A Tale Of Two HCA's

I have two new HCA's working for me, one of whom wants to do a good job but struggles, the other of whom doesn't really want to do a good job yet still struggles. It's interesting to see the approach taken by the two of them. While the first does her best to pay attention to what she is doing, the second is almost completely unaware of what's going on while she works with me, seeming almost resentful about having to do the work.

So lets start with the most problematic, my new morning HCA. She has been through this routine a couple of times. When she arrived she said she wanted to get the commode chair. I said she had to drain me first, to which she replied "We can drain you in the shower." I think somehow, notwithstanding other mornings, that I might magically drain my own bladder while sitting in the shower. I know others can do that; alas I cannot.

She grabbed the catheter supplies and started the process of draining me. I reminded her that we had to do peri-care first, to which she said "Why do we have to do peri-care? You're going into the shower." I reminded her that I didn't want he shoving that catheter down my urethra without cleaning that area first. She was unimpressed.

There were a couple of other questions like that, none of them seeming to come from curiousity about process. Instead they fell into the category of asking why she had to do something, looking for a way to not do it. I could attribute them to a desire to fine efficiencies. Somehow, based on tone of voice and approach, they didn't sound like that.

The worst moment came when she was transferring me into my commode chair. She had the brakes on the chair, while the chair feet were braced against by bedframe. When the chair became jammed, she went to move it back, only to realize the brakes were on. She undid one brake. As she moved to the other side I said "Be careful. This chair is going to fall.." My warning went unheeded. She undid the other brake. My commode chair slammed to the ground, potentially hurtling me onto the floor. I was ready, my hands gripped tightly to the handles. I knew my warning would go unheeded.

Perhaps the best one of the morning was when we were close to done, having successfully failed to do exercises or make breakfast. She was wondering if we could start making some sandwiches. I asked her if she had read the list on the door. She said "I know what is on the list!" I replied "Then why don't I have any water on the table." She filled my water jug.

The list on my apartment door shows the five most important things the HCA must do in the mornings. They are

1. Make my bed and ensure the sling is setup for the next use.
2. Ensure my water jug and mug are filled.
3. Sweep or mop the floors as needed.
4. Empty or start the dishwasher as needed. Clean other dishes not in the dishwasher.
5. Take out the garbage or recycling as needed.

Total combined time to complete the list, assuming you have read it and focus on the tasks, is about 10 minutes or less. It's easy to do while I am in the sling, minding my own business. I asked her to start the dishwasher and handwash the few remaining dishes. When that was done, she immediately when to the daily book to sign off on her tasks, notwithstanding that some remained undone.

The floor is still stained and dirty. The garbage and recycling are both full. As to making the bed, well, she took a minimalist approach; no quilt, sheet only, and it was upside down with the head at my feet and the foot at my head.

The there is my new night HCA. She is trying hard. I know it's difficult for her; she's a mother of four so her days are long. I am her last client of the day. Yet each time she is here she has become more proficient, getting things done in a timely manner, remembering the things I need in place before she leaves. The final thing on her list to remember is plugging in my power chair. I am confident she will get that done tonight.

I will leave you to decide what the difference is between the two, and why. For me, I just have to live with it until things can change. Today we did not do my exercise. I have had no breakfast; I won't eat until dinner in about 3 hours. I'll live.