Personal Care Assistant Issues (long!)

peds_cna · Dec 26, 2007

If you feel you are being taken advantage of, simply state this is not what you signed up for or expected and either change the terms of the job so he understands fully or leave. People will take advantage of you if you let them, not saying everyone will though. It does sound like to me some things are being put in that were not intended in the original job description, but terms such as grooming can range from very light to very heavy depending on the person. It is always good to get these things down to a list if possible so there is no confusion.

gwenith, BSN, RN · Dec 26, 2007

Wound care - especially packing wounds would not be in any CNA/personal carers job description I would think. This sounds WAAAAAY" outside your scope of practice - as for rolling a 250 KG man by yourself - that too is not on.

One way around this might be to just leave at 1 pm. "Sorry you only paid me until now - I have another patient to go to"

turbohound · Dec 26, 2007

Congratulations, you are letting him take advantage of you. And by not standing up for yourself and your profession, you are doing a disservice to all those involved.

First, understand that you were lied to when you were told that the job would be 'light housekeeping, meal prep, and some grooming.' This is typical, since if they presented the assignment as it really is, they would need to pay a fee commensurate with the real service being provided. So by making light of the job, then loading you down with extra work for no extra pay, they are pulling the old "bait and switch."

Next, by forcing you to provide service beyond your scope of care, they are saving the cost of having to hire a provider with the requisite skills/licensing, and they are placing all the liability for that care on you. Do you understand how dangerous this is? By accepting those tasks which are beyond your scope, you are accepting blame for any negative outcomes from that point forward. It doesn't mater whether you are to blame or not. The moment you go outside of scope, you are fully responsible for everything afterwards. You accept all liability for the outcome.

And what are they paying you to accept all this extra work, and incredible risk? $10.84/hr?

Let's put it another way. Are you prepared to risk your future for $10.84/hr?

And I'm not even going to mention the unethical split shifting you describe above (working 8-1, then 5-9). Except to say that by agreeing to work under those conditions, you are saving them from having to hire another aide for the evening shift.

Demand the pay and respect you deserve. It sounds like you've already earned it.

Virgo_RN, BSN, RN · Dec 26, 2007

I used to do in home care as a CNA. Wound packing would never have been in my scope of practice. Everything else you've mentioned would have. But I worked for an agency and was hired in that capacity. It sounds like you've been hired private duty under less than honest circumstances.

Tait, MSN, RN · Dec 26, 2007

This sounds like an absolutely abyssmal situation!!

First you have my sympathies, I would never have been able to roll a 250lb man on my own.

I think it is time to respectfully deline the position to the place that hired you, and let them know they need a higher level of staffing to take care of this man.

Tait

PS. I wasn't aware quadrapelegics could get erections, guess its all different...or hopefully he doesn't get his jollies faking...

(Just a thought since we had a pt here last week who kept urinating and defecating on himself in order to get the nurses to wash his scrotum, he didn't stop until a nurse called him out on it, then it didn't happen again that shift. All signs of his condition assured us this man should not have problems with incontinence.)

Daytonite, BSN, RN · Dec 26, 2007

Does anyone have any experience with this job description? Am I doing things I shouldn't be? I know I kind of walked in to this,but I really feel like I was mislead.
Any advice would be so appreciated,and I apologize for the length!!!

I worked as a private duty nurse for a number of years and my mother owned a private duty nursing agency. Yes, this is exactly what a private duty nursing assistant is expected to do with this kind of patient.

Private duty is a whole different animal from hospital nursing. You are attending to the patient's ADLs in their home and are giving very personal service. That is why he hired a nursing assistant. Maybe he didn't make it clear when he first hired you, but he needed a nursing assistant to help with his ADLs. That's not just cooking and cleaning. That includes giving medications if they are over the counter or prescription and there are directions on how to give them and you follow those directions. That is because this is the person's home.

Activities of Daily Living include:

Bathing
Dressing
Transferring from bed or chair
Walking
Eating
Toilet use
Grooming

The only thing I would suggest is that you get the work hours and payment for them more clearly defined. Being paid for the hours you work is only fair. This is where working for an agency would help you. Being an independent contractor, you will have to be businesslike and address this yourself with your client.

People in this condition contract for independent nursing assistance because it is cheaper than going through agencies. Sometimes they don't want to pay for a full 8-hour shift which an agency will require after a person works at least 4 hours. Sometimes, they have exhausted the agencies because they have abused the services they were requiring of the nursing personnel and asking for services way outside the realm of nursing. Sometimes, these people are just difficult to get along with. One thing I can tell you about taking independent jobs like this is you need to be very wary of what you are being asked to do and that you are careful not to get into a situation that could end up in malpractice. As an independent contractor you must address any violation of the contract, verbal or written, immediately. I know of one CNA who was driving her client around to appointments and ended up having an automobile accident. The client sued her for the injuries he suffered in the accident and her auto insurance wouldn't cover it because she was using her car for a work related purpose. It practically bankrupted her.

pagandeva2000, LPN · Dec 26, 2007

The hours should be clarified, for sure. Also, ADLs, no matter how hard and unexpected the skill is for that particular client is expected. I don't think that it is far that this person adjust your hours at will because you do have a life. Home care is a different demon, because it is more casual, the employee is more independent, and is also flexible, but, do not allow anyone to take advantage of your services and time.

SICU Queen · Dec 26, 2007

Yes, you were mislead. The job description does not fit the duties you're currently performing.

I do not think you should be packing wounds. You are not a nurse and haven't been trained to do this properly. You should NOT be rolling a 250# man around by yourself. You're setting yourself up for serious injury.

Please do not "give away" your time anymore. You need to leave at 1pm. Period. Working for free is not cool. Also, a split shift wasn't discussed, so don't do it.

Remember that you can only be taken advantage of if you ALLOW it, and basically what it boils down to is that you're being taken advantage of, so put a stop to it. Unless you can stand your ground and demand the working conditions that the job description described, then you need to consider moving on.

Personally, I couldn't do it.

caliotter3 · Dec 26, 2007

For $10.84 an hour, you are being taken advantage of. The job has turned out to be way different than the ad described. No PCA has any business packing wounds for $10.84 an hour. You are being cheated on your hours. Do not even try to rectify the situation. Not enough could be done to make it appropriate for you. Look for a new position.

Ms Kylee · Dec 26, 2007

For $10.84 an hour, you are being taken advantage of. The job has turned out to be way different than the ad described. No PCA has any business packing wounds for $10.84 an hour. You are being cheated on your hours. Do not even try to rectify the situation. Not enough could be done to make it appropriate for you. Look for a new position.

Well said, thank you! I'd be out of there so fast my butt would have flames attached. If you're working for an agency, I would call them and explain you worked 3.5 hours over, he wants you 5-8 also, and I'm not staying over unless I'm paid. Nobody should be forced to donate their time and services. I'd also tell whomever is in charge that I wouldn't be going back to the job because essentially fraud was committed.

EmmaG, RN · Dec 26, 2007

Agreed. I wouldn't even give 'notice', as in my opinion the contract was broken by the employer.