Working with pca's

[ceridwyn]

Just wanting to know if this is a usual thing. I have only just recently began to work in an aged care facility.

Apparently the pca's were in charge until last few years when RNs, mostly div 2's have been employed. The other night I was called to see a resident that did need a review by her GP but an ambulance was not needed nor an admission to hospital.

In front of all the staff in one area of this facility this pca yelled full voice at me, "what the hell I was doing and she was not happy with the lack of urgency of her care for this lady". I reassured her that what had happened to her was not unusual and happens more regular that you think,(gynae problem) but under pressure I called the GP on call who reiterated to me what I thought....keep an eye on her and notify her gp first thing MOnday...

Well now I find out the pca has written in charts she is not happy with the lack of urgency of my care and also I found out today told the son she was being rushed to hospital on that night. I am fed up with the place already...no RN div 1 or 2 for that matter needs this undermining by pca's I cannot be bothered to even have her on my personal care team again, :argue: who knows how far these people can go.......nurses registration board. btw other RN DIV 1's have backed up my actions as well, but I do not think this woman is going to stop there, it feels like a vendetta.

[joannep]

I have worked in aged care also, and yes it seems that pca's with a minimum of education are running the show. Isn't it amazing how much they think they know (and they don't have a clue) and they will certainly take any grievance to the top and probably win. Oh, and they always tell the family what they think should have happened and what the RN should have done. Been there, done that and have moved on.

[hardworker77]

i am a pca who was in charge at an aged care facility on night shifts. i suffered from stress and anxiety as a result, this main reason was because i simply didn't have the knowledge to assess as situation properly. if someone is screaming from abdomen paid (and i mean can hear it across the facility) has something burst? is she constipated? i have no idea how serious it is, so i call an ambulance to come and i get critised by in charge morning staff who is a div 2.

i don't pretend to have the knowledge that is required and when i was offered the incharge morning position i turned it down because i thought i was under qualified, although i know pca's who take it on and do exactly what was quoted above. i'm actually quite concerned its not only happening at my old facility!

it definatly shouldn't be legal to have a pca incharge of residents lives, its just too dangerous. i was working in a srs, and i think there needs to be tighter legislation in place to protect the residents who are paying a fortune for care that isn't there.

[BanoraWhite]

Sorry to hear that Cerdiwyn !

I am a PCA in a Nursing Home and thankfully most of my PCA colleagues follow the advice the nurse gives them. Whenever I am unsure about anything, I see the nurse on duty and I trust them to know what they are doing - after all they have done more schooling etc. They know what they are on about !!

If you are still having a problem with this person, next time she tries to have a go at you, get another nurse in another section to back up what your saying / doing and document exactly what you did, getting the other nurse to co-sign it and add her comments (such as "doctor reiterated what Ceridwyn said. In my professional opinion this is the correct treatment for the resident at this time".)

[joannep]

Always call an ambulance if you are in doubt.

If it had been serious and you hadn't you would have been in deep ****.

Many nurses would have done exactly as you did, so you didn't do anything wrong at all.

[Grace Oz]

There's rocket scientists in every facility!!! *sigh*

If you follow procedures and also do as Joannep suggests, if in doubt ....

(GOOD LORD! am I really backing up something a Victorian sez??!!) Phew! Must be the lateness of the hour! Hahaha!

Hope the days ahead are better for you, Ceridwyn. ((((hug))))

[Mr Ian]

I can only agree with the others on the issues of those who think they know vs. those trained and paid to know.

I'm no knocking PCAs - worth their weight in gold and places grind to a halt without them. But it sounds like there are some serious culture issues that need adjusting.

I am very concerned with this part:

Well now I find out the pca has written in charts she is not happy with the lack of urgency of my care and also I found out today told the son she was being rushed to hospital on that night.

1. She obviously does not understand the context of charts as a legal document. It is also very wrong to write opinion about another worker's care - worse still an unqualified opinion.

