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Future Care Cost Reports - Nurse V’s Heath Care Assistant! I am currently preparing a future care costing report on a young man who suffered devastating injuries following a work-related incident. This case is both heart breaking and distressing and directs us to acknowledging that some families are presented with extremely challenging life events. While preparing the above report I contacted a nursing agency, an agency that I would regularly quote in similar reports, to identify if the previous quoted rates remained unchanged. This is a process that I would perform, on a yearly basis, in order to ensure that the rates I quote are accurate and up to date.After contacting said agency and speaking with a very helpful and friendly lady over the phone, I was advised that this agency no longer provided nurses in the community and that a health care assistant ‘would do exactly the same job and there wasn’t much difference between the two’. I’ll be very honest, with gritted teeth, I graciously thanked the lady for her assistance and ended the call in the manner it was commenced; politely, respectfully and kindly.After hanging up the phone, I was left with a feeling of dissatisfaction and annoyance. How could someone be advocating for a health care assistant to replace the need for a nurse and even more concerning believe that there was very little difference between the two! This is not the first time that this issue has arisen. I have read many nursing care reports (most certainly not my own) that refute the need for a nurse and replace the skills, knowledge and expertise of said nurse with those of a Health Care Assistant. If you have not already guessed, I take great issue with Health Care Assistants being viewed as an equal, yet more cost effective, alternative to a nurse.Before I get an onslaught of anger from all the wonderful healthcare assistants out-there, I would like to outline that I consider that health care assistants in Ireland are a crucial component of our healthcare system. The level of care, support and role they play in the delivery of our health services, both in hospital and in the community, is outstanding and I do not mean to belittle their importance. They are an essential and wonderful group of carers who do a tremendous job on a daily basis.However, I would consider that the care provided by nurses and the care provided by health care assistance is most certainly ‘not the same’. Their paths may interact and overlap on a daily basis yet their roles and responsibilities are entirely different and diverse. I would also consider that when completing future care cost reports there are times when the use of a health care assistant is adequate and appropriate. Additionally, there are times when the skills, knowledge and expertise of a nurse is most definitely required. I’ll give the example of medication administration. I have read some future care cost reports that have costed for medication administration and quoted for health care assistant rates for such a role with suggestions that a nurse is ‘not necessarily required for such an activity’.I would like to begin by respectfully outlining and strongly emphasising that Health Care Assistants in the community DO NOT administer medications. Therefore, any future care cost report that quotes a health care assistant rate for medication administration is inaccurate. Additionally, any future care cost report that suggests the role of a nurse (for example in medication administration, wound care management, stoma care, dialysis care etc) can be replaced by a health care assistant is merely an attempt to reduce future care costs and in my opinion is inappropriate, situation dependent of course!
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