According to a Government of Ontario report, there are approximately 100,000 PSWs in Ontario.
Personal Support Workers (PSWs) work in a wide variety of settings.
According to the Health Professions Regulatory Advisory Council (HPRAC), there are no uniformly established duties for PSWs in the province.
College of Nurses (CNO) has stated that unlike Registered Practical Nurses (RPNs) and Registered Nurses (RNs), PSWs are primarily required to perform tasks for patients that are direct, front-line, and hands-on.
“The work of a PSW is directed by a plan of care developed by a regulated care provider. The PSW does not organize the care plan but is responsive to it in supporting the client.”
The fundamentals of a Personal Support Worker job description are the same everywhere, however; its scope of practice is governed by many factors such as:
- Type of setting (Private home, Long-Term Care home, Retirement home, Clinical care setting)
- Requirements of the family or client when working in a private setting
- Policies and procedures of the clinical care setting
- Type of Personal Support Worker(PSW) training
- Type and amount of experience
Therefore, the PSW job description can be personalized and customized according to the type of support someone needs.
Often tasks performed are based on the patient-specific care plan put together by Registered Healthcare Professional(s).
Although the job description of a Personal Support Worker is determined by many factors, however, one very important consideration to keep in mind is that, regardless of the experience and skills, a PSW always work with the patients, residents, or a client whose health is fairly predictable and are considered to be medically and clinically stable.
PSW Job Description – General
The PSW job description will always vary but in general, some of the common duties are:
- Following the care plan, observing and reporting any substantial findings and/or changes in patient/resident/client’s behavior to the appropriate registered member of the healthcare team.
- Working under the supervision of a Registered Healthcare Professional such as a Registered Nurse (RN) or a Registered Practical Nurse (RPN)
- Performing tasks delegated to them (only if they are trained to perform the delegated task)
- Assisting with ambulation, positioning, and transferring using mechanical lifts such as a Hoyer lift.
- Assisting or providing total personal care such as toileting, bathing, and perineal care.
- Assisting with eating, dressing, and grooming.
- Assisting nursing staff by answering call bells (In Hospitals and Long-Term care homes)
- Performing sitter duty or patient watch for confused patients in clinical care settings.
- Computer or paper documentation of Activities of Daily Living (ADL’s) and other findings.
- Reporting behavioral and clinical changes to a Registered Nurse, Registered Practical Nurse, Resource Nurse, or Manager.
- Self-actualization by helping patient/resident/client to reach maximum potential.
Besides the above-listed duties that a PSW can carry out, the Regulated Health Professions Act (RHPA) sets out guidelines that allow unregulated health professionals to perform certain controlled acts.
Additionally, PSWs are required to possess a skill set of abilities that will enable them to perform their job effectively.
These abilities include:
- Overall competency in working under pressure
- Experience in providing general care and support
- Knowledge of home care services
- Proficient in written communication
- Proficient in oral communication
PSW Job Description – Facility-Based Settings
Facility-based settings are institutionalized settings such as:
- Nursing homes,
- Long-term care homes,
- Retirement homes, or
- Other similar facilities.
In such settings, PSW’s job depends upon the policies and procedures of the institution.
Some of the typical tasks associated with such settings are:
- Assist nurses and physical therapy staff with the personal care of patients and physical therapy goals.
- In long-term care: Assist in dementia care by doing cognitive activities.
- Paper or computer documentation
The work is always closely supervised by either a Registered Nurse (RN) or a Registered Practical Nurse (RPN).
PSW Job Description – Community-Based Settings
When working in such settings, PSW job duties include:
- Assistance with toileting, bathing, and dressing
- Preparing meals
- Walking the family dog
- Grocery shopping and
- Generally, assist the client with any activity they would do if able to live independently.
Other PSW Job Duties
Prior to the start of the shift, a PSW must report to the nurse assigned to the patient and explore pertinent information that you may need during the day.If the patient is independent, these tasks can be performed by herself but if not, a PSW must ensure that they are completed and reported to a Registered Nurse (RN) or Registered Practical Nurse (RPN) at the end of the shift.
- Mouth care – provide supplies and assist
- Bathing – Partial or full bed bath, set-up basin at bedside or shower
- Dressing and grooming including shaving
- Observe and report the following when providing personal hygiene: dry, cracked, swollen, or blistered lips, loose teeth and redness or swelling of the gums, condition of the dentures, and any other pain or discomfort.
- Also observe for any skin redness on the bony prominences such as coccyx, heels, elbows, shoulder blades, and back of the head.
- Set up food tray in front of the patient
- Feed patient as directed. Please note if the patient has any swallowing difficulties, if the head of the bed needs to be elevated to a certain degree, and the type of diet the patient is on such as regular, diabetic, puréed, honey/nectar thick, etc.
- Measure intake – the amount of food from the tray. Sips, 1/4th, 1/2, 3/4th or full. Also, measure the amount of fluid intake.
- Provide toileting to the patient according to the schedule using a bedpan, urinal, commode, or ambulate to the bathroom. Please note that when transferring the patient to the commode, you may need assistance from another staff depending upon how much the patient is able to participate in the transfer. Also, keep in mind the weight-bearing status when transferring and ambulating patients.
- If the patient is incontinent, discourage the use of a diaper. If the patient has a particular type of incontinence such as stress, urge, or overflow, please be aware of available products such as pads, liners, and mesh panties.
- Change incontinent pads and diapers while providing proper peri-care.
- Measure output. If incontinent, describe output as small, medium, or large. Also record the number of bowel movements including the consistency, texture, and amount (small, medium, or large).
- If independent, encourage self ambulation.
- Provide assistance using a cane, walker, or during transfer.
- Encourage patient to sit up in the chair, as directed.
- If the patient is on bed-rest, it is very important for a PSW to reposition according to the protocol. The patient’s on bed-rest need to be repositioned every two, three, or four hours depending upon the risk of skin breakdown.
- If the patient is on any type of restraints, monitor the patient closely and report any changes.
- Wear protective gear such as a mask, gown, and or gloves if the patient is on any type of isolation.
- Depending upon the risk of fall, monitor the patient closely.
- Ensure the bed is in the lowest position, call bells are within reach, and bed alarms are working.
- Confused, patients with dementia, delirium, or depicting aggressive behavior need to be monitored very closely.
- Provide orientation to date, time, and place.
A PSW is also responsible for changing bed linen and keeping the room clutter-free.
PSW Tasks During Patient Watch
Close patient observation is often required in hospitals or other types of acute care settings.
Patients on a high risk of fall due to post-operative delirium or confusion due to some kind of a disease process are required to be monitored twenty-four hours a day.