Would you do this???

[RN1263]

We had case conference today and were informed that we (all nurses) would have to make visits (rotating) for one patient 4x's per day- 6AM, noon, 6PM and midnight for an indefinite amount of time . Does this seem like a ridiculous request or is it just me?

Our normal business hours are 8-4:30p, unless you're on call. What would you do if asked to do this?

I have health problems and take meds at night, it takes all that I have just to be on-call every 4-5 weeks.....

[Blackcat99]

No, I would not do it. That's the most ridiculous thing I have ever heard of.

[berube]

i have never heard of that in Home Health,,,we are suppose to be doing intermittent visits, not q6h visits indefinitely,,,,,what are they requesting this for? is this a medicare patient?

[RubyRN,CHPN]

Right, it sounds excessive though many years ago, we use to do q8h IV visits in the absence of a trainable caregiver and insurance use to pay but that no longer be the case. Believe me, if your agency feels they have the resources to meet this clients needs and the insurance or client will pay for the service, they will take the case. Perhaps, you can negotiate with your employer that on your call nights you come in later or take a comp day, the following day after call so you can get some rest. I know, call sucks and it is asking quite a bit out of already thin stretched staff members. I once worked with a gal who took meds at night which prevented her from practicing and driving safely and she negotiated a work schedule (worked every other weekend) instead of being in call rotation. It worked well for her. Become part of the solution....good luck!

[tencat]

Ridiculous. No, I would NOT agree to off-hours visits. If someone needs that much care, they need to be in a different setting such as LTC, not home health.

[RN1263]

i have never heard of that in Home Health,,,we are suppose to be doing intermittent visits, not q6h visits indefinitely,,,,,what are they requesting this for? is this a medicare patient?

No, not a Medicare patient and I'm reluctant to say the "skill" or get too specific regarding the case, in fear of a co-worker reading this thread and it being a violation of patients privacy ....

And, Ruby RN said:

>>>>>>>>>>Perhaps, you can negotiate with your employer that on your call nights you come in later or take a comp day, the following day after call so you can get some rest. I know, call sucks and it is asking quite a bit out of already thin stretched staff members.

To clarify, it will not "specifically" be the on-call nurse doing these visits. It will be any nurse scheduled to do the visit, whether it's at midnight or 6am, then expected to turn around and work their full shift 8-4:30p.

[caliotter3]

I would hate to be the nurse stuck doing the midnight or even the 6 pm visits. This is not reasonable. They should find somebody willing to take on the different visit times "permanently" and pay them accordingly, like 1.5 points or two hours pay or some kind of incentive, for disrupting their offtime. I suppose the person lives across the river and down the beaten path to boot.

[RubyRN,CHPN]

Yea, like a 3 hour minimum call back time for that 6pm and 12mn visit plus a shift premium for working after hours. Not to mention all that travel time and mileage.

[anticoagulationurse]

Um, NO!

[RN1263]

>>>>I suppose the person lives across the river and down the beaten path to boot.

YEP! Patient is definitely FAR away and in the woods, how did you guess...LOL

[gardenvarietyRN]

If this patient really needs Q6 hours then a RN who is not on call needs to be assigned to this case so that the on call RN can be the back up incase illness, accident, etc. Even if the patient is stable enough to be managed at home, it is important to consider the RN's safety in traveling and going in and out of the home alone. Anyone who has any interest in targeting the home or RN can figure out that the visits are Q6 hours.

I aggree that anyone on medications that may impede their practice should discuss it with their employer and make alternative arrangments. Not only is it hard on the RN, but it can create a situation that endangers the patient or place the RN's license at risk.

[RN1263]

it is important to consider the RN's safety in traveling and going in and out of the home alone. Anyone who has any interest in targeting the home or RN can figure out that the visits are Q6 hours.

Absolutely....Not too mention there are no street lights, since it's in BFE!

I agree that anyone on medications that may impede their practice should discuss it with their employer and make alternative arrangments. Not only is it hard on the RN, but it can create a situation that endangers the patient or place the RN's license at risk.

I have Multiple Sclerosis, but never thought I would ask an employer for a work accommodation until now. So, today I saw my doctor and he said "no way" to the midnight and 6am shifts. He isn't happy about the fact that I have to be on-call every 4-5 weeks as it is, because when I'm on call I have to alter my sleep pattern and medication times and doses due to side effects, just to be able to function. He said pushing it any more could cause an exacerbation. So, he said I can't work before 7am or after 10pm on a "regular" basis, unless I'm on-call. He said he will write them a letter or whatever I need....

So, tonight I wrote my request for accommodation letter, according to ADA guidelines and I will give it to my employer tomorrow.

Thanks for the replies!:)