A nurse or an attendant will be alone with the most vulnerable person in your family for twelve hours at a time. The hiring deserves more than a phone call and a hope. It needs the doctor's word on the level, ten minutes of the right questions, the certificates, and a first shift watched properly. Here is how.
First, the level, from the doctor
Before you post, ask the doctor at discharge: attendant, nurse, or ICU-trained, and for how long. Then post that. The rate follows the level: an attendant at ₹1,100 for 12 hours, a GNM nurse at ₹1,800, an ICU-trained nurse at ₹2,500. A family that posts "a nurse" for a patient who needs an attendant pays double; a family that posts "an attendant" for a patient with a tracheostomy gets a dangerous week.
On TheHire the request asks the level, the shift, the duration and the diagnosis in one line; adding "catheter", "Ryles tube", "dementia, wanders at night", "heavy patient", "female attendant" gets the right people calling back.
On the phone: seven questions
- "What is your qualification?" For a nurse: GNM, ANM or BSc Nursing, and a state council registration number. For an attendant: the training course and the institute. "Experienced" is not an answer to this question.
- "What was your last patient, and for how long?" You want a patient like yours, for months. Six homes in a year is a pattern.
- "What can you not do?" The best answer from an attendant is a list: injections, tubes, wounds. The best answer from a nurse is: prescribe or change medicines. A person who can do everything is a person who has not been trained.
- "How do you keep the chart?" Vitals, intake, output, turns, medicines ticked. They should describe it without prompting.
- "What would make you call the doctor, and what would make you call an ambulance?" Chest pain, breathlessness, a face droop, a fall with pain, a fever with shaking. Someone who has done this work answers at once.
- "Which shift, which days off, and who covers your off?" A 12-hour attendant six days a week needs a seventh person. Settle it now.
- "What is your rate for this level and shift?" Compare with the card: ₹26,000 a month for a 12-hour attendant, ₹42,000 for a nurse. In range means they know the market.
The certificates to see
- A nurse: the GNM, ANM or BSc certificate, and the state nursing council registration. Photograph both. The registration number can be checked with the council.
- An attendant: the training certificate, if there is one, and a reference from the last family you can call.
- An ICU-trained nurse: the nursing certificate plus hospital experience in an ICU, with the hospital's name and a reference you can call.
- Everyone: ID, which every nurse and attendant on TheHire has had verified before they can reply, and a current address and a second phone number.
A certificate is a floor, not a ceiling. The first shift is the real test.
The first shift, and what to watch
Pay the day rate for a proper first shift and watch five things.
- Hands. Washed at the door, before and after every contact, without being told. This decides the rest.
- The chart. They ask for it, read the care plan, and start recording. A person who does not ask for the chart will not keep one.
- Handling. The patient is told before being moved. Turning uses the sheet, not the arms. A bed-to-chair transfer is slow and on the weak side. The patient's dignity, during a bed bath or a diaper change, is treated as part of the job.
- The questions they ask. About the diagnosis, the medicines, the diet, the numbers that mean "call", the patient's language and habits. Someone who asks nothing is someone who will guess.
- The end of the shift. A handover with the chart, fifteen minutes, with the family present. What was given, what was passed, how the skin looked.
Then ask the patient, alone, how it went. The answer is the last test.
Red flags
- No certificate, or a certificate they will not let you photograph.
- "I can do everything." An attendant who will "manage" the catheter, a nurse who will "adjust" the insulin.
- No question about the chart or the care plan in the first hour.
- Hands not washed at the door.
- A rate far below the card for a nurse. It is an attendant with a different word.
- A phone on the chair through the shift, or a patient left alone to go out.
- Any suggestion of a medicine, tonic or supplement that is not on the chart.
- Pressure for a month's advance. A week's pay in advance is reasonable for someone leaving another job for yours; a month is not.
- No reviews, no ID, no way to call back. On TheHire every nurse and attendant is ID and phone verified and reviewed after each job.
What a fair arrangement looks like, in writing
One page, read together on the first shift, photographed by both.
| Item | Example |
|---|---|
| Patient | Mother, 78, stroke six weeks ago, left side weak, diabetic. Dr Rao, number. |
| Level and why | Attendant; nurse visit twice a week for the catheter check and dressing; physio three times a week. |
| Shift | 7 am to 7 pm, six days. Night: family. |
| Rate | ₹26,000 a month, paid on the 1st by UPI. Physio at ₹500 per session in a package of ten; nurse visits at ₹500 plus the procedure. |
| Weekly off | Sunday; cover by the family or a day's cover posted at ₹1,100. |
| The chart | Vitals at 8, 2 and 6; sugar before breakfast and dinner; turns every two hours; intake and output; medicines ticked. Shown to the family at 7 pm. |
| The numbers | Sugar below or above the lines Dr Rao gave: hold the dose and call. BP above the line: call. Saturation below the line: ambulance. |
| Diet | Soft, diabetic, low salt, from the cook's copy of this page. |
| Not to be done | No injections, no catheter change, no medicine not on the chart. |
| Illness | Fever or a stomach upset: stay home, paid, say so by 6 am. |
| Notice | Two weeks either side. |
| Review | With Dr Rao every fortnight: what can be stepped down. |
Every number has a time or a rule. The level and what is not to be done are written. The weekly off has a name against it. The step-down review has a date.
For live-in care at ₹30,000 a month, or elderly live-in at ₹28,000, the same page with three changes: the daytime hours and the afternoon rest, a full weekly off out of the house, and a month's notice both ways.
Agency or direct
Direct, through TheHire, gets you the person's own rate, a direct relationship, public reviews and certificates you have seen yourself. An agency takes a margin and in return may provide cover for the weekly off and illness and a supervisor you can call. Direct is right for a single shift with a family that can cover the off day. An agency is worth it for round-the-clock care where two rosters and the cover are more than you can manage, and for ICU-level care. If you use an agency, ask whether the nurse receives the full rate, and read the replacement clause before paying.
After the first week
Read the chart every evening. Ask the patient how it is going. Then do the one thing most families never do: ask the doctor at the first review what can be stepped down. The arrangement that is right in week one is too much in week four.
Then write the review on TheHire. It is public, it is what the next family reads, and it is what keeps the attendants who wash their hands at the top of the list in your city.
When you need more than a nurse
- Food. A special-diet cook who follows a chart; the cook guides cover it.
- The house. Sheets, the commode, the room: the housekeeping guides.
- Equipment. A hospital bed at ₹3,500, an air mattress at ₹1,500, a wheelchair at ₹1,200, a concentrator at ₹4,500 a month on rent, each a separate line from the person.
- Recovery. Post-stroke rehab at ₹800 a session and physiotherapy at ₹600; the fitness and yoga guides cover the long tail of getting strong again.