Patient Care Technician Exam

As you study, keep one pattern in mind. On almost every basic care question, the best answer protects the patient's safety and dignity, encourages the patient to do as much as possible for themselves, stays within the PCT's scope, and reports anything new or unusual to the assigned nurse. The chapters that follow walk through each skill with the steps, the reasons behind them and the traps the exam likes to set.

This chapter explains where the PCT fits on the care team, how activities of daily living differ from instrumental activities, and the principles that guide all hands-on care.

A patient care technician (sometimes called a patient care assistant or clinical technician) works under the direction and supervision of a licensed nurse. The registered nurse (RN) assesses the patient, plans care, gives medications and evaluates outcomes. The licensed practical or vocational nurse (LPN/LVN) provides care within a narrower scope. The provider (physician, nurse practitioner or physician assistant) diagnoses and writes orders. The PCT observes, measures, reports and performs tasks that the nurse delegates and that the PCT has been trained to do.

A PCT usually has a broader skill set than a certified nursing assistant. Depending on the facility, a PCT may also draw blood, run EKGs, perform point-of-care tests and remove peripheral IV catheters. What a PCT does not do is just as important for the exam:

• Does not perform nursing assessments or make diagnoses
• Does not give any medication, including over-the-counter drugs, creams with prescription drugs or eye drops
• Does not insert IVs or change IV rates
• Does not take verbal or telephone orders from a provider
• Does not change the care plan or give medical advice

Activities of daily living (ADLs) are the basic self-care tasks a person does every day to stay clean, fed and comfortable. Instrumental activities of daily living (IADLs) are the more complex tasks needed to live independently in the community.

In the hospital, the PCT mostly assists with ADLs. IADLs matter during discharge planning, when therapists and case managers decide whether a patient can safely go home.

Every patient should do as much for themselves as they safely can. Doing too much for a patient may feel kind, but it can cause weakness, loss of skills and loss of self-esteem. The care plan tells the PCT the patient's level of assistance, such as independent, setup only, standby assist, minimal assist, moderate assist or total care.

Ways to protect dignity during ADLs:

• Knock, introduce yourself and explain what you will do before you begin
• Identify the patient using two identifiers, such as name and date of birth
• Close the door and the privacy curtain, and keep the patient covered with a bath blanket except for the part being washed
• Offer choices, such as the time of the bath, clothing or the order of tasks
• Let the patient finish tasks at their own pace, even if it takes longer
• Speak to adults as adults; avoid pet names such as "honey" or "sweetie"

Most care procedures share the same opening and closing steps. Learn them once and apply them everywhere.

1. Check the care plan or the nurse's instructions.
2. Gather supplies before entering.
3. Knock, introduce yourself and perform hand hygiene.
4. Identify the patient with two identifiers.
5. Explain the procedure and get the patient's agreement.
6. Provide privacy.
7. Raise the bed to a comfortable working height and lock the wheels.
8. Do the procedure, using gloves when contact with body fluids, mucous membranes or non-intact skin is possible.
9. Lower the bed to its lowest position and make sure the wheels are locked.
10. Place the call light and personal items within reach.
11. Perform hand hygiene, report anything unusual and document.

• The PCT observes, measures, reports and performs delegated tasks; the nurse assesses, plans and gives medications.
• ADLs are basic self-care tasks; IADLs are complex tasks for independent living.
• Encourage independence; do only what the patient cannot safely do.
• Privacy, explanation, choice and respectful language protect dignity.
• End every task with the bed low and locked and the call light within reach.