Serving as a Substitute
What should you do when you first meet a client as a substitute?
Introduce yourself, explain you’re filling in, acknowledge the change.
What two distinct components make up compassion fatigue?
Burnout and Secondary Traumatic Stress (STS).
What is the first emergency number you call upon discovering an unresponsive client suspected of an opioid overdose?
Call 911
Who is the only person allowed to update a client's Care Plan?
Care Supervisor
What does each letter in the S.M.A.R.T. de-escalation acronym represent?
S – Stay calm and composed
M – Maintain a safe distance
A – Actively listen
R – Respond with respect and empathy
T – Take action or seek help
True or False: You can add tasks if the client asks, even if not in the plan.
False.
Between burnout and secondary traumatic stress (STS), which one is triggered by hearing about or witnessing a client's trauma rather than overall workplace workload?
Secondary Traumatic Stress (STS).
Why is it important that a provider never test-spray or a Narcan nasal spray device before inserting it into the nostril?
Each device contains only one single dose.
Why should personal care (like incontinence care, dressing, and bathing) be completed before household tasks (like laundry and cleaning)?
Personal care and immediate client needs (ADLs) come first to ensure hygiene and comfort, while household chores (IADLs) come second.
What is the minimum physical safety distance an HCP should keep when de-escalating an agitated client?
At least an arm's length away.
Name 2 reasons a client might refuse care from you as a substitute provider.
-Lack of trust
-Trauma, paranoia, or confusion
-Change can feel threatening for clients with mental health/substance use issues
How does that start and recovery of compassion fatigue compare to chronic burnout?
Compassion fatigue happens faster and recovers faster, whereas burnout has a slow start and slow recovery rate.
How long must you wait after administering the first dose of Narcan before giving a second dose in the opposite nostril if the client remains unresponsive?
2 to 3 minutes.
If a client has an open wound but there is no information about it on the Care Plan, what should you do?
Do not attempt wound care; pause and contact your Care Supervisor or Service Support to report the open wound.
Your client is complaining about their dinner, saying they hate the food and calling the meal terrible, but is not aggressive or threatening. Should you stay, de-escalate, or leave?
Stay (use calm communication, maintain professional boundaries, and finish care).
Why should you document a client refusing help?
Protects you, helps the team track patterns, keeps everyone safe.
A provider says, "I just feel like nothing I do actually helps. I'm so tired of running in circles with no support." Is this an example of STS or Burnout?
Burnout.
If a client is unresponsive after Narcan but breathing normally, what should you do while waiting for paramedics?
Place them in the recovery position.
A client needs assistance with daily chores, medication reminders, and some ambulation support. What level of care is this client?
Supportive.
A client accuses you of stealing their wallet, becomes increasingly agitated, starts clenching their fists, and blocks your path to the door. What should you do?
Recognize the escalation and attempt de-escalation using S.M.A.R.T. techniques.
If the client continues to threaten your safety, attempt to de-escalate just enough to exit the room and call Service Support.
What’s the first thing you do if you feel unsafe as a substitute?
Leave if needed, get to safety, and call CS/Service Support.
Name two unhealthy coping habits that Homebridge specifically warns providers NOT to do when managing compassion fatigue.
Any two of the following: Self-medicating / using substances, blaming others, working harder or longer hours, complaining about family/friends, or making impulsive lavish purchases.
Luisa finds Mrs. Hernandez slumped on the couch, unresponsive with shallow breathing and drug foil nearby. What steps should she take?
1. Call 911
2. Administer Narcan and follow protocol
3. Do NOT clean up the drug foil nearby
A client needs assistance with daily chores, insulin care, and is confined to a bed which requires a hoyer lift for transfers. What level of care is this client?
Critical.
What phone number must you call to reach Homebridge Service Support to report leaving a shift or dealing with an incident?
(415) 992-4284.