A day in the life of a healthcare assistant (inpatient)...

How do we compare to other professions, what roles do we take, etc. Includes descriptions of "a week in the life" of relevant posts.
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A day in the life of a healthcare assistant (inpatient)...

Post by eponymous85 »

Before I got my job as an RA, I worked as a health care assistant in an inpatient unit.

A typical shift

Arrive VERY early for nurses' handover. The shift co-ordinator from the previous shift gives an overview of each patient and how they have been on the night shift. Today's co-ordinator assigns each nurse and care worker a list of patients to work with that day. If possible, these pairings will be with patients' assigned key workers. Duties for the day are shared out.

Patients are up for breakfast (this was an eating disorders ward). Prepare dining room, make sure everything is laid out properly/appropriately, and the dietician's list is up to date. Serve out meals for those that do not yet serve themselves.

Supervise breakfast time. Each staff member sits at a table of about 4 patients. Support patients by giving encouragement, praise, prompting people who are engaging in behaviours that may not be helpful.

Help to clear up afer breakfast. Attend a meeting with all patients to discuss issues within the ward community.
Go down to ward to supervise rest period. Offer 1:1 time to assigned patients. If any accept, we go to a private space to talk about anything they may be finding difficult that day, and struggles etc, but also positives. Advise on distractions from anxiety/self harm urges. If the patient is due for some leave, help them to plan menus and coping strategies.

Attend group therapy session with patients. Can assist the facilitator (psychiatrist, CP or nurse specialist) by giving input to the session, or can just listen and expand own knowledge base.

Plan "snack out" with one of my assigned patients. This is really more of an AP job, but the AP is very pushed for time & i get guidance and clinical supervision from the dietician, OT and consultant CP. We reflect on what happened last time. We agree upon her goals for the session, and how she can achieve them (also, how I can help her achieve them and what will reduce her anxiety). Take patient for snack out in to town, on our return we debrief about the session, how we think it went and what she can work on next time.

help to prepare lunch with another HCA. Make sure the tables are set with the right places, everyone's menu is correct and the chef has substituted all the right foods for vegetarians, allergies etc. Serve food for non-servers, assist/supervise those that are starting to serve themselves again. Again, offer table support, supervision & 1:1 time afterwards.

Write up clinical notes for assigned patients; mood, difficulties, whether they followed meal plans, any issues etc. Hand over important info to shift co-ordinator.


I hope this helps! Feel free to ask me for more info
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Re: A day in the life of a healthcare assistant (inpatient).

Post by Volta »

I am working with eating disorders but in a private hospital. I've now changed from a support worker (so doing the exact same thing Eponymous85 wrote) to a key worker, which means I have some patients assigned and do a lot more work with the careplans. I also mostly do long days so from 7.15am till 9.30pm and a typical day looks a bit like this:

7.00 - Get into work and get a round of teas and coffees ready and catch up with how the night staff is doing (used to do night shifts and I miss working with the night gang :P)

7.15 - Handover starts, so a quick rundown of how all the patients are and staff then go to their units and start the day. I started off on the adults unit but I now work in the adolescents unit.

7.30 - Start waking the patients up and weight those we need weighing and record down their weight, bmi's ect.

8.00 - Start preparing breakfast and observe those who are self-portioning to make sure they're having everything they're suppose to. Breakfast can take up to anything from 15 minutes to 2 hours depending on whether patients are struggling. This is also when we give patients their medicine.

8.30 - After every meal patients have sitdown for an hour where they move as little as possible. I also take the morning BP's and do an after meal discussion in which patients talk about their anxieties around breakfast and how we can reduce these. This take about 15 minutes.

9.30 - If the patients are well enough they have school, if not they tend to spend some time in their rooms or in the lounge. I then spend some time playing games with them or doing a puzzle.

10.30 - Discuss with RMN's how patients are doing and whether careplans need changing, sort out who is having what therapy (body image therapy, CBT, family therapy ect) and write some nursing notes.

11.15 - Snack time, all the patients have different snacks, so making sure everyone is having what they're meant to be having.

11.30 - After snack times there is an half an hour sitdown.

