C.N.A. in Home Health Nursing - I am supervising but kept in the dark

  1. I was under the impression that my home health agency verified the competency of their C.N.A.'s before sending them into my patient's homes. I am only doing infrequent "supervisory" visits, usually unpaid as part of my own nursing visit or recertification visit. I am continually shocked at (1) incorrect technique/results in obtaining vital signs (2) C.N.A.'s not reporting significant findings to me (3) C.N.A.'s being replaced without my knowledge with other staff members (4) insubordination of C.N.A.'s to me and (5) a lot of other questionable behaviors. I just learned today that the way my agency has of checking C.N.A. competency is to have the new hire fill out a checklist of skills that they "think" they know -- the agency does not test them! If I am going to spend my time doing additional supervisory visits to teach C.N.A.'s I may get my supervisors feathers in a ruffle because insurance will not reimburse for these "extra" visits. Any comments or other similar situations?
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    About LuLu2008

    Joined: May '08; Posts: 135; Likes: 42

    3 Comments

  3. by   caliotter3
    I can see why the insurance company wouldn't pay for extra visits to supervise CNAs. CNAs are supposed to be competent before they are sent to people's homes. Their skills should have been learned while in CNA school. If they are that deficient, you should speak to your boss at the agency and suggest mandatory inservices at the office where these CNAs can get their act together in the presence of their employer instead of the patient/family. This could be unnerving for the patient. The agency can pay everyone involved out of their own budget, instead of relying on the insurance company to pick up the tab. Suggest a two to four hour "skills day" to have X number of CNAs checked off in the office. If time is needed for extra training or practice, that could be taken care of. When you do supervisor visits in the home, you should just have to write up the supervision as it occurs. If the CNA is acting like a do do bird, maybe removal from the field would be warranted until they decide they want to be up to par with their job. Good luck with this. I don't really think your agency is concerned with the problem.
  4. by   LuLu2008
    Quote from caliotter3
    I can see why the insurance company wouldn't pay for extra visits to supervise CNAs. CNAs are supposed to be competent before they are sent to people's homes. Their skills should have been learned while in CNA school. If they are that deficient, you should speak to your boss at the agency and suggest mandatory inservices at the office where these CNAs can get their act together in the presence of their employer instead of the patient/family. This could be unnerving for the patient. The agency can pay everyone involved out of their own budget, instead of relying on the insurance company to pick up the tab. Suggest a two to four hour "skills day" to have X number of CNAs checked off in the office. If time is needed for extra training or practice, that could be taken care of. When you do supervisor visits in the home, you should just have to write up the supervision as it occurs. If the CNA is acting like a do do bird, maybe removal from the field would be warranted until they decide they want to be up to par with their job. Good luck with this. I don't really think your agency is concerned with the problem.
    I hear you 100% and agree! The agency is not really concerned, and I KNOW if I suggest the skills day idea I will be told to dream on.......
  5. by   Ginger's Person
    I'm a CNA, and applied for a bunch of jobs last month. One home health agency called to interview me after I submitted the shortest job app I submitted in my life... no references, no resume, no nothing. The interview consisted of the following questions:
    Have you done personal cares before? (They were totally uninterested in when or where or what)
    Are you willing to work for $10/hr?
    Do you have access to a car and full insurance?
    Do you mind doing light cleaning and cooking?
    Are you sure you're really willing to work for 10$/hr??

    I didn't feel remotely safe about working for that company (or very excited about working for $10/hr), so I don't. But, I was shocked to realize that's the kind of screening some CNA's go through before they're hired.

    I don't know what you could do to fix the situation to keep your license and your patients safer, but if they are forced to improve their hiring process by nurses who are unwilling to supervise dangerously bad CNA's, perhaps they could find a more serious bunch of CNA's?

    It sounds like a crappy situation, I hope you're able to make some change in that company.

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