2. She obviously does not understand her boundaries in regard giving information in relation to the son.

Personally I would take her to taks immediately on the strength of the written record, any testament of the son as to informatin given and the witnessed behaviour about the unit at the time of the 'urgency'.

Her behaviour is a serious compromise to organisational integrity and I am sure those who are required to manage the home/unit would not want her sort of behaviour to be an example of the kind and standard of care given.

[talaxandra]

I agree with Mr Ian - disagreeing with your decision is one thing (and clearly an issue in itself), documenting that in the notes and talking to the family is something else entirely.

Is it possible to get your organisation to arrange a talk from a legal adviser about communication (written and oral)? Or about your role? As hardworker77 says, when people don't know why you're doing what you're doing (eg assessment, previous experience, what is and isn't relevant), everything's an emergency.

[hollway2]

I am a PCA in an Aged Care facility and I work night shift.This is a low care facility so I work on my own but I have an RN Div 1 on call.It is true that a lot of PCA's think that they know everything and a few, like myself have done their nursing but for one reason or another are working as PCA's.Do not tar all PCA's with the same brush. There are good ones and bad ones, the same as Div 1's or Div.2's.In regards to her documentation and family contact, yes, she was way out of line.Sounds to me like you did the right thing. Good luck in the future

[ceridwyn]

Hi everyone, I only just got back to this post.....to followup what happened next, I c attended my next shift to explain to the second in charge what I was finding out about the place, who had been through similiar situations, I could not return after that, I had constant nausea when I thought about the place.

I rang the supervisor whos reply was...just imagine what it used to be like. when nurses first came here? You get used to pulling the knife out of your back!. residents were always being sent to hospital for the most simple things their GPS could fix in the next few days....it was quite embarrassing for this facility..was not helping me at all....I knew what was happening NOW with some of the pca's.

I wanted the pca involved and her croanies, to be given more education about team work and the legal standing of the progress notes and dealing with families like Mr Ian said. But there was no mention that any of this would happen.

Found myself back at a job I did before and really enjoying it, now ,knowing more of whats out there... hope to do masters and move on to diabetes education or aged care assessment in the community.

When anyone mentions nursing home or hostel work I just shudder ..... it does reflect on the organisation involved, I do believe the nursing care is good, no complaints there, just the team thingy thing is not happening except between the nurses and I doubt any RN will work there. Which is a pity as many residents will find themselves at the hospital down the road for coughing twice in one hour. Families frantic because their loved one has "gone to hospital" and the "nurse" said it was urgent. I have heard another RN left just after me, probably the same thing. Thanks again for all your support. Ceri

God give strength to all those nurses working in aged care.

[alvardalton]

I do believe that education is definitely lacking in the actions of this PCA, as no one has the right to bark at you while at work, patients aren't so staff should not feel entitled either! I find that the action of this organisation in promoting the behaviour of this PCA over the RN is inconceivable, as I work in ED and quite frankly am aware that some of the nursing home patients that present are in no way urgent and could have waited for their GP to review. I hope this organisation now realises the wrong in their actions and that an RN on staff reduces the amount of hot water the organisation can find itself in. I could only begin to imagine what the son of that patient would think after such an incident. I believe you made the right choice in leaving as no professional should have to endure that type of mistreatment. We work too blinkin hard to get where we are.

All the best mate.

[Grace Oz]

I read the other day how they can't attract trained/qualfied nurses into aged care.

One reason cited was the disparity between the wages of acute care nursing and aged care. Same nursing qualifications, but it would appear that those working in aged care are deemed less worthy to be paid the equivalent as their peers in acute care settings.

Add in situations such as posted here, and little wonder nurses work in, or stay in, aged care.

Sad really because older people are still people and deserving of top class, qualified, quality, competent care!

I've always joked; if ever I win the BIG one, lottery, I'll set up a nursing home/hostel for retired nurses and only competent nurses will be employed to care for us! lol

To quote Martin Luther King:... "I have a dream!" lol