Need experienced home health nurses input on this situation.
I think that when a home health aide gets a new patient they should at least know the patient's diagnosis. A person at one of my home care jobs feels that the HHA does not need to know what is wrong with the patient. My response is what if the person has a diagnosis such as:
seizure disorder
H/O previous MIs
H/O CVA or TIAs
H/O falls
bleeding problem
Osteoporosis
Swallowing diagnosis
I could go on and on with I think is a "scarey" thing to not tell someone caring for a patient as each one ties to precautions of signs you might be more observing of given a person's history.
I think the HHAs need to know this................
Specializes in Hospice and Palliative Care, Family NP.
I appreciate everyone's input on this subject. The DON still feels the same way and the hha's are not told.
Scarey to me,
renerian[/quote
I work for a home health/ hospice agency and our CNA's know DX of all patients and participate in IDT meetings as well. It only makes sense. Many times when they are out in a home, they will notice a need or change in condition and call it in to the office. I don't know how your CNA's can give good care and folow a care plan without knowing. It is scarey!
I have been with the same hospital for almost 17yrs.Every nurse that I have work with has given me a complete history of a new patient on the service and also of the ones I may only see once,because someone is off.We have an ABC book with the patient SOC info in it.And the nurse always gives verbal info about the patient. Bettyboop1 in Tampa Bay
I'm a nurse that works in home health and my aide(s) know exactly what the diagnosis(s) is and the plan of care of the patient. What if the patient has IDDM? Sleep apnea and on a c-pap? And so forth.... Aides I know, work overnight with no nurse present. Apparently, this DON has never worked in home health. Besides, in my experience, home health "rules and regulations" tend to be "a little bent", when it comes to practical care, anyway. A knowledgeable aide is invaluable, and could be a "lifesaver", which has happened occasionally.
I AGREE THAT HHA'S NEED TO KNOW PT DX!!!! I HAD A PATIENT WITH DM THAT THE HHA CUT HIS TOENAILS:angryfire CAUSED MAJOR PROBLEMS!!! THE AGENCY I WORK FOR DOESN'T EVEN ALLOW THE RN TO CUT DIABETIC NAILS WITHOUT A MD ORDER, IS THIS THE SAME EVERYWHERE??
When i worked as an aide, i worked with nurses that though diagnosis were none of my business as well. So here i was, trying to get a resident to walk, not knowing they had a risk of falls or CVA.
Like alintanurse said, it only makes sense that we deliver better care to our patients when we are well informed about their condition. Really, that should include everyone.
I have encountered the very same thing!! And I totally agree with alintanurse's statement!!
I work as a CNA and HHA in Ohio. I'm not given explicit diagnoses most of the time, but I am told about their capabilities (mobility, ADLs, continence) that will affect how I give care. For example, I will be told to give someone thickened liquids, but not that they need them because they had a stroke. I will be told that someone is confused, but not that they have Alzheimers.
While I feel it would be beneficial and more thorough to know the actual diagnosis, I feel I am given enough information about how their diagnosis affects their ADLs that I can perform my job efficiently. Especially in home health, I always ask my manager lots of questions about the resident's abilities and needs before accepting the assignment since as someone mentioned, there's no quick way to get help.
So in a nutshell, if your HHAs are given info about the resident's needs (based on their diagnosis), I don't think the actual diagnosis is that crucial. What's crucial is for the HHA to have enough information to effectively and safely provide care.
This is a big part of the reason why I can't continue being a CNA-- I don't feel like a part of the team because some places DON'T want you to read patient's charts to find out dx.
Wow if you get report from your manager rather than your case managers it must be a smaller company that has that homey feeling. Most DONs with over 100 to 200 plus patients their care don't have time to give report about the home health aide care plan/nice they have time to do that. The agency I am referring to has over 400 so no the DON does not have time to talk to every aide but the case manager does.
I am still convinced that writing down something like:
Epilepsy
It better than something like watch for seizures as the etiology of the seizures is not known without the illness descriptor.
Thanks everyone for commenting and yes I agree the CNA/HHA is part of the team and should be deemed party to information needed before caring for someone.
Wow if you get report from your manager rather than your case managers it must be a smaller company that has that homey feeling. Most DONs with over 100 to 200 plus patients their care don't have time to give report about the home health aide care plan/nice they have time to do that.
Well, sort of. I work at a "senior living community" that has independent, assisted, and chronic care living situations. I work as a CNA in chronic care, and a HHA in independent and assisted living. I don't know how many clients we have in home health, but it's probably around 30-50 total, so yeah, pretty small. We've got a manager and a coordinator who does all the scheduling, and both are very available to me if I have questions before, during, or after providing care for someone. I'm sad to hear this isn't common, since it really makes for a much more comfortable work experience.
CANRN, MSN, RN
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