[SDALPN]

I have worked with another agency for about 3 years. I've had to deal with the typical agency issues and have always gotten through them fairly well. I just recently started with Maxim and while I understand every agency is different, some things should remain the same. (I think). I guess I need a little advice on how to handle this as well as need to rant a little.

I was just recently informed by my patients family (not Maxim) that Maxim will not pay for a nurse while the patient is at the Dr. office but that Maxim requires that the nurse stay with the patient. I was also told that it would be ok to stay late those days to make up for the time. Can they do that? It also frustrates me that they never bothered to tell me this but that the parent had to. Its not the parents place to go between the agency and nurse about pay issues.

Its also frustrating that they require us to chart using no abbreviations at all. I've heard all sorts of rumors such as a patient died, they got sued, so the parents can read the notes easier, because JCAHO doesn't accept any abbreviations (I know thats not true), and all sorts of other stories. I'm still trying to get used to this way of charting. If you accidentally write an abbreviation you have to drive to their office to cross it out and rewrite it or they refuse to pay you for the week.

I work on Sat. and they require notes to be sent in by 0800 Mon. They insist we drive our notes to them about 30 minutes away before we go home but we don't get paid for our extra travel time. I understand not being paid to and from a case as its like driving to and from the hospital or clinic. But I have already driven to the case and then they want me to drive 30 minutes (one way) out of the way to deliver notes. If they don't get the notes by the time set, they refuse to pay us until the next pay period if the notes are in.

The other agency I'm with doesn't do anything like this or treat us this bad. I know agencies don't have the best rep for treating their nurses well but this is rediculous. I think I may leave after the case I'm with ends whenever that is. I really like the family and the patient. The family was about to leave the agency until they found me. They were not happy with the other nurses sent out but seem very pleased with me. The family has signed a paper with Maxim saying they can't use me as a nurse through any other agency for 6 months after leaving Maxim or else the family says they would just go to another agency.

Am I being rediculous? or is it the agency. I've been with the other agency for a while and never had problems like this....a few crazy parents or whatever but nothing like this. Thanks for listening!

[MeghanRN]

I worked for a Private Duty Company as a staff RN, and also as a care coordinator.

A few things:

1. Maxim must pay for the nurse even if the patient is at a drs. visit. If your shift if 7a-7p, and the drs appt lasts 2 hours during that shift, you are not required to stay until 9p to make up that time. Oh no..

2. The No abbrevations thing is interesting. Are you sure ? We had a list of accepted/approved abbrevations that we could use, but nothing else.

3. The only time our nurses ever came to the office was for yearly inservice. Prepaid envelopes were provided in each patients home for notes to be mailed into the office. It was the responsibility of the Sat PM nurse to mail the notes for the previous week.

I think something fishy is up there..have you considered another agency?

Also, if you switch agencies and the parent switches to the same agency (without you mentioning 'hey, come to XYZ agency thats where im going!" ), there isnt anything you can do about that. I dont think they should have had to sign anything saying they cant use you as a nurse..thats just odd..

I think i'd find another agency if it was me...

[SDALPN]

The No abbrevations thing is interesting. Are you sure ?

I'm 100% sure. Think it could be a local thing? I know other Maxim offices in the area do the same thing. They don't allow a single abbreviation or symbol. I think its very wierd.

Prepaid envelopes were provided in each patients home for notes to be mailed into the office.

The other agency I'm with does that. I've asked this one if they did and they looked at me like I was crazy.

Maxim must pay for the nurse even if the patient is at a drs. visit. If your shift if 7a-7p, and the drs appt lasts 2 hours during that shift, you are not required to stay until 9p to make up that time. Oh no

I called the labor board about that and they said there was nothing wrong with them doing that. BUT, if those hours and the paid hours added up to 40 they had to pay me overtime. Does that mean I could work 40 non-paid hours and then automatically start getting overtime from them on? Thats scary! I'm very frustrated.

I wonder if the corporate Maxim knows that this is going on in this area. They won't keep nurses doing stuff like this. I feel a little better knowing its not me. Thanks.

[ArwenEvenstar]

Hi! I am an RN that does private duty through Maxim in the southeast (South Carolina). I do not have any of these issues. They gave me a list of "acceptable abbreviations" and many of the common nursing abbreviations are indeed okay. However, there are a few abbreviations that are pretty common/routine that are not on the list. I know that I have accidentally used them from time to time, but I have never been called to the office to correct it!!!

Our paperwork does not have to be in until Noon on Monday. (8 am at your Maxim seems awfully early!!) Plus there is a drop box, so you can drop your paperwork off anytime even if Maxim is closed. I've been a little late with my paperwork before (like handing it in an hour or two late at 1 or 2 pm) and it was not a problem at all. I still got paid on time.

I've heard before that different Maxim offices can be a bit different. I've heard of some people who love Maxim and others who don't. It may just depend on who is running the office you work at...

Only minor issue I've had with my local Maxim is one of the guys who helps do staffing seems like a "young punk" (young and unexperienced) and he doesn't quite grasp that nurses are professionals. I'm an RN with 17 years experience, and I like to work through an agency for flexible scheduling. My life comes first, and my job second. If I need time off, I need time off. Plain and simple. And I always give ample notice. Anyways, to give an example - I called in over a month ahead of time to let him know that I would be unavailable to work several Mondays the following month. He acted like this was a HUGE deal!! He repeatedly said "your killing me", and then preceded to grill me at the stake (asking me all kinds of questions) wanting to know precisely WHY I needed the Mondays off. Annoying.....I am a very conscientious employee that rarely calls in sick and I always give a ample notice if I need time off...so I don't expect to be harassed and given a hard time - especially since it is agency work.

