There are HCA's who work with me who always seem to be in a rush, going through the motions as quickly as possible, sometimes so quickly that they forget things. Now I understand that things can be forgotten, especially when there are so many little things day to day. Yesterday, for example, my HCA forgot to put on my shoes, even though I had asked. She wasn't rushing. It was just one of those things. On the other hand, for some of them the hurry is a constant. Asking them do to something different, something new, is almost guaranteed to draw a scowl.
I've had an idea for quite some time as to why some are hurried where others are not. So today I asked my morning HCA about how her work was structured and how she got paid for it. The conversation was enlightening.
First of all, the HCA's are often given multiple clients with either the same time or within a narrow block of time. The "coordinators" then leave it to the HCA's to negotiate their schedule. That's why one of my Saturday HCA's asked if she could be here at 10:00 AM instead of 10:30 AM. She has two clients in the same time window. By adjusting me forward a bit, and the other client back a bit, she can care effectively for both of us. However some of the HCA's seem unable to do this negotiation well, ending up with crowded schedules where they have to hurry through to see everybody.
I try to be flexible with these needs. I recognize that others have care needs and waiting is frustrating for all of us. I am reasonable. In most cases if they HCA needs a half hour here or there, I don't make a fuss. If it gets to be an hour, then I start to assert myself. It sets a boundary, and it makes life more manageable for them.
The second factor is how they are paid. If the HCA is given an hour to work with me, but finishes in 30 minutes, the HCA is paid for the full hour regardless. So if an HCA can cram two people into a slot designed for one, or even close to that, the HCA gets paid more, as much as twice the normal hourly rate. Getting done with me in a hurry when there is another client waiting means they make more money.
In this area I am not terribly flexible. Cheating my time to make more money doesn't seem right to me, especially when the rush produces errors in care. I have enough issues with my health. I don't need to let that profit motive make things worse for me. I understand their point of view; their hourly rate is really low, barely above minimum wage. So by cramming they can make a better income. I need them to understand my point of view, that rushing my care insults my humanity and can end up in disaster.
I worked in home health care as a young 20 here in the U.S. We didn't get to manage our time. My boss gave me set hours at my patient's home and I did whatever needed doing in that time. I worked 12 hour shifts with some overnight as well as 1-4 hour stints depending on the needs. It was a wonderful and fulfilling job. I got paid 7 dollars an hour because I wasn't an RN/LVN. I did the cooking, cleaning, driving, calling family/doc/nurse care in, etc...I did a lot of transfers from bed to bedside and wheelchair transfers as well. I always had someone working with me. A two-person team. I've always hoped they would issue another HCA to help you. One person just doesn't seem like enough at times. I'm sorry you get the short end sometimes.
ReplyDeleteSeems to me... you should get your full hour worth.. but asking for what is your time surely would bring grumpy HCA's
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