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A day in the life of a personal support worker
June 2007- The following was recently sent to Concerned Friends by a very caring and compassionate staff person. The worker wrote this two years ago while employed in a long-term care home to demonstrate the difficulties faced by personal support workers as they try to administer to the needs of residents.
We would like to hear reactions from others working in Homes.
1:00 am
Uncovered resident, changed incontinent product (has not been toileted after supper ), turned to the other side, covered (10 minutes spent with resident)
4:00 am
Uncovered, incontinent product checked, no faeces, only urine, so not changed (because the time to get up is close no sense to waste the product, apparently good up to 80% of saturation with urine) (5 minutes spent)
6:30 am
Bed bath (washed in bed), dressed in bed, bladder full of urine but, because unable to verbally express the urge to urinate, not toileted holding the urine until too painful and urinating into incontinent product while being transferred into the wheelchair. Full mouth care not done except insertion of the dentures, because of the time pressure three aides have to prepare 35 residents for 8:00 breakfast (15 minutes spent)
6:45 am
Wheeled a wheelchair into the lounge area and left waiting until 7:50 am then taken to the dining room
8:00 am
Breakfast fed in a hurrying manner there are 10 other people that need to be fully helped with meals and only three aides to assist the whole dining room (always two residents assisted by one aide at the same time) (20 minutes spent per two residents)
8:45 am
Wheeled from the dining room into the lounge area TV is on and other residents of that unit are sitting in their wheelchairs. (The aides are assisting with the baths once or twice a week for each resident and taking approximately 20 minutes per bath. Between 4 and 5 baths are given per day, so the aides are busy with baths, shaves, bed making and toileting.) Taken into toileting area and transferred from the wheelchair onto commode chair. Left on for 10 minutes, transferred back into the chair, wheeled into lounge area and left there until lunch time (sitting in the same position in a wheelchair without any chance of moving lower extremities and not able to ask for help and repositioning)
10:00 am
Juice/snack offered
11:45 am
Brought into the dining room
12:00 pm
Lunch time the same manner as breakfast
12:45 pm
Wheeled from the dining room into the bedroom, usually semi-private or shared with three other residents left beside the bed until dining room empty
1:00 pm
Transferred to bed for the afternoon rest
2:00 pm
Juice/snack offered missed because asleep
3:30 pm
End of bed rest incontinent product changed and resident transferred to the wheelchair, then brought to the lounge area, left waiting for supper in the same position in a wheelchair 4:45 pm
Wheeled into the dining room
5:00 pm
Supper time the same manner as breakfast
6:00 pm
Wheeled from the dining room and into the lounge area or, if weak, beside the bed left sitting in the same wheel chair until assisted with evening care consisting of :undressing, transferring to bed, washing of face, hands and peri area and changing of the incontinent product (time spent: 15 minutes?)
7:00 pm - 11:00 pm
During those three hours the residents are being assisted and transferred to beds - because of shortage of nursing staff only basic needs are covered, there is no toileting,- only two or three aides designated to assist 35 individuals at evening time. If there is someone with special needs, such as palliative care or emotional distress, not much of an extra support is provided due to the lack of staff's time
Note:
No time for social interaction or for emotional support;
No exercising (requires one-to-one), or physiotherapy;
Bound to the wheelchair all the time when not in bed;
If any activities are provided by the institution, they are usually group events, when people are herded together few times a week for loud music or bingo, etc only small fraction of the residents participating (anticipating);
Every day, every week, the resident is deprived of normal, intimate human contact and the undivided attention of another person. If there are no supportive relatives, the only time of human interaction is when being washed or fed, or given the medications. |
