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Aide expectations - Am I being unreasonable?

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  • #31
    Years ago, about 15, I was an RN but staying home and a new mom i went to work early mornings for a guy who was a quad. I worked from 5-6:30 in the morning a few days a week helping him out in the morning so he could get to where he was going. He was a c- something I don't recall exactly. I learned alot from being around him. I had not worked in this capacity before but acouple of things that made it work.. He was very good at communicating his needs. He was incharge - I remember him reeling me in as I was trying to do things for him he wanted do himself but there were days when he wanted the help so no problem. I was only there as a tool to do for him what he needed at his direction or request, He was organized. When he hired me he was very clear about the expectaions. It also helped that I really liked him. Really cool. He could have a great conversation at 5 in the morning. We disgreed alot but got along fine. the fact that if I didn't get up in the am, he couldn't, got me out of bed at that hour. His job ended so he moved closer to his family. We lost touch. I think about him alot since my son's SCI. Can't locate him but think about him every morning for years because I used to dry the bottom of his feet after his shower and it would make him crazy because he would just be putting it back down to get wet until he transferred. He was right and I tried not to do that. Commumication is key.

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    • #32
      Originally posted by marmalady
      So would I - and I'd love to have someone do my dishes, and clean my house, and sort out my closets, lol - but that ain't the way life is. Sorry - just feeling a little 'tough love' here this morning.
      Ah, hello-you're not a victim of SCI and all that it entails. We aren't lazy,are not children. It is degrading to have someone dress you and wipe your a** and we don't ask for the hell of it! I remnember the days when I could get dressed in a minute. Now it would take an hour to get my pants up to my hips and get a shirt on, then I'd have no energy to do anything else the rest of the day.Sweetie-live a day in our shoes and don't dare ask for help-cause that ain't the way life is!Show your "tough love"elsewhere.
      A relationship w/ your husband and all your chores don't even compare to living in a disabled body, let alone a quad body.
      Quad life is exhausting and twice as hard as your AB life. I've been AB before and wore out-it doesn't compare one bit..hopefully you never break your neck to find out.
      With sincere gratitude for your advice,
      Shannon
      Last edited by quad79; 09-25-2007, 02:13 PM.

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      • #33
        Sigh, so once again the war between caregivers and SCI comes to an ugly head - I do apologize if I offended anyone. I'm so flippin tired of the attitude toward caregivers by the SCI'd on these forums.
        _____________

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        • #34
          Originally posted by marmalady
          I do apologize if I offended anyone. I'm so flippin tired of the attitude toward caregivers by the SCI'd on these forums.
          Well, it's not your doing if people choose to get mad over this language:

          I'd love to have someone do my dishes, and clean my house, and sort out my closets, lol - but that ain't the way life is.
          while ignoring that you also said this:

          I understand that you can do these ADL things, and also understand how you want to prioritize your time by not doing them.
          For the record, all of you who are SCI -- we deeply get it that we will never know what it's like. We wish we could; it would make us better partners, parents, lovers, and friends to you. Some of us would literally give our lives to make your spinal cords what they once were, if that were possible. Lots of us do give plenty of energy to making your lives as pain-free, hassle-free, trouble-free as they can possibly be.

          That said, nobody's perfect . . . but I think marm has long ago earned the benefit of the doubt when it comes to how she sees things.

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          • #35
            Originally posted by marmalady
            Sigh, so once again the war between caregivers and SCI comes to an ugly head - I do apologize if I offended anyone. I'm so flippin tired of the attitude toward caregivers by the SCI'd on these forums.
            I don't think your comments were out of line, you are coming from a different perspective, that of a parental caregiver. I think there is a significant difference between a parental/spousal/familial caregiver and one who is for hire. If I'm paying, or causing the pay of, some one then I expect them to do as I require not what they determine they'll do.
            I think every rehab program should include a class in employee management.

            To all: if we are going to demand others to see things from our view. we must also seek the view from their perspective.

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            • #36
              Is this thread going to deteriorate into another battle royale? Let's get back on topic, which was expectations for an aid. An aid is not a PT or OT, and should not act as one by asking the patient do more than she cares to do. If I hire someone to paint my house, should that painter ask me to do it too, just because they think I could and should? I would not accept it from a painter, and would not accept it from an aid either.

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              • #37
                Originally posted by Ben Rolfe
                I think every rehab program should include a class in employee management.
                I agree! I hate being the "boss", especially since I'm younger than my "employees"

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                • #38
                  You are right. Since 1990 our program has included a 1 hour class on PCA management, handouts, and individual instruction for our new injury patients in our rehab program. We also have a twice annual PCA training program (40 hours) that prepares those interested in working as PCAs in the basics, and we can then refer our clients to these trained PCAs as potential employees. Too few rehab programs offer anything like this, and it had always been a dream of mine to create one....which we did when I helped opened our program. The first 5 years it was a grant-funded program...now it is part of our regularly funded and staffed programs.

