Contact us today! |

Monthly Archives: March 2020



Go placidly amid the noise and haste and remember what

peace there may be in silence.   As far as possible, without surrender

Be on good terms with all persons.   Speak your truth quietly and

clearly; and listen to others, even the dull and ignorant;

they too have their story.

Avoid loud and aggressive persons; they are vexations to the spirit.

If you compare yourself with others, you may become bitter or vain,

for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans.

Keep interested in your own career, however humble;

It is a real possession in the changing fortunes of time.

Exercise caution in your business affairs, for the world is full

of trickery.   But let this not blind you to what virtue there is;

many persons strive for high ideals; and everywhere life is

full of heroism.   Be yourself.  Especially do not feign affection.

Neither be cynical about love; for in the face of all aridity and

Disenchantment it is perennial as the grass.

Take kindly the council of the years, gracefully surrendering

the things of youth.  Nurture strength of spirit to shield you in

sudden misfortune.  But do not distress yourself with imaginings.

Many fears are born of fatigue and loneliness.  Beyond a

Wholesome discipline, be gentle with yourself.  You are a child of

The universe, no less than the trees and the stars; you have a

Right to be here.  And whether or not it is clear to you,

No doubt the universe is unfolding as it should.

Therefore, be at peace with God, whatever you conceive Him

to be, and whatever your labours and aspirations.

In the noisy confusion of life keep peace with your soul.

With all its sham, drudgery and broken dreams,

It is still a beautiful world.   Be cheerful.  Strive to be happy.

Max Ehrmann 1927


It has come to our attention that some service users receiving care in their own homes have been cancelling the visit from the HCA.  This is because they are fearful of the HCA bringing infection from other homes they have visited.

It has also come to our attention that in many cases the HCA visiting people in their own homes are not being supplied with the equipment to protect themselves and their clients from the infection.

You the HCA can bring the infection to the service user but you can also pick up the infection from a service user.  Most of the people you care for are in the ‘at risk and vulnerable’ categories.

You have a duty of care to the service user which means you must practice to the highest level of care in the interest of safety.  Your employer has a duty of care to you, a front-line worker, therefore your employer has a responsibility to provide you with the resources to protect yourself and the service user.  You should be supplied with non-sterile disposable gloves, plastic aprons and face masks.

The following link takes you to information on how and when to use gloves and aprons.

Kaylas Kitchen

Kayla is a 10yr old girl with a neurodevelopmental disorder called Rett Syndrome.  Kayla’s Dad, Emmett, has been her full-time carer for the past six years. In that time, through continuous research and working with nutritionists and dietitians at The National Children’s Hospital in Tallaght, he has learned the nutritional and functional benefits of a whole variety of foods.

Looking after a busy household with Kayla’s mum Paula traveling for work, Emmett found batch cooking to be the simplest way to manage a young family along with a child of very special needs without compromising on taste or nutritional value. Soon after starting, Kayla’s Kitchen began providing delicious meals for friends and family.

Kayla’s uncle Karl, who recently passed away from Motor Neuron Disease, used the delivery service during the last few years of his life. This gave him the independence he needed to stay in his own home until just before he passed. Kayla’s grandparents who are in their eighties eat from Kayla’s Kitchen every day. They order every two weeks, taking away the stress and hassle of having to plan, shop and cook for themselves every evening.

Our aim now is to open Kayla’s Kitchen up to others who may benefit from ready made meals of great quality food.

Kayla’s Kitchen is approved by Missy Kayla (she has a very discerning palette for a 10yr old) and by the Tallaght Hospital Diet Clinic, endorsed by her Consultant Paediatrician, Denise McDonald.

Each year, 10% of the retained profits will go to Missy Kayla Trust. The Trust was set up to provide our Kayla with the best possible quality of life and providing for her future to ensure she stays out of state care and always in the care of her family.