12.00 - Depending on how much exercise each patient is allowed, we take them on their allocated walk which can be anything from 5 minutes to 30 minutes.

12.45 - Pre-meal discussion for lunch.

13.00 - Lunch time, which is often sandwich group, so alongside the OT we support the patients whilst they make their sandwiches.

13.30 - After lunch there is an hour sitdown and the after-meal discussion.

14.30 - Around this time most patients receive their therapies or spend time in their room or the lounge, whilst we write up the nursing notes. We often have staff meetings, MDT meetings or clinical supervision at these times. Or meet with exercise psychologist and/or OT for updates and new plans.

15.15 - Snack time.

15.30 - After snack sitdown.

16.00 - Patients can also go on trips as part of their exercise, so we take them bowling, cinema, arcades, to the park ect.

17.15 - Pre-meal discussion.

17.30 - Tea time. This if often when patients need most support and often takes the longest.

18.00 - After tea sitdown and after-meal discussion.

19.00 - This is when the patients are given their phones for an hour so they can phone family and friends, go and facebook ect. Again, we tend to write notes at this time and discuss how the day went with each other. We also write the careplans and diet plans for patients going on leave for the weekend and make sure the parents have a copy of this too.

20.00 - Phone time is finished and it's time for the final snack or milky drink.

20.10- After snack sitdown and the evening BP's are took.

20.40 - At this time we tend to leave patients alone in the lounge so they can have some staff-free time and relax. They often watch a DVD or do a puzzle together whilst we write the final notes and get the handover notes ready.

21.15 - Night staff arrives so we give them an handover.

21.30 - Home time.

This is what a typical 'good' day looks like. On a bad day we have patients self-harming and purging which means there are a lot of one-on-one or 15 minutes observations. There are quite a few incidents when we then have to do room searches. We also spend a lot of time on the phone to parents and to out of office staff such as the doctors and the psychiatrists. Oh and we have to make sure all the doors and all the bathrooms are locked at all times. The patients also require a lot of time to just talk or for emotional support, so I spend a few hours a day making sure I've talked to all the patients at one point or another. Overall, I think most sw/hca positions do the same kind of stuff and that the small differences just relate to the patient group they are dealing with.

Hope this is useful.
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Re: A day in the life of a healthcare assistant (inpatient).

Post by nomnom »

I'm not sure if this is in the right section but I thought I'd to this from the view of a lead healthcare assistant working in restricted environment in a mental health team.

08.30 - 09.25: Paperwork on the patients that are to be seen in the morning - mainly checking for any alerts, anything on the patient plan that I should be aware of before going in to the session.

09.30 - 11.45: The period consists of one to one sessions working with clients across the prison - the issues will often range from anxiety to severe PD and sometimes the planned session doesn't go as well because all they want to do is talk. One of the things I enjoy in this role is having the flexibility to move away from structured sessions because listening to them does what the session is designed to i.e. make them feel a bit better and feel supported.

11.45 - 1.55: This time is used for lunch and the bulk of the paperwork to record the sessions from the morning - this includes the content of the session, patient interaction level and general manners as well as outline for future aims of the sessions. This time is also used for a team meeting to bring any concerns with patients or assessments to the attention of the team as well as opportunities for supervision should anyone require it. Plans for the group sessions are also planned during this time.

2.00 - 3.55: The afternoon is usually a time for group sessions - these include acupuncture, anxiety management, anger management, self-esteem group, substance misuse, yoga class, gym session, art group, cross stitch group and a general support group.

4.00 - 4.30: The final part of the afternoon is used for the paperwork from the afternoon.

This is a typical day but often priority will be given to going to see the patients have self-harmed in the morning to do a risk assessment - it is normally the person whose caseload the patient is on that has a delay in the morning sessions however this is not always possible. Like I said, having the flexibility within the role I feel allows me to prioritize appropriately and ensure that the support is received where needed most.

Hope this is useful for someone :)

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Re: A day in the life of a healthcare assistant (inpatient).

Post by rabbit »

As these posts are about life as a HCA on an eating disorder ward I thought I would show some variety and show my day in a medium secure forensic hospital. At the moment I work on a rehab ward. I am leaving for my first AP next month.