                  (KLD)
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                  • #39
                    Personally, I do what is asked of me. I do have friends who are CNA's who won't. It's frustrating sometimes. There is a lady I work with who won't feed herself even though she can, but other that that I do what I'm told.

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                    • #40
                      Couple more things...After you come out of rehab, I don't think someone should try to make you "more independent" because you already know what you are capable of doing.

                      About that CNA training thing...Rules for working in a nursing home and home health care are way different. In a nursing home a CNA can NEVER do anything ADL care. In home health care, a CNA can cath, do bowel programs and much more.

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                      • #41
                        Originally posted by SCI-Nurse
                        We also have a twice annual PCA training program (40 hours) that prepares those interested in working as PCAs in the basics, and we can then refer our clients to these trained PCAs as potential employees. Too few rehab programs offer anything like this, and it had always been a dream of mine to create one....which we did when I helped opened our program. The first 5 years it was a grant-funded program...now it is part of our regularly funded and staffed programs.

                        (KLD)
                        That is a brilliant idea!

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                        • #42
                          About that CNA training thing...Rules for working in a nursing home and home health care are way different. In a nursing home a CNA can NEVER do anything ADL care. In home health care, a CNA can cath, do bowel programs and much more.
                          That is simply not true. CNAs who work in nursing homes help with ADLs all the time. This includes dressing, grooming, hygiene, feeding, transfers, wheelchair mobility, etc. All of these are ADLs (activities of daily living), and it will be rare in a nursing home and anyone BUT a CNA will do them. It is common that CNAs in nursing homes (or hospitals) are not allowed to give any medications, including suppositories, do bowel care, catheterizations, tube feedings or suctioning.

                          In many states, CA included, nurses aides who work in the home, through an agency (who must be certified as a HHA = home health aide) are also NOT allowed to do caths, bowel care, tube feedings or any other procedures that "invade an internal body organ", nor can they administer medications. This is common in many states.

                          A PCA = personal care attendant (privately hired, not necessarily certified as either a CNA or HHA, not working through an agency), in many states, has no restrictions at all in what they do, as long as it is something that the employer would be able to do themselves if they were able. This does include caths, bowel care, wound dressings, suctioning, tube feeding, etc. etc.

                          It is the state, usually through the board of registered nurses or the legislature that establishes these rules, rarely just the agency.

                          (KLD)
                          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                          Comment


                          • #43
                            Marm's paid her dues.

                            If I had to pay somebody to do something, I would definitely want them to do what I requested. It's pretty demeaning to have a low level employee refuse, on your dime, to do what they were hired to do. They're gonna stand there, with the clock ticking, and tell you what you need? It's one of those "I'm not paying you to think" situations. If the funding is coming from the government, that is unfortunately another kettle of fish. I still wouldn't like an employee telling me no, but I might have fewer options.

                            I am in favor of everybody doing as much as they can, if for no other reason than being stranded is just that much worse if you've let your shirt-changing skills slide. The time for building those skills is post-injury, before you return to work and your busy life. Nobody needs to spend 30 minutes putting on a shirt before work, or even before church or brunch on a weekend.

                            I just can't see what would qualify a PCA to tell you no.
                            Blog:
                            Does This Wheelchair Make My Ass Look Fat?

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                            • #44
                              Originally posted by SCI-Nurse
                              That is simply not true. CNAs who work in nursing homes help with ADLs all the time. This includes dressing, grooming, hygiene, feeding, transfers, wheelchair mobility, etc. All of these are ADLs (activities of daily living), and it will be rare in a nursing home and anyone BUT a CNA will do them. It is common that CNAs in nursing homes (or hospitals) are not allowed to give any medications, including suppositories, do bowel care, catheterizations, tube feedings or suctioning.

                              In many states, CA included, nurses aides who work in the home, through an agency (who must be certified as a HHA = home health aide) are also NOT allowed to do caths, bowel care, tube feedings or any other procedures that "invade an internal body organ", nor can they administer medications. This is common in many states.

                              A PCA = personal care attendant (privately hired, not necessarily certified as either a CNA or HHA, not working through an agency), in many states, has no restrictions at all in what they do, as long as it is something that the employer would be able to do themselves if they were able. This does include caths, bowel care, wound dressings, suctioning, tube feeding, etc. etc.

                              It is the state, usually through the board of registered nurses or the legislature that establishes these rules, rarely just the agency.

                              (KLD)

                              I'm sorry, I forgot to write BUT in the sentence. That in a nursing home you Can't do anything BUT adl's! And in home care you get checked off by the RN to cath. I've always done BP's in home care...suppositories and dig. stim. We also give meds that the RN has already put in the pill box. I live in Michigan so the rules might be different here. I also think the rules change when anything is funded by medicare.

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                              • #45
                                No, it has nothing to do with Medicare. It has to do with state law. In CA an RN could loose their license for assigning or teaching an aide to do caths, bowel care, dressing changes, suctioning or any other procedure that "invades an internal body organ". This is why we never use agency, but instead use private PCAs. Agencies require only an RN or LVN do these procedures to be compliant with state law.

                                (KLD)
                                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                                Comment

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