I'm keeping my nose to the road pretty much these days.
About the aides: What I am seeing in our area is a lot of transient aides...here today, gone tomorrow. Agencies hire off the street, provide little in the way of training and then put them in the homes with clients who are pretty fragile for the most part. What really bothers me most is the lack of certification...(in many, but not all instances).
More than once I have asked an aide why a wound wasn't reported and am told something to the effect....'I didn't see it' or 'I didn't think it was important' or 'well, the client wasn't complaining'. This gets me back to my other question to them: "How often does the RN make supervisied visits with you?"
Most of the time the aides don't know what I'm talking about and, in fact, can't tell me who the nurses are because they've never met them.
I have noticed that the aides who stay on the job are the ones who are: #1 Certified and #2 work for a hospital based home care agency.
For those of you who work for a private, non-hospital based home care agency, are your aides certified? How often do you make supervised visits? Are your aides included in care conferences? In my experience with home care, when aide input is acitively included in the care planning process, there is a higher degree of dedication to the work because their input becomes a part of the patient care planning process and because they are given on-going inservices and RN precepter training to meet the needs of their patients.
I know this doesn't address the pay issue, but honestly, when has anyone working in HHC been paid a decent wage--considering the work that requires doing?! That complaint can go from aide to LPN to RN with great justification.
That gets me back to the old question that used to keep me awake at night.....'where does the money go'? Someone is making a big salary and it's not the employees. Even when all has been taken into account including wages, supplies, mileage reimbursement (if there is any), office supplies and help, office rental (if any), advertisement (if any), how much is left over and who does it go to? (Just look at the charges to insurance or out of pocket fees for home visits and then start deducting).
I could never get figures to quite come out right...any way it was sliced or diced, the employer ended up receiving the greatest share of the profits which are, 'in-their-pocket', profits.
If a belt needs to be tightened in order to provide quality patient care from the nursing assistant on up, then who ought to be cinching up first?