But other than that, I like my local Maxim. I prefer them over the other agency I worked for in the past.

[caliotter3]

I worked for Maxim for years and was generally satisfied with the company, if not with individuals within my local office. I was always paid when I accompanied my patient to the doctor as well as when I accompanied my patient to the ER. I don't know where this came from. If your local office has indeed instituted this change, then I would go off duty when the patient goes to the doctor. Simple as that. As a matter of fact, I had a patient one time where the family refused to allow the nurses to accompany the patient to MD appointments because they liked to be in control of what the nurse found out about any new orders or what exactly was said to the doctor. That was one of the reasons that I stopped working on that particular case. Whenever a client/family keeps medical care a secret from the nurses and agency, that is an invitation for trouble. We were provided with stamped, self addressed envelopes to mail in our notes. If they didn't receive the notes by the cutoff, occasionally a staffer would call and take your hours over the phone to make sure you got paid. Regardless, they have always accepted faxed notes with the hard copies to be mailed in. Driving 30 minutes or miles just to deliver notes has never been a requirement with any office that I've heard of. As for the abbreviations rule, this came about a few years ago when they got very picky about using the list of acceptable abbreviations and making employees aware of the Don Not Use List put out by JCAHO as one of their safety goals. It only makes sense, that one refrain from using abbreviations at all in order to keep from making mistakes. That is the tactic I employed when they made this an issue. I didn't find it very difficult at all to start spelling out my words. You aren't responsible for writing that much in the shift summary/nurses notes anyway, so just train yourself to write it out. I would feel put out and taken advantage of, as you do, about not being paid while you are with the patient. That is enough of a reason to leave Maxim. Look at it this way, you are with the patient and still are legally responsible for them while traveling to and from the appointment. You are legally responsible for communicating with the medical personnel. And not get paid for it? Find another agency. Maxim, or at least this office, is deteriorating in their practice of sound medical care. They are placing you at risk and not even paying you what you are owed. It is not worth it. There are agencies out there with a better sense of ethical behavior.

[caliotter3]

I forgot to add that the clause that the family told you about not being able to use you for six months after their case has left Maxim is just smoke. Maxim has utilized nurses from other agencies on shared cases and when cases are moving from one agency to another. It is your choice whether you want to go with your case should the family decide to change agencies and Maxim can not stop you from doing so. They can treat you badly, but they can't stop you and they know this. Just make certain that you are not the catalyst for the family changing agencies. It is their decision and they should make this decision without undue influence from you. Frankly, since you are dissatisfied with how Maxim has been treating you (as you should be) it might very well be to your advantage to follow this case to a better agency while your professional reputation is still intact. Good luck.

[SDALPN]

Thanks for all the advice. I got some of the problems worked out. Still not very happy but things are better than they were. Thanks again!

[ArwenEvenstar]

More on Maxim....Different topic than OP...Although I like Maxim as an overall whole, staffing/scheduling things are getting on my nerves...

I called in earlier this week 5 hours before my shift started, and I was told that the policy is that you have to call-in 24 hours ahead of time! I was hassled. 24 hours ahead?! How is that possible?? How can you know the day BEFORE you get sick or a personal crisis arises?? I wish I could know 24 hours ahead of time when I was going to get sick or something bad was going to happen - then I could possibly stop it from happening! (I already vented about this on another post...See that one. haha) I know with private duty cases, a family/patient is really counting on you, but everyone needs a sick or personal day from time to time.

Does your Maxim have this 24 hour ahead call-in rule? I wondered if this is a nationwide Maxim thing now, or just my local Maxim?

Since I rarely call-in (like 2 times a year is average for me) I shouldn't let this bother me. Who cares, right? But Maxim contradicts themselves. If I notify them MONTHS in advance that I need time off (like for a family event or vacation or whatever), they still hassle me. "What?!?... Why do you need this time off?!?..."

I always thought (maybe I'm wrong here?) that one reason nurses chose to work through agencies was for scheduling flexibility. I am given a more difficult time by Maxim about needing time off than I was given as a hospital employee!! I thought it was suppose to be the opposite - hospitals have more rigid and difficult scheduling policies, and with agencies you can have more flexibility!

Well, thanks for letting me vent. I let LITTLE things annoy me.

[ArwenEvenstar]

Oh- one more thing. When I called in, they asked me if I had called the client to let them know I would not be coming! They indicated I should have called the patient's family myself!
Huh? I thought this was why I worked through an agency because they were the liaison! I don't even know the family's home phone number, and I certainly don't want to call them myself because then they would know my home phone number (caller ID). No way do I want the family to know my home phone number and be calling me at home...

[billssisbeth]

I work for Maxim in Saint Louis, MO.
I'm also struggling with the no abbrevations thing. My office won't let us even use et, s/s. c/o or AFO (I had to write out Ankle Foot Orthitic Brace)
I can understand not using MSO4 or Mag Sulf. but not being able to write PRN or GB for G-Button makes me nuts!
JCAHO will still allow most of the standard nursing abbreviations.It has nothing to do with JCAHO I was told in Orientation Maxim now has an independent firm that governs thier charting issues.
I'm off on Mondays so it isn't a big deal for me to run in and fix any "corrections".. FYI it is ilegal for any employer to HOLD a check... call em on it!!! Or get Direct deposit going.
Hope things work out better for you. Maxim is a good company overall if you can get past the picky little details.