The first healthcare assistant I worked with was called Maria. Maria was tough. She could, if she wanted, lift a car should there be one stopping her from making a bed or bathing an 80 year old patient with advanced dementia.
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Maria worked very hard. When she was not hurtling around the old decrepit ward we worked on she had a large family to care for, did a cleaning job part time and enjoyed welding. I liked Maria, she had worked on that ward for over 20 years and taught me more than the nurses did.
After I had earned my stripes so to speak - by doing the dirty jobs willingly and being polite - she was kind enough to listen to me when I said I thought some of what we were doing was less gentle than it could be. She didn’t have to listen to me, after all I was just passing through and she must have seen hundreds like me before. So I think listening was generous and it’s good to notice when other people are generous.
Anyway Maria and her colleagues did most of the direct patient care along with the students. This was 1986. New research tells us that healthcare assistants are doing the bulk of direct patient care. I know a lot of things pass me by - who noticed Wimbledon for example - but why is anyone surprised?
‘The government is setting up phone lines for people to call in with ideas on how to save money - can I suggest we have fewer government call centres?’
We know that in many care settings - particularly those for inpatients - it is healthcare assistants who are undertaking the fundamental care. We know that this raises all sorts of questions, not least: how does it redefine the role of the nurse? Are we ensuring that healthcare assistants are supported? And, is it the case that care delivery is designed not by things like “skill mix” or policy but simply by economics? Still?
But it seems to me that in a climate like the current one, where the government is setting up phone lines for people to call in with ideas on how to save money (can I suggest we deport Prince Andrew and have fewer government call centres?), the problem with rediscovering how hard healthcare assistants work is the extent to which it becomes an excuse to save money by - for example - denigrating nursing.
Now if healthcare assistants were delivering care while trained nurses were out the back on sun loungers reading about research methods I could see there was a problem. But they are not. Despite the sometimes hysterical criticisms healthcare assistants are not delivering hands on care because nurses have degrees, or don’t like patients, or are all doing the work formerly done by junior doctors. Nurses are too busy to do everything and so they gather assistance. There are not enough nurses and thankfully they have healthcare assistants to help them.
Let’s not use information like this - information that should enable us to appreciate and value healthcare assistants for the excellent job they are doing - as a means to belittle nurse education or the nursing role. It is self defeating and inaccurate. In times like these we need to value each other all the more rather than give anyone an excuse for you to make do with fewer staff tomorrow.