People don't take Home Health serious enough..

[Ms. Nurse Assistant]

I am a nurse's assistant (I should be starting nursing school this fall) and landed a job as a home health aide. It is the easiest job I ever had in my life.

The downfall is that the aides seem to not take their job serious enough. I had been scheduled to work 3-11pm shift two days in a row last week and I almost worked three shifts..the next aide did not show up to relieve me later that night at 11pm. She was suppossed to work a double shift but chose not to come in because her husband did not agree with her work hours. I was FURIOUS. She had no business making a committment like that if she knew it would conflict with her family.

even worse, the elderly lady's phone had been shut off due to not making any payments on time..and my cell phone battery was low and I couldn't make any phone calls to contact someone about the aide not showing up. So I worked the whole midnight shift (11pm-7pm) I was ****** when I woke up the next morning to see another hour go by and NO ONE had showed up. I had to leave the house and ask a neighbor if I could use their phone. by the time I had notified the company it was 9am and the aide that was supposed to relieve me did not show up till 11am. And I had to be back to work later that day at 3pm but of course I did not work it. That was the most unacceptable behavior I've ever experienced on a job

I'm starting to notice a pattern is that sometimes the aides seem to show up 30-45 minutes late..and waltz in like it's no big deal. I mean, what if I have another job to go to? I don't think I can do this any longer if I start nursing school..I cannot be late and staying over if this is going to continue. The job is so easy and people can't seem to show up on time for that. It's not like you have to do any hard labor.

[Ms. Nurse Assistant, LPN]

I agree that this is extremely unprofessional, on all counts: the lateness, AND the no-show.

I *have* to comment though, as a home care nurse for a number of years, I wonder what kind of patient you are caring for that makes you say it "is the easiest job I ever had in my life."

For many home care patients that need an aide, they require almost total care. There is the other extreme where someone has an aide but the aide has little to do.

Seems to me that if this is "the easiest job I ever had" that this patient is either not an appropriate candidate for a home health aide, or many things that *could* be done to care for him/her are not being done by the aides involved. Since I hate to think of that happening (though it happens *way* too often unfortunately), then maybe this person really doesn't need an aide? A home health aide is not supposed to be a "babysitter", but is supposed to help the patient with their personal care needs if they are unable to manage them alone.

so far from my experience the home care patients don't need nearly as much care as the ones in nursing homes. She can bathe and use the bathroom all by herself. It's just that she has dementia and needs to be reminded to take her medication and to eat at certain times of the day. Also, she is likely to fall so she needs someone to watch her up and down the stairs.

[CseMgr1, ASN, RN]

That aide who came in extremely late is still employed. I suspect that the RN is desperate for home health aides and really need us working for her.

Desperate or not, this RN is going to have a lot of explaining to do to your State's ORS, if this Aide's behavior ever generates an unwanted phone call to their 24-hour "hotline".

It was for this reason that my former Manager made it abundantly clear to our Aides during their orientation that if they did not show up or were habitually late for a case, they would be terminated. Period. And that was not a threat. It was a promise. "We have applicants who want to work", I heard her tell more than one of her orientation groups, "And you will be replaced, because one call to our State's hotline by an unhappy Client or family member could very well close our doors".

[pagandeva2000, LPN]

This makes me curious...what is the current rate of pay for home health aides these days? The last I remember (and this is at least 10 years ago), many were paid minimum wage. The pay might be one of the problems regarding the screeninig process and retention of HHAs. This doesn't mean that I support their unprofessional conduct, mind you, however, it does give insight to their lack of incentive.

Also, I am hearing that it is harder to get a case for an entire day...many times, HHAs have to be clustered with several cases in order to earn a full day's pay (which is not much for minimal wage earners). Now, if you look at the fact that some may have to take an additional bus, walk long blocks between clients for 2 and 4 hour cases (and there are cases like this in my area, where the insurance will only cover for 2 hours-it happened to my mother), that can be daunting for their bodies and time consuming. Some HHAs work for several agencies in order to get a respectable paycheck to pay their bills.

The entire health care system needs to be revamped in my opinion.

[Katie82, RN]

. I suspect that the RN is desperate for home health aides and really need us working for her. She is a very nice woman, the nicest boss I ever had:)

quote]

I would stick with the job, as long as your boss understands that you have school obligations that take priority. She sounds like someone who will understand and work with you.

You have to remember that some of your co-workers are not on a professional track like you are. They are not likely to ever be. As a Case Manager, I work with a lot of Home Health Agencies. Usually with the office staff, but occasionally with the caregiver. I can tell by talking with them which ones take the job seriously and which are using the job for a paycheck alone. Hang in there, soon you'll be out of school and into a hospital where people can really abuse you..... But the pay is better.

[dusky1228]

I just *have* to comment back. :) Perhaps it is where I have come from - As a hospital nurse (for 14 years), I usually had 8 to 10 patients and sometimes half of them were total care. It was insane. You took off running when you arrived on the unit and did not stop until you left. Yet, you left feeling that your patients did not get proper care from you. It was impossible to do all that needed to done. It was hectic, stressful, and very hard work.

Ah, but see, there's the difference. I also came from a background of having a crazy number of patients to be responsible for-sometimes up to 18-impossible, really. But that's a different issue. An *aide* should be able to have things to do if the patient is involved enough to *need* an aide. With licensed professionals (RN, LPN etc.) of course going from 9+ patients to 1 is a huge break. But for an aide, specifically a home health aide, who always just *has* one patient, there should be enough things to be busy for much of the time they are there.

I think you are thinking like a nurse (and well you should ) but I am thinking not just as a nurse, but as the nurse who is responsible for a home health aide, and that means I have to know what the regulations and rules are for having an aide in the first place. Hospital aides are different too-they also have a more superficial level of care for a number of patients, as opposed to the more focused care of 1 patient like a home health aide does.

[Virgo_RN, BSN, RN]

Ah, but see, there's the difference. I also came from a background of having a crazy number of patients to be responsible for-sometimes up to 18-impossible, really. But that's a different issue. An *aide* should be able to have things to do if the patient is involved enough to *need* an aide. With licensed professionals (RN, LPN etc.) of course going from 9+ patients to 1 is a huge break. But for an aide, specifically a home health aide, who always just *has* one patient, there should be enough things to be busy for much of the time they are there.

Not necessarily. When I did HH as a CNA, there were many times when everything was done, and I had no more to do. In many instances, my role was not direct care, but rather, supervision. For example, one client was a lady with Alzheimer's dementia, who had the potential to leave the house and wander. She was perfectly capable of performing her own ADLs (just needed cueing), but just needed someone to watch her to remind her to do her ADLs and make sure she didn't leave the house unsupervised, and the family was perfectly willing and able to pay for those services.

[pagandeva2000, LPN]

I have to agree. As a home health aide as well as a nurse, I have had cases where after ADLs (or the supervision of ADLs) were done, there was not much to do. It varied with the needs of the patient. If it is total care, afterwards, most of the time, it was turning and positioning every two hours, changing briefs as needed, heat up a meal, but unless the patient had specific needs, the chances were high that I sat there for the rest of the time with not much to do. Some clients don't even want much conversation-something I would be willing to provide because I would get bored sometimes. I usually made sure that I brought books with me to help me stay alert. I never had a client with dementia, but I know with them, would usually involve their immediate safety from wandering, perform or reinforce ADLs, encourage to eat and to alleviate anxiety. Again, the needs would differ with the patient, as well as the agency.