Writing Assignment 1.2

Daniela Balint

The Role of the Carer in Health Care Settings

The role of a health care worker is to provide a safe environment for clients while meeting their medical and emotional needs. Care assistants provide basic personal care, social care and emotional support to elderly people who need help with day-to-day tasks. Care assistants may work in hospitals, day centres and residential homes for the elderly. Carers must meet the holistic care needs of the client, including: physical, psychological, social, emotional and safety needs. Maslow's hierarchy of needs is a theory of motivation and personality developed by the psychologist Abraham H. Maslow (1908-1970). Maslow's hierarchy (1954) explains human behaviour in terms of basic requirements for survival and growth. The needs hierarchy provides a useful framework for understanding clients, and this framework has been incorporated into several important theories of medical and nursing care.

The most basic physical requirements, such as food, water, or oxygen, constitute the lowest level of the need hierarchy. These needs must be satisfied before other, higher needs become important to individuals. When these needs are unmet, human beings will focus on satisfying them and will ignore higher needs. Responsibility of the carer to meet the physical needs: assisting residents with their hygiene needs, pressure area care, helping at meal times ensure dietary needs are adhered to, the mobilisation of client, recording care plans, reporting to nursing staff any complaints from client, care of the unconscious and incontinent clients, preparing clients for therapy or medical treatment.

Social needs include needs for belonging, love, and affection. Relationships such as friendships, romantic attachments, and families help fulfil this need for companionship and acceptance, as does involvement in social, community, or religious groups. Esteem needs: after the first three needs have been satisfied, esteem needs becomes increasingly important. These include the need for things that reflect on self-esteem, personal worth, social recognition, and accomplishment.

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Daniela Balint

Self-actualizing needs is the highest level of Maslow’s hierarchy of needs. Selfactualizing people are self-aware, concerned with personal growth, less concerned with the opinions of others, and interested fulfilling their potential. Health care assistants responsibility to be aware and care for the psychological, social and emotional needs of clients, treat clients with dignity and respect, talk with patients, listening them, be empathetic, help clients to feel comfortable in their environment, protect the client rights at all times, be friendly and helpful.

Once the individual's basic physical needs are met, his or her needs for safety emerge. These include needs for a sense of security and predictability in the world. The person tries to maintain the conditions that allow him or her to feel safe and avoid danger. Many people are afraid of hospitals and nursing centres. They are in a strange place with strange routines and equipment, strangers care for them. Some become lonely, scared or worried. The client need to know what will happen, so the carer responsibility is to let the client know why it is needed, why will do it, how it will be done, what sensation or feelings to expect. Additional responsibilities of a health care assistant are: ensuring that supplies of medical equipment are replenished, 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 labelled and brought to laundry, changing sheets, making beds, disposing the waste, setting up equipment needed by healthcare professionals, assisting the healthcare professionals while they administer therapy or treatment.

Observation skills are very important in the care sector. Get into the habit of observing the client during all of your contacts with him. These contacts include bathing, bed making, mealtimes, and any other time when you are with a client. Client observation is a continuous process. Observing begins the first time you see a client. Observation means more than just careful watching. It includes listening to the client, talking to him, and asking questions. Be extra alert to anything unusual when you are with a client. Changes in the client’s conditions, appearance are most important. Watch also for changes in the client’s attitude or moods and the way in which he interacts with other people. Pay attention to complaints of pain or discomfort and to complaints that seem to have no reason. Be alert when the client relates events that took place in your absence. Observation of the client’s

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family and friends is also important and may have great implications for the client’s future care. Use all of your sense when making observations: You can see some signs of changes in a client’s condition. By using your eyes, for example, you can observe a skin rash or swelling of the feet. You can feel some signs with your finger – a change in the client’s pulse rate, puffiness in the skin, skin temperature. You can hear some signs, such as a cough or wheezing sounds when the client breathes You can smell some signs, such as an odor in the client’s urine. Listen to the client talking to hear other changes in his condition. Some changes only the client can feel and describe. Examples are pain, nausea, dizziness, a ringing in the ears, or a headache. Observations are useful only if they contribute to the total care of the client. Therefore, it is an important part of your job to report these changes to your supervisor. Then the client’s total care plan can be revised.

