Care Assistant

An interview with Lydia Peppard, Care Assistant.

How did you go about getting your current job?
My current job is a Health Care Assistant. I have worked for the Health Service for the last 20 years as an attendant. Up until the last year an attendant was the only non-nursing role within the hospital. All non-nursing roles were classed as attendants. This role consisted of some care of the clients, cleaning and some catering duties.
In the last few years the national strategy within the Health Service was to break up this group of staff into three distinct roles, Health Care Assistants, Catering Staff and Household Staff in order to provide a better service to the clients using the service. The staff working at ward level were given the option of which group of staff they wished to be part of. The role of Health Care Assistant was determined by staff who had completed the Health Care Assistant's course, staff undergoing the course and then seniority of staff.
My role for the last 20 years was as an attendant within a kitchenette at ward level. I have completed a Skills VEC FETAC Level 5 Course Modules including: Communications, Care Support, Food Preparation and Service, Legislative Procedures & Quality, Nutrition, Work Experience, Infection Prevention and Control and Stock Control and Material Systems.

I wanted to return to the caring role so I opted for the Health Care Assistant's role.

Describe a typical day?
I work in Unit 1 of the hospital. On a typical day working in the unit we have a Clinical Nurse Manager 1, four staff nurses and either three or four Care Assistants, one Household Assistant and one Catering Assistant and we have thirty six clients.
Work starts at 7.45am with the morning report, at 7.55am we assist clients who need help to sit up for breakfast and then we assist them to eat their breakfast. At about 8.45am we collect the dirty dishes and leave them on a table for the catering staff to collect. We then proceed to assist clients with their their toileting, washing and dressing needs, making beds and ensuring that clients are warm and comfortable for the day. Some clients go for physio and some are brought up to the hairdressers to get their hair done and some go up to the Activities Nurse to do activities.
Following a 15 minute break, we ensure we have all the clients settled for the day. Then we fill in their care plans and then bring the dirty laundry to the laundry and dispose of any waste. We then clean the client's bed tables and their lockers.

At 11.30am the clients get their soup, milk or tea whichever they prefer, we assist any client who needs help with their soup. At 12pm the clients get their dinner, again we assist anyone who needs help. At about 12.30pm we collect the dirty dishes onto a table for the catering staff and clean the bed tables and the table in the day room, then we assist clients with their toileting needs and assist clients who wish to go back to bed.
In the afternoon we continue to assist clients back to bed, or give care to clients who are in bed. During the day we make sure to give drinks to clients who are in bed or who are not able to take drinks themselves. If time permits we might bring clients for a walk around the hospital or if it was a good day out into the hospital grounds or garden.

We try and take time to read or write letters for clients who wish us to do this or to sit and talk to clients who are upset or just feeing lonely. At 4.15pm we start getting clients ready for their tea at 4.30pm, again we assist anyone who needs help to eat their tea. We collect the dishes after the tea and clean the tables. Some of the staff go home at 5pm and that leaves two staff nurses and two health care assistants on duty until 8pm.
During the evening we assist clients back to bed, give care assistance to clients who are in bed, put on televisions for clients in their wards, bring soiled laundry to the laundry and dispose of any waste. At 7.30pm we give extra supplements to clients who need extra nourishment and who can't take them themselves. At 8pm the night staff come on duty and we go home.

What are the main tasks and responsibilities?
Assisting residents with their hygiene needs, such as, bathing, hair care, shaving, dressing and undressing.
Pressure area care.
Helping those who need help at meal times.
Ensure dietary needs are adhered to, including special diets and supplementary drinks under the direction of the nursing staff. Report to nurse in charge if any client is not eating/drinking.
The mobilisation of clients including, assisting the nursing staff to turn and re-position using the appropriate aid, i.e. Hoist, sliding sheets etc. Help those who need help with walking and limb exercises as directed. Ensure clients are comfortable in bed or in chairs.
Recording care plans, vital signs and fluid balance as necessary.
Escort clients within and in some circumstances outside the hospital.
Reporting to nursing staff any complaints of pain, distress etc. from clients.
Cleaning and restocking of linen presses/wardrobes and ensure personal clothing is in the correct locker/wardrobe. Ensure correct laundry bags are used, tied and labeled and brought to laundry.
Care of the unconscious client and assisting with the Last Office and with the preparation of the deceased for transfer to the mortuary.
Care of the incontinent clients, promoting continence awareness among Clients who are confined to bed with their toilet needs.
Toileting of clients to include giving, removing and emptying of bedpans, urinals and commodes and the use of bedpan washer disinfector. Reporting on clients bowel function as appropriate Oral and eye care.
Dispose of waste including clinical waste.

What are the main challenges?
The main challenges are the changes that are taking place within the Health Service, everyone has to be more accountable for the decisions they make while they are working in a hospital environment. All grades of staff have to be aware of all the work policies and the correct procedures to be followed while at work.
Up until the last few years attendants didn't need any formal training, they were just there to assist the nursing staff but now they need to be trained and they have to take responsibility to ensure that clients get the care and attention that they are entitled to. Policies are changing all the time so you need to keep updated on them. This means taking time to read and understand them and the affect they have on your role at work.

What's cool?
Cool is not a word I would really use in relation to my work, but what I like about my job is working within a team, having a say in how my work is done.

We have a good partnership committee at work and this allows us to have an input into the changes that are taking place and how they affect us in our working lives. As one of the union shop stewards I have always had some input, but partnership gives more of my colleagues a chance to have their say. This is a very good development because for years our group of workers have felt that they had no input into the work of the hospital and partnership has given a real sense of having some ownership regarding our work.

What's not so cool?
The things that are not cool but are necessary aspects of the job are dealing with bed pans, commodes, cleaning up after clients have had a toiletry accident or have vomited, smells can be bad sometimes. Dealing with the death of clients, most of our clients are long stay residents and you get to know them and their relatives very well, so this is not one of the nicest parts of the job.

What particular skills do you bring to your workplace?
The skills that I bring to my workplace are good communications skills, listening skills, empathy, good work practices, skills on how to control and prevent the spread of infection, team working skills, working on your own initiative.