Hand Washing

Hand Washing Advice

For Healthcare Assistants

  1. Keep fingernails short, do not wear artificial nails to work.
  2. Remove rings, watches and bracelets, place in your bag or pocket, it is preferable not to wear these items to work.
  3. If you have a ring that won’t come off move it up and down on your finger as you soap your hands, to ensure the skin under the ring is cleaned.
  4. Roll up your sleeves.
  5. Open the tap, wet your hands and apply soap.
  6. Wash hands and wrists according to HSE instructions.
  7. Rinse hands so that they squeak, in other words there is no soap left on them.
  8. Dry hands with paper towel
  9. Turn off tap with your elbow or with a paper towel.

For homecare staff:

  1. It is preferable to carry your own bar of soap in a box and a wad of paper towels.
  2. Wash your hands on entering the persons house and before you leave.

Hospital and Nursing Home staff.

  1. Hand washing equipment will be provided in your place of work.
  2. Wash hands between patients
  3. Carry out clean tasks first where possible, washing hands between tasks for the same patient.

Moral Distress

Moral Distress and the Healthcare Assistant

Anne Marie Lee

Working in any area of healthcare we come across moral distress.   Some healthcare workers are better able to manage their moral distress than others.

What is moral distress?

“In 1984, Andrew Jameton defined “moral distress” as a phenomenon in which one knows the right action to take but is constrained from taking it. Moral distress is different from the classical ethical dilemma in which one recognizes that a problem exists, and that two or more ethically justifiable but mutually opposing actions can be taken. Often, in an ethical dilemma, there are significant downsides to each potential solution.”

Through research it has been discovered that moral distress can cause some healthcare workers to change career, it can also be the cause of burn out in staff.  It is a subject that has only recently been taken seriously and is still not generally recognised and catered for.

Moral distress is widely recognised in the nursing sector but may not be as well recognised in the case of healthcare assistants.

Examples of Moral Distress for healthcare assistants

You have been trained in manual handling.  A member of staff, senior to you, asks for help in moving a patient up in the bed.  Standing on either side of the patient she proposes catching the patient under the arms and hauling him up the bed.   You know this is an incorrect manoeuvre, but your colleague outranks you and you are reluctant to correct her.  You are aware of the damage this manoeuvre could do to the patient and you are also aware that this is common practice.  The moral dilemma here is: do you protect the patient from possible injury or protect yourself from the wrath and ridicule of your senior colleague? Would you express your concerns and to whom?  Would you continue to carry out this manoeuvre if you were not listened to?  This is the moral dilemma which may cause you distress.

The nursing home in which you work has a routine which you believe serves the staff over the residents.  Most of the residents spend the day sitting around a large room with little to do but watch TV.   The staff claim to have no time to carry out activities with the residents.  The residents are bored and in your opinion are deteriorating gradually from lack of physical exercise and mental stimulation.  When you try to entertain them, you are quickly given a task to do and told not to be wasting time. The moral dilemma here is to weigh the wrath of management against creating a pleasant atmosphere of activities and entertainment for the residents.  Do you put up with this situation; bring it up with senior staff or report to HIQA?  Failing a response that satisfies you do you seek employment elsewhere?

You are a healthcare assistant (HCA) working in a day care centre for people with dementia. The person who was responsible for cleaning the centre resigned and the manager decided that the HCAs could do the cleaning and save the salary of the cleaner.  Some of the HCAs resented this and one felt so strongly that when it was her turn to clean, she did a very poor job. As a result, the clients were likely to suffer e.g. they might pick up infections. You had been of the belief that an HCA carries out hands-on tasks with the care recipient while the cleaner does the domestic duties, cleaning, laundry etc. You didn’t train to be a cleaner.  Resentment is building up and the atmosphere is becoming very difficult to work in. What do you do?  Put up with it; refuse to clean; discuss with the manager or seek new employment.

Moral dilemmas occur in all disciplines of healthcare.  In Britain in the 1970’s there was major moral distress among healthcare workers when abortion was legalised.  Initially most clinics were sympathetic to those who had a moral or religious objection to working with people seeking abortion.  It was also the case that where one’s objections were dismissed many health professionals felt the need to resign rather than comply.  Since the Irish referendum this may be a moral distress facing us into the future.

