This is my first time starting a thread here, I've been reading a lot of your posts and find great useful information. I am an LPN in New York City area. My full-time job, I work on a Med/Surg floor in a fairly big hospital and I do HH two nights a week 8hr shifts. On top of all that I'm also finishing my RN through Excelsior College, I have the clinical component left and a couple more general education requirements I should be finished by August.
I've been working HH for about three months now, with the same case. A elderly female, trached to vent not really much to do since it's nights. It's about a thirty minute drive from my house, pays ok could be better but I make almost $2,000 a month (not bad for extra income). The problem is I just quit....why? Well, the patient keeps taking out her trach, this was the second time she did it while in my care. I don't want to make it a third time. Although, when she takes it out her daughter is trained to reinsert it. I don't know what's wrong with the patient she does not seem to be confused but she feels compelled to take it out. Even in her sleep she reaches for the trach.
Two weeks ago I called the agency and told them to find someone else because I didn't feel comfortable working under those conditions. The agency said the daughter would agree to restraint the mother (the patient). The night after I called the agency when I got there the daughter had her restrained. I could tell that it was hard for the daughter to do this, I mean who wants to see their mother restrained. Last night when I got there she was still trying to pull at the trach and the daughter did not have her restrained. I'm not sure why, the daughter said one nurse did not feel comfortable having her tied down. I told her it's for her own safety, I said she should get a doctors order (that's how we do it in the hospital setting). The daughter left the room without her being restrained. So eventually she pulled it out again last night. I said to myself that's it...no more. I called the agency and told them to find another case for me, I won't be going back. It's just not worth the money, I mean what if someone happens to her in my care..lets say she pulls it out and goes into resp. distress, what would happen to me???
Was there something else I could have done in this case rather than quit? I wish I could have stayed to help the patient and especially the daughter because I know this must be really frustrating. I have never met or spoken to the other nurses, but the one who works the nights I don't has not shown up in a few days. Just hoping I made the right decision. Please give your opinions, all and any welcome.
May 17, '09
Did you discuss this with the nursing supervisor? She should have intervened to get a written order from the doctor for restraints, if they are even legal in this circumstance. You were right to leave the case if you were expected to be in the room with the woman in restraints and no written order to cover your behind. The agency was wrong in not following through with this. Since you discussed the matter with them at least once, you did what you could. Sometimes when a nurse is too proactive, they don't get much cooperation from the agency management. If they don't find you another case and you want to continue, then you may be better off finding another agency. Good luck.
May 19, '09
Hi! There can be unique challenges with private duty. And you as the nurse must feel comfortable with the patient and home situation. Sometimes quitting is the best option. I quit a case a couple years ago - what a heartwrenching decision it was for me. I was deeply attached to the child, yet there were "issues" with the family and with another nurse on the case. (Long and complex story...) Like you, one of my concerns was my personal liability if something went wrong. I also worried about what would happen to the child if I left. The other nurse was scary incompetent and I shuddered to think of her being the only one caring for the child. Yet, we can't think that "everything depends on us". It doesn't. Don't want a "martyr complex"! (haha) And ultimately the family is responsible for their loved one. Although it was tough to leave, I felt it was the best decision. In hind site, I feel the same way. Sometimes it is just time to move on! But I felt terrible about it for awhile...So your mixed feelings are normal!
Did I understand right that you work 2 eight hour shifts a week and make $2000 a month?? That is good pay for private duty!!! But I guess you are in the NYC area! I work about 15 hours a week, and only bring home about 1,000 a month (take home after taxes). I am a RN in the southeast though.
May 19, '09
Well, this was suppose to be the night I go back to work. I'm at home on allnurses now. I kind of wished I would have stuck it out and waited for a new position to come along...but I'd only be doing that for the money and that would have been unfair to the patient and myself. I called the agency today as a matter of fact and was told there was no positions for me. I plan to sign with another agency, right now I'm going to take some time out for myself.
Arenevenstar, yes you did understand me, it's almost $2,000 a month. Wow, that is a big difference in pay comparing you're an RN and I'm an LPN. Thanks for the great advice to both you posters. It was a hard decision but in the end I think I made the right choice.
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