SDALPN 14,938 Views
Joined Apr 10, '07.
Posts: 1,041 (50% Liked)
Personal experience with the laundry issue:
I had a patient I worked with for a few years. The mother started asking us to do laundry. We did it with hesitation since it was "for the patient". However, as we all know...give someone an inch and they'll take a mile. Soon after that the family started leaving their clothes in the dryer for us to fold before we could move the patients clothes in the dryer. After that they would start leaving the clothes wet in the washer. Well we couldn't leave the wet clothes...so of course they got dried. It quickly became a habit of the family to leave the wet clothes in the washer.
I think its best to leave nursing to nurses and leave housekeeping to housekeepers. Parents should be parents. The reason we are in the home is to provide nursing care and education. We aren't babysitters, maids, repair people...etc. If the agencies would make this clear when they started a case there would be a lot less frustration on both sides. But the agencies are scared to be honest with the families. So it isn't discussed when a case is started and then it leaves a grey area.
Don't get me wrong...if I have a wonderful family who treats me right, I'll go out of my way for them when it is *needed* and not expected/demanded of me. The parents that work should think about how they respond to a boss they like vs. a boss they don't like. Its the same way in the home.
As I'm writing this, I'm in a home where the parent just asked me if I would like him to pick up a movie for me while he is out. Of course I said no. I wouldn't feel right saying yes to that. But knowing how well they treat me makes such a difference. I will bend over backwards for this family. They also provide coffee and tea all day for the nurses along with a fluffy couch and big screen tv. I know this isn't the norm and only fill in on this case. But I always thank the parents for being so kind.
I never tell the family. I work for the agency, not the family. And if you tell the family why, they may retaliate.
Just recently a nurse left a case I'm on. She told me it just wasn't a good fit. The agency told the parents that the nurse wanted more hours. Of course that wasn't a good lie and the parents saw through it. Its best if the agency leaves it as confidential if the parent asks. Then nobody has to lie and it won't hurt the family as much.
That behavior is common. Nobody tells these parents how things should work because the agencies are scared if running the parents off to another agency. Right now I'm lucky that I have a parent that is involved without being over the top. But she is home all day, sleeps til 2p. Then watches tv the rest of the day. She whines about how hard the work is to take care of the patient. But acknowledges the hard work we do. She complains about how hard 4 hours is with the patient while we do 12 hour shifts. But I've seen worse. We enable these parents to avoid being parents sometimes. We do need to be there so they can go out at times. A babysitter wouldn't be able to do what we do and give the parents peace of mind. However, so many take advantage that it ruins our view of things. I have some parents that refuse to change a diaper. They walk in and tell the nurse to do it. But then they don't change the kids diaper and wait for the next nurse to arrive hours later. We are there to be nurses and give the parents a chance to work our take a break. But so many get greedy and take advantage. Then they go through nurses quickly and complain they can't keep nurses. The good families keep nurses for years. Sometimes I wonder if these parents with special needs kids weren't meant to be parents but our medical technology saved the kid. I had another case where the parents flipped out if they didn't get a nurse on Fri nights so they could go out. They both were home all day living off the system. But they couldn't be flexible to choose a night when they had nurses and be appreciative of that. They act like its owed to them. Luckily not all parents are like that. Its just hard to find the good ones. But yes, it can be extremely frustrating dealing with that day in and day out. It may be time to find a new case or float for a while so you can find greener grass!
Just because you don't see a camera doesn't mean there isn't one.
I'm not sure why a nurse would purposely block a camera. What do you have to hide? At the very least it makes you look like you have something to hide.
There is a video monitor in my patient's home, but I always assume I am being watched even if that monitor is not trained on me. Who knows whether there are hidden monitors?
I can't say I blame any parent or family member for having monitors. I absolutely would do the same thing if it were my child. I have seen and heard too many horror stories about the bad things people do when they think no one is looking.
I started in home health. I wish I could have started differently, but the hospitals in the area don't hire LPN's. I was lucky though. The agency that I started with had a daycare for medically fragile kids that I was able to learn needed skills at. But I only got a week there to learn trach changes, replacing Mic-key buttons, etc. Then I was on my own. But again I got lucky. The daycare for medically fragile kids was inside a regular daycare. They child I was assigned to was in the regular part of the daycare. So even though I was on my own, I could go to the other daycare if I had questions.
Looking back, I see all the things that still could have gone wrong. The agency wasn't supposed to hire me. But they lied to who they needed to and told them I had a year of experience. I didn't find that out until after a year with that agency. At that point it didn't matter. I also never took a case that I wasn't comfortable with. But with the lack of experience I had, how did I know enough to know if it was an "easier case" or if there was something underlying that I wouldn't realize that I didn't know how to deal with.
As time went on, I took some classes on ventilators. Unfortunately in doing private duty, you don't get much time with another experienced nurse with a real patient on a vent. Taking a class and working with a patient are 2 different things. Again, I was lucky. My first couple of vent patients weren't vent dependent. I was able to use what I learned in the classes to apply to working with a real patient without as much danger as a patient that was vent dependent. As I became more familiar with vents and how to handle situations with patients on vents I moved on to vent dependent patients. During that time I was also exposed to all sorts of feeding tubes, types of trachs, types of vents, TPN, IV/ports, etc.
All I can say is that I was lucky considering how much I didn't know. I had no idea what I had gotten in to until I gained experience. In the little bit of time I had with more experienced nurses on the cases I worked, I'd try to learn as much as I could. I would read their notes to learn interventions that I may not have known.
The agencies don't care about their nurses. Most (not all) just want a warm body with a license. The agencies want to make as much as a they can and some of the nurses don't care about the risk because they want to make as much as they can. Its a bad mix. They agencies will try to pressure you in to taking cases you aren't ready for. Its unsafe, but happens all the time.
If you still decide to go with an agency. Ask questions. Don't let them pressure you in to taking a case you aren't comfortable with. Learn as much as you can from whoever you can. If you do peds, quickly figure out if the parent has a clue or not. Some parents are wonderful and very knowledgable. That can be good or bad. If you come across as incompetent those parents will let you go. If you can learn from the parent or have a parent that is a nurse/doctor it will help. If the parent is one who basically stops caring for their child and leaves the child for the nurses then be careful. Sometimes the challenge isn't the nursing skills needed on the case. Sometimes its the skills in dealing with the family. Some family members want you to do things that are against what you are trained to do or request that things are done in a way that is different from what you know. Then there is the drama in the family. All families have drama. If you do choose to do home health, get to know some nurses who have been with the agency for a while or float quite a bit. They will be able to tell you which cases are better for you and which ones to run from. Don't trust the agency to tell you the truth. The agencies will look out for themselves and do everything they can to get you to work the bad cases or fill in for shifts on cases you aren't ready to do. Good luck!
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