Another moral dilemma can occur over medication administration.   While healthcare assistants have no national scope of practice they are bound by the policies and protocols of their workplace.  In the case of a person with dementia whom you are caring for in their own home. You know this person will not remember to take her medication.  She is also not capable of responding to suggestions and doesn’t know how to manage the blister pack even with assistance; nor does she know what to do with the tablets if they are handed to her.  You are only permitted to remind her to take her tablets!  If she doesn’t take her tablets her condition worsens, the registered Nurse can’t call in twice a day to give them to her and there is no one else available to do so. What do you do?  Apparently, this is quite a common problem.  Do you report to your line manager?  Do you refuse to help with medication administration and let the employer solve the problem?

You are caring for an extremely difficult patient in her own home.  She is your first call each day and you find yourself dreading coming to work in the mornings.  You are very stressed and it is beginning to affect your family life. One of your colleagues advises you to request a second healthcare assistant be appointed to share the task with you on a four-day/three-day plan.  You put in the request but your managers refuse.  You are very disappointed and frustrated but work on for another six weeks or so.  Then, backed by your colleagues you put in the request again.   Again, you are refused.  What do you do?  Continue working with this patient while your distress builds up.  Contact HIQA, find another healthcare position or change career altogether.  (The HCA in this situation moved out of healthcare entirely)

Outcomes from ignoring morale distress

Where moral distress exists the healthcare worker always suffers and the patient may be at risk too but not always.  Where the cause of the moral distress is not relieved the healthcare assistant can become numb and bad habits kick in. ‘It must be OK because this way of behaving is the norm in this workplace.’ This will in turn lead to poor standards of care.

In a lot of cases healthcare assistants will vote with their feet and leave the healthcare sector for less challenging roles.

 What can be done to alleviate morale distress?

Would a prescribed national standard of training on how to manage moral distress benefit healthcare assistants?

Should employers have a moral distress policy and procedure and an appropriate structure for dealing with issues raised by staff?

Healthcare assistants need to have a debate on the issue and raise the general level of literacy of moral distress in the sector.

What do I do if I believe I am suffering from morale distress?

Since moral distress is beginning to be recognised and since it can lead to burn out and staff retention problems in the sector, the individual healthcare assistant should talk to someone about their concerns.

  • Talk to your line manager or employer and explain why you believe the health or welfare of the care recipient is in danger
  • Talk to HIQA
  • Talk to a trusted friend in confidence
  • Contact us at the Alliance of Health Care Assistants in Ireland to arrange for someone to talk to you
  • Make arrangements to attend counselling.


When you join the alliance of Health Care Assistants, we have a range of courses available to our members for which there is a certificate of course attendance.   These courses are free.  They are on line courses and when inspections are carried out in your place of work it is to your advantage to have copies of these certs in your portfolio. They also look good on your CV as they show your commitment to your role and your ability to be pro-active.   It looks good for your employers also.

Cork Conference

The Alliance of Health Care Assistants in Ireland held its second conference in the Kingsley Hotel in Cork City on Saturday 9th February. The title of the conference was ‘Working to Build a Better Future for Healthcare Assistants’   Many positive moves are being made to improve the discipline of the Healthcare Assistant and have it recognised and respected as a career in its own right.  We were inspired by the excellent speakers informing us of a new way of working in the hospital setting through mindfulness; of the progress of the apprenticeship program for HCAs which is in the pipeline; our HCA spoke on dignity in care and we had an input on the work of the Wheelchair Association.  So much is happening through the AHCAI, don’t be left out.

We would like to know why we had so few attendees.

Was it because:

  1. Of the storm Jorge
  2. Of the Corona virus which had arrived in the country
  3. You didn’t hear about the conference
  4. You thought it would be of no interest to you
  5. Some other reason

We would be most grateful if you would contact us on info@ahcai and let us know.

When we have information for HCA’s we would like to be able to make direct contact.

If we had the name and email address of one HCA in each workplace, that person would get the occasional email to keep you and your colleagues informed.