Wednesday, May 18, 2011

PSW training, scope of practice, employee rights

I posted a question on the PSW Facebook page.
The answers ranged from wrong and illegal, to exactly right. I believe that those who work providing intimate care of our loved ones in long-term care (LTC), home care, or in private institutions, should have much training.
No wonder we read about PSWs taking advantage of seniors. Without training that sticks, and employers that ensure that employees have ongoing PD, and monitor nurses who supervise PSWs...
No wonder many refuse to place seniors in LTC. There are many institutions that provide excellent care. Others where horrible conditions exist.
No wonder we have elder abuse.

This is why I believe we need training standards for PSWs, regulation and registration. We need 2-year programs, not a medley of 1-year compacted, or other types. I think that the larger the institution, with internal regulation standards, the safer our seniors are when many are involved in care. Those in small, private retirement homes, at home, and LTC, are susceptible to abuse.

PSWs is smaller settings are similarly subject to abuse from residents.

  • truly a sad story that explains other stories about neglect and abuse. Requiring PSWS to work past their limits (including too many short shifts. too many overtimes working short or working alone with known abusive clients) are..

  • I agree with you Jennifer, there is a fair amount of staff that are victims of abuse from residents. I know of a case where a resident punched a PSW gave them a fractured jaw for being at the wrong place at the wrong time. This resident would also chase staff where staff had to lock themselves in an area until help could arrive. This resident's uncontrolable rage was part of his condition appartenly. I've seen another resident who believed another resident was her husband and once that resident left with his wife...the female resident went into a rage and would try to hit staff with her walker when trying to calm her down. They had to call the police to restrain her. There is numours accounts of verbal abuse as well. Alot of these residents do not want to be in a LT home and will take it out on staff.

One post:

  • Whatever happened to the 1 year and 2 year courses for PSWs? Why are they now down 24 weeks? It's no wonder no wants to be PSW with that meager amount of training. How can it be safe for the PSW, or the people they care for? PSWs are NOT A JOKE! They are a vital part of the health care system, and are frontline workers. Most, if not all of the time, they are the first on the scene, and the last leave!

Another woman wrote:

  • having worked with the same company for 6 years, which i won't name. I'm almost considering switching careers after the way i have been treated. thinking i was doing the responsible thing, i notified my company the minute i was pregnant, just in case i was assigned to anything that may have put myself at risk. one occasion i was concerned when i found out that a client tested positive for tb, i called asap and explained that i wasn't comfortable going into to them, until we had further information, i was told too bad you have to, i have no one else, however they had private care that could've taken over for me. then they slowly started reducing my hours so that it was costing me money to work. when i questioned why i wasn't getting hours or going to clients that i had been with for years, they said it was the clients request, how do you dispute that? it's not like i can go and ask the clients if they did. i find it hard to believe that they would request me not to return, when they requested me to begin with. the final straw for me was when they didn't give me a raise. when i asked why, they said they didn't have too. whick they don't by law. my doctor had to sign me off on medical leave due to stress. it's been 4 weeks and i still havn't got my ROA for unemployment. my boss hasn't even called me to find out what is wrong and why i had to be signed off work, that's to me is just ignorant and rude. they did was a survey filled out that was suppose to be anonymous, to give feed back on there company and how they treat employee's so summit to CCAC, i got a phone call asking me all of the questions. what a horrible company to work for. 

seniors take a wide range of meds
Jennifer Jilks asked How many PSWs are giving medications during the course of their work? In the retirement home where I volunteer with a palliative patient it seems to be the job of the PSWs.

The answers varied...

  • If you work in a LTC or Retirement home it is illegal for HCA/PSW to dispense any kind of oral medications. Your not even suppose to do tropical.
  • You must have a licensee and be registered with the college of nurses and be valid. HUGE fines....
  • at some of the retirement homes here in Kingston PSWS have been giving meds..they have blister packs and they pop them out..they cant give the meds to the person, they can hand them to that person and say here you go ..and when I worked in homecare i gave their meds also..
  • In retirement or group homes, PSWs/HCAs dispense meds and do treatments. In nursing homes, it's the job of the RPN/RN.
  • i work in LTC now and of course its a must for the nurses to give all meds...Let me rephrase that actually, not ALL meds, we can apply the prescribed creams..
  • Also, when I was doing homecare, I dispensed meds either from the bottle or a blister pack. That's the only thing I can do too. Even if a Band-Aid falls off, I am not allowed to put it back on.
  • Home care if different when it comes down to legislation and ministry rules. I would seriously call and ask the ministry.
  • PSW's do give meds in Group Homes such as Community Living. But they are not allow to give meds in other institutes. Sometimes they do with Ontario March of Dimes as well. Just one other area where there is no standard! Nothing more than risky, dangerous business! We need standardized training, and maybe regulation!!!!
  • In the community where i work some of the disabled cannot open their blister packs.We open and place them in a container for them.
    a blister pack
  • we were taught in the PSW course how to pour and dispense meds now in home care were allowed to open the bottle and hand them the bottle and monitor what they take others are in the blister pack and or they are already dispensed . in hospitals and LTC RPNs and RNs do that
  • i have done wound care the nurses have taught me
  • as well as long as were trained we can basically doing anything
  • i wouldnt say anything, theres no way a psw can do things such as catheters, injections etc.. no matter whether a nurse trains me or not i'd say no..unless i have a license like nurses do..i wouldn't do it..
And final answer: the right one...
  • Just curious, doesn't anyone remember their training? and the scope of practice? you are allowed to assist with meds. that means if your putting eyedrops in for example, your hand literally has to be over their hand. yes your are trained on how to dispense medication in school, but that's for the purpose of understanding how it's dispensed. remember your not a nurse and if anything goes wrong you could hurt or potentially kill someone, your liable. it's your career it's your lively hood. the Ontario march of dimes offers a special training program for catheters, but i don't believe it's regulated by the ministry. depending on the company you work for in home care, and there policy, you have to have written permission to apply creams i.e., polysporin. and perscription, but again you can only assist. generally speaking if the home care is employed via CCAC their policy will coincide with the ministry, but if it's a private business, they will do whatever they want. so it comes down to what your choose to do, and since your not a nurse you do have the right to refuse if it's going against your training.


Anonymous said...

can We as PSWs administer supossitories and give care to clients with colostomy

Jenn Jilks said...

It depends upon where you work, and which part of the world. I'm not convinced it is, as it is an invasive treatment, and I would suggest you talk to the folks at Please contact for more information.

Jenn Jilks said...

According to,
"PSWs are not allowed to go beneath the skin or give suppositories, injections, etc. "

This is beyond their scope of practice.

Unknown said...

I have only recently been introduced to the grim reality that our Long Term Care Facilites provide. I watch how stretched out and overworked these PSW's are. They have an impossible task. I defy the Prime Minister to get ready in 6 minutes. Thats the true time alloted per Resident..and some are completely dependent for dressing and self care. PSW's need to be paid more, and their working conditions need to improve or we wiĺl be facing an even bigger Health Care Crisis in Long Term Care.