SDALPN 10,998 Views
Joined Apr 10, '07.
Posts: 1,041 (50% Liked)
I started working for a home health agency a month ago and just found out that they are withholding 12 hrs of overtime pay that I desperately needed on this wks check because my employer says they did not receive my nursing notes from a patient on Tues. I worked 5 days in a row and dropped off all of the notes in person. They told me that someone should have called to inform me of the missing doc but no one did before the deadline to enter time. I told them per Florida law, it is illegal to withhold pay for this reason. They said it was illegal for me to withhold a doc. I wasn't withholding a doc as I dropped it off and they admitted that they fired their billing person last week and things have been hectic (obviously paperwork lost) They have my time sheet with the parents signature on it proving I worked. My week totaled 58 hours but I am only getting paid for 46. They said they will pay me the OT when I redo the note and turn it in. Isn't this illegal? They had all of my signed time sheets. Don't we get paid for service rendered and not be allowed to hold pay for missing patient? I learned last night that they with help pay from another nurse because she wrote her notes on the wrong forms. How are they getting away with this?
That's the problem when the family believes you work for them rather than the employer, and the employer plays into it.
Maybe your friend would prefer home health, more autonomy and more money?
My friend is a home care nurse, and she's been instructed by the family to bring her own toilet paper. That's right, BYOTP. They also pointed out that she is to sit in the hard, straight back wooden chair during her shift, "so she doesn't get too comfortable". Another colleague on a different case has been told she is never to speak with a family member unless they speak to her first. I used to think dirty houses were the worst part of home care, but there are families who make the job a nightmare. I guess I'm blessed to work in a friendly, collaborative home!
What are your most outrageous home care demands?
This may sound unfeeling, and I don't want to sound like I don't care, but I am not indispensable. If I were to leave, they would probably miss me for a while, but - a year from now - they won't even think about me except maybe once in a while. My shift will belong to another, and they won't miss me. Life moves on.
Your life also moves on. What was right for you, what was a good fit then, might not be a good fit now. That's OK.
I'm always honest, but that doesn't mean that I have to explain that which is really my own business.
Is there any actual scholarly research that documents why new nurses (new to nursing, not new to an agency) do not belong in private duty settings, especially with inexperienced parents and high-needs children?
I talk about this topic a lot when talking to parents of MF/TD children and someone said that she was planning to hire a new-grad nurse that is her friend. She got back to me and said her friend wanted to see research on this matter.
I countered with all the normal logical stuff (a quick trach change on a sim-baby is not the same as a trach change on a squirming, crying child; no one to help in the event of an emergency; the 6-hour vent class for an agency doesn't teach enough to troubleshoot and correct a technical problem; because she is an inexperienced parent - her child is still in the hospital - she is unable to fill in knowledge gaps that the nurse has).
If anyone knows of any legit research, please let me know. If this hasn't been researched, why do you think it has not? How do states with experience requirements justify their rules if there is not adequate research.
I am not a new nurse, sorry forgot to mention that , I graduated in 2008, have done telemetry,postpartum, and school nurse. I am working PDN PRN and during my breaks.
It's typical. It sets up nurses with boundaries for failure. The agencies only care about the money. So if the family is happy, the agency turns their heads. I've lost plenty of cases for keeping boundaries.
Here in lies the rub. She IS paid to assess his communication skills specifically by the family who employs her through her employer. If she is not specifically assessing his educational experience, she is not overstepping her legal boundaries. Cognition, and verbalization are an accepted nursing assessment in all arenas of health care, It does sound like the school is attempting to control her legal practice of nursing, and her employer, and the child's parents should be the ones to stop this behavior.
I just want to say that you rock!! I am a parent to a nonverbal child as well. He does not require nursing, but we have had the run around with getting information relating to the classroom. Ask for their policy in writing, chances are they don't have one. Secondly, have the parents get up their asses about the lack of communication. Have them call an IEP meeting and then provide the teacher and team with a sheet that the teacher must fill out every day (i'm happy to provide an example of one It sounds as if the school has something to be worried about. I had this issue at the beginning of the school year, they wouldn't let his 1:1 speak to me. We switched schools and I have no problems now.
Thank you. I am a night owl right now, I can't fall asleep before 1 or 2. I'm sure I will be fine once I switch my sleep schedule.
Thank you! I think my body just didn't have time to adjust since I only worked a few nights on the other case. I know I can do it, I just need to adjust my body to it. Thankfully it's only an 8 hour shift.
You need RN oversight. There was a new grad considering a PDN case. No RN, 2yr old care plan, etc. even if not billing insurance you still need to meet the standard of care for documentation and orders.
If paid by a trust be prepared for a 1099 and mandated self employment taxes. Know your risks of not reporting income and make an educated choice. I think you lowballed yourself if less than $20
Don't take on a vent client without formal classroom education with at least 24hrs preceptorship with an experienced nurse (my agency is 3x 8h per level--infant (to 18 mo) child (19 mo to 17y) and adult (18+) some have a 4th level senior/geriatric (62+)
You need to be able to operate, basic trouble shoot, such to back up power or vent, hand ventilate (BVM), do routine and emergent trach changes. Clinical details come from a clinical nurse manager not HR. You are it. You should have a nurse supervisor on call via phone 24/7 and DME phone support 24/7 (should be able to bring back up equipment within a few hours in case of failure) otherwise you are it aside from phone support. Calling EMS for severe situations (unable to replace trach, power failure with no generator) but need to make sure ALS unit as EMTB cannot manage trach/vent.
How can you monitor a patient if you are driving especially a seizure or critical airway. You can't. Don't do it.
Emergency procedures are not covered during interview but during orientation and formal vent training. You should be offered at least a full day class with practice vents and mannequins. You replace the trach following protocol. Switch to back up for vent failure then call DME. Can't ventilate or replace trach call 911.
Unfortunately, I have worked for several private duty companies and the schedulers lie, bait and switch, and play such nasty games.
Are they actually trained to do this?
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