In our hospice company i am 1 of 2 RN's who handle only group home patients. These caregivers in the group homes can be demanding and lazy. You have to remind the group homes that these patients pay for their care, these patients pay for caregivers who are available 24/7 and at least one caregiver must have a medication administration certificate or license to administer or deal with medications. If not, that group home isn't complying with state laws. Its not our duty as a nurse to go back and forth to do a little errand. Also remind them that CNA or AID services for patients are always just supplemental help, it is not their job to clean or wash patients before breakfast. I get that issue once in a while. Anyways, dont be afraid to scare the caregivers, they may be worn out from taking care of 5-10 patients in one group home but they signed up for that. They still have responsibility. What if the family came? Would they neglect giving the medication because a hospice nurse is "supposed" to do it? Or what if the patient is soaked in urine by 7:00 am and the family came to visit, would these caregivers not render care or change their pads because a hospice cna/aid is responsible for that? Its ridiculous!
Anyways, always make sure you make it clear to them their responsibilty vs a registered nurse's responsibility.