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.

[katie258]

Short sideline. We got an ambulane in about two, three months ago with a DOA from our local nursing home. When the boys got there the RN was holding her hand telling her everything would be allright. So ambos dutifully

transported her to us.

Now I know our doc might think he's god.....

Then she rang to see how she was doing, I said she's dead, she was dead when they picked her up, like what did she think we were going to do? Then the family ring and abuse us because she didn't die at the NH. I mean how dead do you have to be before your dead in these places? They send us diabetics whos BGLs are out, well they control the food, if it's low give them some juice and a banana, what do they think we are going to do with them?

[Mr Ian]

I said she's dead, she was dead when they picked her up,

Surely if she was dead before the ambos loaded her - they would have noticed and called for a GP to certify death instead?

[hollway2]

Must have been pretty dumb ambos if they can't tell a dead body from a live one.All the ambos iv'e called always check the patient/resident. Also you said it was an RN. Doesn't really say much for her either, does it.

[katie258]

The ambos said if they are called they have to resus. I don't know but seems a little odd to me. Mind you these are the same people who bring us drunk and disorderlies too, love to know what the rules actually are. Yes the RNs and PCAs are a little short on grey matter. Same RN decided since she has (apparently) her masters in critical care nursing she would come and work in our wee hospital. Poor thing had never heard of patient centered care and thought the ENs were supposed to make her beds and do her showers and meds. Not sure what she thought her role was. I think that some people work so long doing the same things they get out of touch with the rest of the world. As for the PCA the OP mentioned I think the same thing applies, as soon as this PCA came accross somthing she thought she knew a little about she overreacted and then couldn't back down. Some of them like to put new people in their place.

[alsal41]

I'm glad I got to read this thread, it gave me a greater understanding of who feels what when. I don't want to sound down on either side in particular but ............

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.

Having been a PCA in aged care, I can actually see her side ..... having worked with some pretty atrocious RN's, I can REALLY see her side. PCA's can be treated awfully .. maybe not by you, and maybe not by some of the rest of you, but there are RN's out there, who make Hitler look like the nice guy. You don't know who she has had to deal with before, and I'm actually impressed she actually noticed something wrong with the resident .. I've seen too many residents ignored by PCA's whilst an underlying infection turns septic, I've seen too many RN's blow off a cerebral bleed, a CVA, a heart attack. Yes, this PCA could have approached this in a much more professional manner, but sadly, there is a breed of PCA out there that do think they own the place and yes, a little bit of knowledge can be a dangerous thing.

I am now a Nurse .. in a hospital, and there is no way, in God's earth I would go back to Aged Care even qualified now. Aged care is brutal. It's all about the damn paperwork and the $ ... I have worked in a variety of NH's and trust me, from the PCA side, they're all the same. Maximum nursing for minimal $, whilst the RN's and EEN's have to jump through the paperwork hoops, answer to supervisors who know nothing about nursing and only see the business side of things. Everybody is stressed.

When I was a PCA, I had a resident having a stroke. I noticed one eye had blown. I rang the RN who said "So what?" 1/2 hour later, she had a lopsided smile .. rang the RN who said "So what?", yes, all minor things but I KNEW what was happening and nobody was listening. 1 hour later, this residents arm was paralysed, rang the RN .. yeah .. you got it "So what?" .. within 5 hours, this lady was fully paralysed down the right hand side .. THEN the RN rang the doctor .. bit late sunshine ........ pity the "caring" part was ignored *sigh*.

That's one of the reasons I got qualified. So I CAN make a difference. So I CAN educate upcoming PCA's and let them, those at ground zero, help me give better care. I probably would have sat this PCA down and explained what I was doing and why. I'm asked to qualify my judgements in hospital, I would expect no difference in Aged 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

Yes .. ME TOO!!