Private Duty Workers In Hospital

[Nurse0621]

When pts have their own CNA's in hospital do they normally do all the cares? Or do you do it as the nurse? I had pt recently who has private CNA's around the clock and do all the repositioning, bedpans, meal assist. At the end of my shift the pt said that i didn't wash him.??? I had asked the CNA several times if she needed help and she said no... I am so confused now as to why they didn't wash pt or ask for help? Does anyone have a similar experience? Thx.

[Flo., BSN, RN]

When my pts have had private duty CNAs they do all CNA dutites except vital signs. Our CNA do the VS so we are sure of the accuracy.

[RubyRN,CHPN]

I would think from the onset I would have a discussion with the private duty personnel as to what assistance they would be providing the pt. so our plans of care would mesh. That way, there would be no miscommunication as to whom was doing what.

[SKM-NURSIEPOOH, BSN, RN]

also, check with your facility's policies regarding private duty personnel & staff personnel's responsibilities. i would think that the facilities' staff are ultimately responsible for the overall care of patients.

for example, what if the patient has a private duty rn, would they be responsible for doing meds/treatments? would they dispense medications to the patients that are non-formulary (or belonging to the patient)? or would that responsibility belong to the onsite/facility nursing & pharmacy personnel?

it would seem to me that any and all care is ultimately under the responsibility of the facility's nursing personnel. remember...whatever is not documented is not done. if you, in fact, either supervise or perform adls & pass medications, then you will document it & it will stand-up in court. if you haven't observed or perform said tasks, then legally...it wasn't done.

hope this help ~ cheers,

moe

[ObtundedRN, BSN, RN]

I have only encountered a few patients with private duty workers in the hospital. And they always sat in the chair watching TV. It is my job to take care of the patient, but it is also their job. Obviously I wouldn't allow them to do any kind of meds, dressing changes, or any other therapy. But I would expect them to at least help reposition, maybe do a little mouth care. Then again, I dont' know why the patient really felt the need to pay for them to be there, other then I'm sure they've developed a relationship with their care provider and it may be similar to having a friend or family with them.

I think I've usually only seen this in pre-existing quads or ALS patients (or something similar). Someone that needed someone to always be by their side for when they needed something and the patient could do it or call out for help.

[P_RN, ADN, RN]

Make it specific to the point of giving them a check list. If they just sit and not work then you should tell their agency they did not work as a CNA but as a sitter-a much lower pay rate. OUr hospital only allows certain agencies in the building and they have to have a contract with the hospital as to what each category of personnel will do.

[caliotter3]

I made it a point to speak to the private duty CNAs to get them on the same page as what they would be doing and what to expect from our facility personnel. That way there is no reason to get to the end of the shift and find out that the resident has not been cared for, even though the private duty CNA still might have plenty of time to watch TV or read.

[steelydanfan]

A private duty nurse is either a sitter or a CNA who will only do basic care and/or monitor the pt.s safety needs.

Have a meeting at start of shift to delineate responsibilities, according with your facilities policies.