Personal Care Assistant Issues (long!)

[fifi2323]

Ok,so this isn't a nursing thread per se,but I am having a dilemma,and am in desperate need of advice!

I just started a job as a 'part-time' PCA for a quadraplegic man in his 30's. He is pleasant,but meticulous and demanding (I understand he probably needs to feel more in control of his life,so I can deal with that aspect), but I really feel like I am doing things that are not within my scope of practice (1 semester of LPN school!,not a CNA) On my first day (12/22) I was told by the patient,and his caseworker that I was going to to work from 8-1.

In that time I had to give him a shower,transfer him via hoyer 4 times,roll him without a draw sheet, as well as insert a suppository and change his condom cathether.The job was originally described to me as 'light housekeeping,meal prep and some grooming'!

After all this,I ended up there until 4:30 (but only paid until 1!!!) He told me it had been a busy week and that it wouldn't happen again.He then tells me he wants me to come back from 5-9. At this point I became very visibly upset-I was clearly in way over my head.

The next day,it was the same lousy schedule.I was so sore (not used to rolling over somebody 250lbs by myself!) but I went back because he didn't have anyone else to help him.He tells me bowel care wont be a routine, then he has a loose BM in his brief,and acts surprised (he has some sensation as he knew when he had to go the day before) Finally toward the end of the second shift,I was packing his wounds and when I turn around to get a 4x4 he had a full-on erection!

I don't want to ditch the guy,but alot of what I was doing made me very uncomfortable. Am I being unreasonable?

I am supposed to go back there on Saturday,against everyones advice. I dont want to let anybody down,but I think for $10.84/hr I am being taken advantage of.

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!!!

[caliotter3]

As sorry as I feel for the client, he has probably pulled these tactics on caregivers before and may have trouble getting people to work for him. He would not be very welcome at any agency. They tend to stick up for their employees more than this scenario indicates. It would probably be in his best interest to advertise for a male caregiver and to mention heavy lifting in the ad. Just because there is a hoyer lift to be used, doesn't mean that you're not doing heavy lifting. Good luck finding a better position and don't be overly sorry for the client. He is most likely aware that his behavior is partly to blame for his inability to get caregivers.

[chadash]

Ok,so this isn't a nursing thread per se,but I am having a dilemma,and am in desperate need of advice!

I just started a job as a 'part-time' PCA for a quadraplegic man in his 30's. He is pleasant,but meticulous and demanding (I understand he probably needs to feel more in control of his life,so I can deal with that aspect), but I really feel like I am doing things that are not within my scope of practice (1 semester of LPN school!,not a CNA) On my first day (12/22) I was told by the patient,and his caseworker that I was going to to work from 8-1.

In that time I had to give him a shower,transfer him via hoyer 4 times,roll him without a draw sheet, as well as insert a suppository and change his condom cathether.The job was originally described to me as 'light housekeeping,meal prep and some grooming'!

After all this,I ended up there until 4:30 (but only paid until 1!!!) He told me it had been a busy week and that it wouldn't happen again.He then tells me he wants me to come back from 5-9. At this point I became very visibly upset-I was clearly in way over my head.

The next day,it was the same lousy schedule.I was so sore (not used to rolling over somebody 250lbs by myself!) but I went back because he didn't have anyone else to help him.He tells me bowel care wont be a routine, then he has a loose BM in his brief,and acts surprised (he has some sensation as he knew when he had to go the day before) Finally toward the end of the second shift,I was packing his wounds and when I turn around to get a 4x4 he had a full-on erection!

I don't want to ditch the guy,but alot of what I was doing made me very uncomfortable. Am I being unreasonable?

I am supposed to go back there on Saturday,against everyones advice. I dont want to let anybody down,but I think for $10.84/hr I am being taken advantage of.

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!!!

This is typical care for a quadraplegic patient. Their job description was very unreal.

I did this work, and the needs are great for this kind of patient.

I would suggest initiating a bowel program to get a handle on when and where this happens. It is good for the patient, and make your job easier to manage.

If you can redefine what you have to offer, and set your own parameters, that would help.

I am concerned about you turning a 250 pound person who can not assist in the turn. That is just out of the question. The caseworker should be aware of this issue.

I am glad you have a hoyer. Is it stable, and do you feel you can use it safely alone? In general, two people are to be present with a hoyer.

Is the condom catheter effective? how new is this injury? Does he do intermittent caths for bladder retention? It seems a quad would need this.

Just sounds like there is not anyone that is overseeing what he needs, and how these needs can be addressed.

I think this is a situation you might have to leave.The case worker just does not seem to have a real picture, so she underplays and isn't providing for this poor man. You, singlehandedly, can not compensate for her lack of judgement.

Have a good talk with her, explain what the job really entails, and maybe you will increase her understanding, and therefore his care should improve as a result. I am concerned about you and him.