5:30 wake up...erghhhh

6:30 set off walking to work. I enjoy this, I actually feel awake by the time I get to work if I walk.

about 6:52 arrive at work, wait for outer airlock door to open, hand in my pass to the control room operators. Wait for the inner air lock door to open, recieve my keys and attack alarm. Attach my keys to my belt lanyard (no neck lanyards!) and my alarm to my belt. Go out of the inner airlock and head up to the ward (via the psychology department... where I now smile at the assistant psychologist door :) )

7.00 handover, the night staff hand over anything from the previous night shift and anything else important. As forensic patients are on quite high doses of medication (generalisation I know, but has an element of truth all the same!) they tend to sleep throughout the night with few incidents at this time so night-day handovers are usually quite quick

7.30 night staff leave, and the 4 morning day staff are on. The ward has a 14 bed capacity (the whole hospital is 92 beds). We settle down with a cup of tea, I read any emails etc

8.30 some of the patients start to wake up and go down to breakfast (but many stay in bed). On a rehab ward a lot of our patients have internal leave so we just unlock the ward door for them, the patients who have just come up to a rehab ward or have had some form of a set back are escorted as a group down to breakfast. (on the acute wards patients are often escorted 1:1). We also have to do the security aspect of the dining room and check patients take 1 of each knife, fork and spoon and hand all 3 back in.

09:30 escort patients downstairs for a smoke break... walk around breathing in smoke to check its only tobacco they are smoking (this is my least favourite part of the job!)

10:00 patients start to go out into the community either escorted or unescorted and start their psychology and occupational therapy programmes. We take patients into the local towns and supermarkets, on days out, to visit new placements, to court and hospital appointments etc. Psychology groups include anxiety, mental health awareness, good lives group and a whole host of others. Occupational therapy includes everything from education, exercise, gardening etc. Unfortunately, a lot of patients also return to bed!

12.30-14.00 This is protected time. Patients have their meal in the dining room as per breakfast, then we have another smoke break. Afternoon staff come in at 13.00 and recieve a handover (we have 5 staff on an afternoon as patients are more likely to be awake!), morning staff leave at 14:00

14:00-17:30 similar to 10:00-12:30... patients on escorted leaves, unescorted leaves, OT, psychology. We also have a lot of family/friends visits during this time. Visits in medium secure are very different to AWA. All visits are specialed to hinder the passing of contraband items (everything from the obvious like drugs and guns, to the not so obvious like blue tak and pot noodles!). We also try and engage the patiens still on the wards at this point and maybe try and take them to the Astroturf. However, a lack of staff often gets in our way!

17:30-19:00 repeat of protected time: dining room and smoke break

19:30 night staff come in and recieve handover

20:00 We leave... yawning, a lot!

My basic hours include 2 of these 13 hour shifts a week and 2 shorter shifts (mornings or afternoons). Although most of us do many many more hours than this. Its not a bad shift pattern as far as shifts go!

Throughout the day the staff attack alarms go off. Most of the time it is a false alarm, as the alarms are easily knocked. However, when it goes off we run in the direction of help needed. Real alarms, as expected, are most frequent on the itensive care unit. However, I feel that secure units are really not as scary as some people think. With 7 wards, if an alarm goes off, approximately 10 members of staff (including ward staff, OT, medical and psychology) are at the incident within seconds and if the incident lasts a long time we can rotate staff. In AWA and LD I have found myself with no back up... much more dangerous I feel.

Let me know if you have any questions :)
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Re: A day in the life of a healthcare assistant (inpatient).

Post by BlueCat »

I have checked this thread as a member of the moderating team. I really appreciate the time these posters have spent giving others an insight into what the realities of these roles are. However, having read through them, I am struck by the language used in one or two - psychiatric and labelling. It is tricky to work within a diagnostic, dehumanising environment without picking up psychiatric, dehumanising language. I would argue that it is extra important in these types of roles to hold the person first, and the diagnosis, label, or treatment plan second. This can be tricky to do without psychological leadership, but it is an important point worth bearing in mind.
There's no such thing as bad weather, just the wrong clothes. Billy Connolly.
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