Acute Care PCA’s made clear that expectations of them have been too heavy to provide the best patient care, and we’ve heard that. In our most recent Contract Negotiations with management, we developed new guidelines which are intended to help.

Changes will begin to roll out over the course of the coming year. A PCA Staffing Committee--made up of SHARE PCA’s, Nursing Leadership, and SHARE Leadership--has begun meeting to oversee the process. They will also develop better standards for PCA orientation, patient-centered care, etc.

In the new model of care, the responsibility for and management of each patient’s needs will ultimately rest on a nurse. PCA’s will continue provide hands-on care for patients, working collaboratively under the direction of the RN. The new contract explains that the PCA will typically assist the RN with workloads based on one of the following two guidelines:

Specific tasks that are assigned for multiple patients such as vital signs, blood sugars, weights, meal preparation, or ambulation

Single patients with multiple care needs such as personal care and activities of daily living. In this guideline, the PCA will assist the RN(s) with up to 6 - 8 patients for the day and evening shifts and up to 8 - 10 patients on nights.

This is a major shift, and we’ll be working to roll it out steadily, a couple of floors at a time. The full text of the new guidelines will be published in the new SHARE contract. (And you can read them online now, on page 18 of the SHARE/UMass Memorial Contract Agreement.)

We heard that you want to give good quality care, and you don’t always feel that you are able to do as well as you want to. We want this new process to provide thoughtful revision of the caregiving practice, with lots of opportunity for PCA’s to provide input and participate in the design. The PCA Staffing Committee will guide the process and adjust as other opportunities for improvement are found. We’re looking forward to involving everyone to develop better teamwork, and a spirit of working together.