Need Your Input Regarding Homecare

[Iphonenurse13]

This question is specifically geared to those working in home health, especially home hospice care. When a CNA is ordered to assist with personal care and ADLs, should the primary caregiver (if able and present) be asked to assist with transfers or turning the patient in bed, particularly with total care patients? My answer is yes, as the CNA is there to assist with care. However, the are other nurses who feel that the CNA should be capable of turning/transferring patients independently in the homes, and should be providing a time of "respite", so to speak, for the caregiver(s). My argument is patient and employee safety is compromised in those situations where he/she may be expected do these activities alone. What are your thoughts????

[JustBeachyNurse, LPN]

Moved to home health specialty forum to elicit targeted response

[systoly]

it doesn't matter what my thoughts are

(in my area anyway) we wouldn't keep CNAs if the job involved heavy lifting

they'd just work for a facility and make the extra money

[turningred15]

It really depends on our physical therapy assessment of the patient. If the patient is a transfer/assist of two, family is expected to be present to assist the CNA.

We expect and feel we deserve a safe work environment for patient and our staff. If either is compromised we discuss this with patient and/or family and if no changes are made we have and will refuse to provide service.

[SDALPN]

This question is specifically geared to those working in home health, especially home hospice care. When a CNA is ordered to assist with personal care and ADLs, should the primary caregiver (if able and present) be asked to assist with transfers or turning the patient in bed, particularly with total care patients? My answer is yes, as the CNA is there to assist with care. However, the are other nurses who feel that the CNA should be capable of turning/transferring patients independently in the homes, and should be providing a time of "respite", so to speak, for the caregiver(s). My argument is patient and employee safety is compromised in those situations where he/she may be expected do these activities alone. What are your thoughts????

I think it should depend on a few things. One being the POC. The family participates in the POC, and if it is documented to do a 2 person transfer/lift then a family member would have to help. If a hoyer lift is available, it shouldn't be too difficult to lift with one person. It also depends on the weight of the pt and OSHA laws.

It would be unreasonable to expect an aide to lift a 400+lb pt alone without a lift or extra person. It could also be unreasonable for one person to lift/logroll a pt with 2 broken hips. For that reason I think it depends on the situation. But if at all possible, the aide should be there to give the family a break.

And no agency wants a workers comp case. Especially if the agency is at fault for some reason. But I think each situation is different and needs to be evaluated based on needs. The family should also be given reasonable expectations.