACK people." Really? And she was VERY condescending and talking down to me like I was nothing to her the whole time I was at her house. She kept looking at me while I was doing my work and kept talking about how many HHAs she gotten fired at my agency and was quite proud of it. I did everything I could to please her and completed the tasks on the care plan and treated her as politely and as gently as I knew how and she STILL called the office and complained about me! I have a good reputation at my company so they knew when she called up to complain that she was full of crap! They asked me anyway what happened and I told them everything she told me. She is still a client of the company because my agency has tried to send me out there a couple of times and I say NO WAY. No I am not racist, but I do sometimes get treated differently at African-American homes. I imagine African-American HHAs probably sometimes gets the same grief at caucasion homes.

I have had my good experiences with HHC though. I had a regular client for over 2 years up until he passed away. I loved him so much and his family. I was even mentioned in his obituary which was very honorable and made me cry when I saw it in the newspaper. I still keep in touch with the family now because we grew that close. I have a client now I have been with for almost 3 years and I am very close with his family too.

HHC can be very rewarding if you can find the right client's that fit your personality and work style.

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I am a C.N.A, NO, you CANNOT call yourself a C.N.A unless you are certified AND licensed by the state. There are classes you must take; do well in the tests for those classes; do your clinical hours; and pass the state exam.Just because you pass tests from the classes, and or have even done your clinical hours, it does not mean you will automatically pass the state exam - if you don't, you need to find out the process in order to retake the state exam & if you need to do anything else. There is a tremendous responsibility to yourself and your patients to make sure you learn everything in the courses, on the job, and whatever else you can on your own. Learning infectious disease protocols, how to avoid x, y, & z is critically important. You also need to get your Hepatitis B series, and speak to your primary doctor as to what other vaccines would be beneficial to you and your patients - like the flu shot, pneumococcal vaccine, any boosters, etc. The medical field is very serious. There are literally lives at stake, including your own. Do not go into it if you do not want to do all the work of learning, all the processes, and all it entails if you are not willing to give it your everything.

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I am a CNA with over 20 years experience and I have worked in a number of hospitals as a PCT (patient care tech) or NT (nurse tech). Currently I work as a HHA/HCA (home health/home care assistant) for an agency. There is a small difference between the three and where you work. Usually, the majority of CNAs work in skilled care facilities performing very basic skills, I.e., bed making, giving showers/bedbaths or in some instances, tub baths, feeding pts who are unable to do so independently, assist with ADLs, grooming, dressing and toileting and personal hygiene. A CNA who becomes a PCT usually has had previous training or experience as a CNA, but get additional training obtaining EKGs and phlebotomy, depending on the facility, and in some instances, simple drsng changes, and d/c Foley's and IVs. Some PCTs start IVs as well.

HHAs/HCAs also have some training as a CNA, but they do not perform any medically related duties. They usually are home care assistants, in that they also perform basic bedside skills, assisting clients with simple day to day activities, light housekeeping, laundry and cooking. They don't obtain VS, or obtain Accu-√s, or administer meds; however, they do remind clients to take their meds.

I guess you can say I wear all three hats but I DO NOT give meds. However, if my patient becomes suddenly ill, feels feverish, lightheaded or dizzy, I will first call 911, and I will check their VS, and if my patient is diabetic, I will also check their blood sugar.

Sorry for the Gettysburg Address here, but I wanted to be clear on each assistive personnel's roles, which, sometimes can overlap.

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Sometimes they overlap...you may have had prior CNA training, and have worked in hospitals or skilled nursing facilities. Hospitals call their CNAs PCTs or nurse techs, and they usually have additional training in phlebotomy and EKGs in addition to basic bedside care. Home care assistants may have had CNA training as well, but they usually do not perform medical tasks, only housekeeping duties, meal preparation, laundry and companionship for their clients.P

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HHAs/HCAs also have some training as a CNA, but they do not perform any medically related duties. They usually are home care assistants, in that they also perform basic bedside skills, assisting clients with simple day to day activities, light housekeeping, laundry and cooking. They don't obtain VS, or obtain Accu-√s, or administer meds; however, they do remind clients to take their meds.

I guess you can say I wear all three hats but I DO NOT give meds. However, if my patient becomes suddenly ill, feels feverish, lightheaded or dizzy, I will first call 911, and I will check their VS, and if my patient is diabetic, I will also check their blood sugar.

Sorry for the Gettysburg Address here, but I wanted to be clear on each assistive personnel's roles, which, sometimes can overlap.

I'm a HHA and we absolutely 100% do do VS and depending on the situation, administer meds (just about 3 weeks ago we were administering morphine to a client who was passing an on hospice/comfort care). Yes, we also cook and clean and bathe and ADLs, but we do just about the same as a CNA, just in a different setting.

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