I was hired by a family to do pediatric private duty as an LVN, and it was explained to me that I would be paid out of a trust fund, which i believe is a public trust for children who experience complications at birth. I filled out a giant employment packet, and was told that she (the child's mom) would call me when I cleared background checks and all that. She ended up calling me the next day asking if I could come in over the weekend, telling me that she called the trust, and that even though they are still processing my paperwork, they can make exceptions to expedite things when she needs it.
I went in for my first training shift (overnight 12 hour shift) with an LVN who is employed there. Here's the thing: this LVN, as well as one RN and another LVN, are employed through a home health agency. Apparently they started off being payed privately by the trust, and then if the mom "liked them" she turned them over to the agency. There are also other LVNs who are employed by the trust. But ONLY the agency nurses document in the patient's medical record.
During my training, it became clear to me that the only place I was expected to document anything is in a composition book that is for the mom. No official record. And the sheet with the meds on it is not a doctor's order, it's just a printed piece of computer paper that says things like "8 pm- half a tab of ____, 200 mg of _____. So i don't even have access to the official medical record, and everything I am supposed to do is either told to me verbally by the LVNs or the mom, or written on plain paper with no official signatures. The nurse training me said that there were things that the mom wanted her to do that she wouldn't, such as giving him homeopathic drops in his mouth since- they are not prescribed, and he is NPO. Also, the girl training me said that I was making $14.50 an hour, and i said that I was told that i would be making 17. She said that it is 14.50 plus overtime for the last 4 hours, because I'm technically hired as a caregiver and I'm working in a "gray area". I know that that is technically hear-say, but I did the math, and she had the numbers right, and it would be absurd for someone to take the time to make that up and even figure out the math if it wasn't true. It just sounded too fishy to me. And we are ON CAMERA- there are 2-3 in every room.
I was supposed to go in tonight and be the LVN on duty and after calling some friends with home health experience to reassure myself that my gut was right, I called to tell the mom that since I personally had no communication with the patient's record, that I could not give medications and treatments , but that i would be happy to come in as a caregiver and monitor him overnight. Of course she raged at me, saying that I must be mistaken, she's been hiring nurses for years and no one has ever had this problem, I don't know what I'm talking about, etc......But I just can't imagine that I am operating within my scope of practice by giving medications and treatments typed up on computer paper and not doing any documentation. There other things too, like the recipe for the formula that we fed him. The LVN put baby food, baby formula, orange juice, several vitamins and supplements in liquid form, mixed it up and poured it into bottles, and that is what he's fed. Don't we need to see a doctor's order to make and/or feed him that? By the way, the patient is on a G-tube, is non-weight bearing, and requires postural drainage and breathing treatments.
Is this mom going around the system and hiring LVNs "under the table", except for the ones who are hired by the agency and document in the chart? In my opinion, even the ones who are legal are sketchy if they are following the mom's med orders instead of the doctor's.
Oh and on a last note, when the RN came in at the end of my training shift, she was dressed as if she's been clubbing all night, with knee high boots, and leggings that were so see through that I could see her thong- not just the outline of her thong, but the actual underwear.