HEALTH FORUM

Hi Again..

This is not a re-post ... but another question..

In a dual registered care home .. the HCAs are giving /administering
medications to residential clients.
The residential clients are under the care of the District/G.P. Practice
nurses.

The question is who is responsible for the actions of the HCAs ... the
D/N or the in house R.N. in respect to the administration of Medications
?

This is getting complicated .. all advice welcome ..
especially any comments from Care Home Owners and Managers!

Regards Graham

Hi Graham

Neither is the answer
the HCA is responsible to the registered manager not the RNs on the Nursing
side

I was responsible for the actions of my aides as manager of the home BUT as
a nurse was not allowed to undertake any care function otherwise I would
have been providing Nursing Care

Its a political mess and minefield all in one

but the basic idea is if the care home is segregated the Trained nurses
should keep well clear of any involvement with residents just care for
nursing clients
I know its difficult but its the way it must be done



--
Regards
Gray

Registered Nurse level 1&2
Speciality - Elderly Care (private)

Personally Im a basket case
www.madcaravanner.co.uk

Pemrgn wrote in message
news:dg9ijs$7eq$1@news6.svr.pol.co.uk...

Pemrgn wrote:

Also worth running this past the NMC (before the shit hits the fan) if not
done so already.

--
To reply replace telone with onetel

Thanks for the replys

I am away for a couple of weeks so not able to reply or post .. but will
continue to try to find out the info I seek on this problem ..

Regards Graham

Pemrgn wrote ...

Certainly not the DN - its a matter for the HCAs employer what the job
description is.

While ultimately the manager is responsible, the RNs will also be
responsible if they are involved in the chain of command - ie they are
acting as line managers for the HCAs, AND/OR if they have, as part of
their job description, overseeing / supervising / teaching HCAs (which they
almost certaily will have, even if not explicit).

When RNs and HCAs work together, only the RN with a very expensive barrister
has zero responsibility for the actions of the HCAs.

And no amount of rewording the question will change that ;o)
--
Andrew Heenan
http://www.realnurse.net/

Andrew

Technically IF the care home has HCAs dispensing drugs then RNs should
NOT be involved in the chain of command at all. CSCSI would come down on
them very hard if they did as they would not be giving Residential Care but
Nursing Care and that is not what the client would have taken their contract
out for.


--
Regards
Gray

Registered Nurse level 1&2
Speciality - Elderly Care

Personally Im a basket case
www.madcaravanner.co.uk

Andrew Heenan wrote in message
news:dgmj7o$ot1$1@news6.svr.pol.co.uk...

Graham A Wilson wrote ...

Its not about the HCA - its about the RN.
Hopefully theyd notice that HCAs were giving out meds. and hopefully theyd
have a view on As Required stuff being administered by folk untrained in
making such decisions?

BTW, Im assuming though all this that the residents - for whatever reason -
are not able to self administer; if they CAN self-admin, then they are
taking the decisions, and the HCA is genuinely assisting; unlikely to be
problematic.

HCAs (hopefully) perform tasks as required by their contract and manager; no
problem usually, as the manager takes the responsibility.

But if the manager is taking tasks FROM RNs and giving them TO HCAs, then
the RN has to take a professional view on that. If a nurse stands by while
something occurs that may be argued as dangerous, they are as responsible as
if theyd done the harm, themselves.

As doctors used to say First Do No Harm. For non-nurse managers and for
non-nurse deliverers of care, culpability is about contract and
expectations.But for RNs, there is the matter of professional
responsibility. As well.

Cheers,


--
Andrew Heenan
http://www.realnurse.net/

Andrew Heenan wrote in message
news:dhfb19$jsl$1@newsg1.svr.pol.co.uk...

Right (scratches head and thinks)
If the home is Dual registered and the Nursing staff dont (as they are
technically required NOT to) have a responsibility to care for the
Residential clients, then anything that happens to a residential client is
NOT their responsibility.
Its not the management who take the task away from the RN its the way
the regulations are written and applied by the regulatory body (CSCI at
present).

If the home is not physically divided then the RN might be asked for
advice by the HCA but the nurse cannot actually physically intervene -
though if the HCA was acting in a dangerous manner then I dont know any
nurse who wouldnt act

Example
I was (Im not now) manager at a residential home
I was not allowed by regulations to undertake any physical care of any of
the clients as that would be deemed to that I was providing nursing care
which they were not allowed to recieve as they were only assessed in needing
residential care. So if a residnet cut themselves and needed a simple
sticking plaster I was not allowed to apply it - I could tell a Care Aide
how to do it but I couldnt do it .


In MY OPINION the delivery of care in establishments where professional
advice (at least) is not available is severely lacking. There are some
places where care is excellent without a nurse present but they do give GPs
and Paramedics an extra load
as a by product of this many GP practises are refusing to cover more than
one care home if they have a few within their catchment



But for RNs, there is the matter of professional

We will always have this consider first aid at the roadsie following an RTA

Doyou or Dont you ?


--
Regards
Gray

Registered Nurse level 1&2
Speciality - Elderly Care

Personally Im a basket case
www.madcaravanner.co.uk