Reporting and recording are accounts of what was done for and observed about the person. Reporting is the oral account of care and observations. Recording (charting) is the written account of care and observations. You report care and observations to the nurse by following rules: be prompt, thorough and accurate; give the person’s name, room and bed number; give the time your observation were made; report only what you observed; give reports as often as the client’s condition required or the nurse asks you to; use your notes to give a clear report. When recording on the person’s chart, communicate clearly and thoroughly. Follow the rules (always use black ink, writing be readable and neat, use correct spelling, grammar and punctuation, sign all entries with your name, record only what you observe, be accurate and factual, record in a logical and sequential manner, be descriptive, use the person’s exact words, record that you informed the nurse, and the time when you made the report, record safety records). Anyone who reads your charting should know what you observed, what you did, and the person’s response.

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Daniela Balint

Different types of care settings in Ireland: Acute care or general hospitals - provide services to diagnose (laboratory, diagnostic imaging) and treat (surgery, medications, therapy) diseases for a short period of time; in addition, they usually provide emergency and obstetrical care. Specialty care hospitals - provide care for very specific types of diseases; for example, a psychiatric hospital Nursing homes or long-term care facilities - provide long-term care for patients who need extra time to recover from an illness or injury before returning home, or for persons who can no longer care for themselves Ambulatory care centers, surgical centers , or outpatient clinics - provide services that do not require overnight hospitalization; the services range from simple surgeries to diagnostic testing or therapy. Home health care - provides nursing, therapy, personal care or housekeeping services in the patient's own home Rehabilitation center - provides intensive physical and occupational therapy; includes inpatient and outpatient treatment Hospice - provides supportive treatment to terminally ill patients and their families

The multidisciplinary healthcare team consists of many different health professionals working to provide quality, coordinated care for the client. The team provides services that support the overall goal of quality resident care. Team members work together to meet the needs of clients. Good communication is essential in providing the best care for the client. A carer will interact with members of the team in different ways: the carer will take direction from relevant health professionals; following observations of the client, the clients environment or equipment, the carer will report back to the relevant health professional, verbally or written mode; where information is received from the client or family members, the carer will report back to the relevant health professional; following receipt of health care plan for individual clients, the carer will implement and report on the relevant aspect of it within their role; carers will record all relevant client information on a record chart. As a carer you will have contact with a number of Health Care Professionals: nursing staff, doctors, physiotherapists, dietetician, occupational therapist, catering staff, cleaning staff, chiropodist, speech and language therapist.

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Equipments used in health care settings: Hospital Beds - These beds allow the user to stay in their own home whether recovering from surgery, illness or maintaining comfort through a long-term disability or ailment. Manual, semi-electric and fully electric models are available. Adjustable beds blend the functionality of hospital beds with the comfort of conventional sleep products. Commodes - Commode chairs and seats are used to assist those individuals that have difficulty getting to and from a bathroom. Hoist - This is an assistive device that allows patients in hospitals and nursing homes and those receiving home health care to be transferred between a bed and a chair or other similar resting places, using hydraulic power. Adequate training is an essential element in the safe use of hoists. A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing. Wheelchairs are used by people for whom walking is difficult or impossible due to illness (physiological or physical), injury, or disability.

Many older adults will reminisce about significant events and people in their lives – it is a way of re-living and re-experiencing their lives. The caregiver can use this to build a better relationship to bridge the past and present to gain a better understanding of the person’s values, needs and resources, but this reminiscing must be directed by the carer to enable a fruitful relationship that ultimately helps the client to become empowered and more able to live with his or her illness in a satisfying and resourceful way.

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References
Sorentino, S.A. and Gorek, B. (2006) Mosby’s Essentials for Nursing Assistant, Elseiver, Philadelphia Preito, E. (2008) Home Health Care Provider: A Guide to Essential Skills, Springer Publishing: New York (googlebooks.ie)

Goble, Frank G. The Third Force: The Psychology of Abraham Maslow. New York: Grossman Publishers, 1970.

Pamela J. Carter (2010) Essentials for Nursing Assistant, A Humanistic Approach to Caregiving, Lippincott Williams, Philadelphia

Encyclopedia of Nursing & Allied Health, ©2002 Gale Cengage. Meleis, Afaf I. Theoretical Nursing: Development and Progress. 2nd ed. Philadelphia: J. B. Lippincott Co., 1991.

Sanders P (2002) First steps in counselling: A students companion for basic introductory courses. PCCS Books

Leathard A (2001) Health Care Provision: Past, present and into the 21st Century Stanley Thornes Ltd.

Coleman P (2000) Village Elders University of Illinois Press

http://www.ncaop.ie/publications/research/reports/40_Support%20Services.pdf

http://currentnursing.com/nursing_theory/

http://webspace.ship.edu/cgboer/maslow.html Timonen, Virpi and O’Dwyer, Ciara (2009) ‘Living in Institutional Care: Residents’ Experiences and Coping Strategies’, Social Work in Health Care, 2009.

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