SDALPN 11,472 Views
Joined Apr 10, '07.
Posts: 1,043 (50% Liked)
Client cancelled long-term private duty (pediatric) case a week before Christmas. Didn't want any male nurses in the house any longer. Three of the nurses that worked the account were males, and we were all let go from this account a week before Christmas. Only female nurses were allowed to continue to
work the account (24 * 7 pediatric case).
Since the State of Pennsylvania MHMR pays for services (through Agency), I thought about filing a sexual discrimination suit. But just let it go.
Have had several parents cancel my case with them over the years for no reason at all. This has happened to several of the other nurses (both male and female) that I work with. Some of these nurses have been in the industry for over 30 years, and who you'd definitely want to keep around if you had a sick kid.
Get shifts cancelled on a continuous basis (usually parents going out of town for a day or two, or else unable to get a day nurse [I work nights]). This is why I work multiple accounts (usually float 6 or 7 cases at a time).
Every month, I get scheduled for 30 shifts, and end up getting cancelled for 6 or 7 of those shifts. Sometimes the kids do get sick, but other times it's the parents going out on vacation for a day trip.
Anyone out there reading this post who really wants to consider a career in nursing. My advice, pick up your shoes and run as fast as you can in the opposite direction.
Seriously, what the hell was I thinking leaving software to do this crappy stuff. After 10 years, I am ready to leave the industry. Nursing is not a profession. It's a coal mining job with no union protection, with slave owner mentality.
I've tried hospital nursing, where you run your butt off like crazy. Tried Long Term Care, which is more or less like hospital nursing. Now, I do Private Duty. At least I get to sit, but the pay is horrendous. Imagine $22/hour for a Bachelor in Nursing degree, which will run you $50 to $60K in tuition alone.
Run, run, run away as fast as you can.
I also forgot: cameras/baby monitors for mom to watch the nurses while mom lays in bed watching TV all day in a filthy house.
Once there was a note at a house I oriented at "NURSES, MANY OF THE NURSES ENJOY CLEANING THE KITCHEN, WIPING THE COUNTERS, WASHING THE FLOOR AND PUTTING AWAY THE DISHES. PLEASE FEEL FREE TO DO THIS BEFORE MR. SMITH GETS HOME FROM WORK. CLEANING SUPPLIES ARE UNDER THE SINK ON THE LEFT SIDE." (same Mom that watched TV all day from her filthy home)
"Please take your shoes off at the door" - heck no, you have dog poop on your carpet!
I am laughing. Yes, there are some kooky families!
Lets see... over the years I have heard of and or encountered: Hard chairs (metal folding chair), a weird little ottoman that makes you sink in and doesn't have back support, "Please do not sit on our furniture, please sit on the floor.", "Please do not bring any food into our home, please do not eat anything while here.", "Please do not turn the ceiling fan on, I realize its 100 degrees outside and 103 in this tiny room but the ceiling fan gives little Jimmy acid reflux.", "please do not change the channel on the TV, my child is brain dead, deaf and blind but he likes ESPN on at all times, 24 hours a day", "If my boyfriend comes in,call the police, he has been on a drinking/drug binge for a week and I told him not to come home!", "oops, there is not paper towels, clean towels, clean linens and no toilet paper? oh, I will work on that when I get home from work in 8 hours." (meanwhile child has soiled the sheets, needs a bath and I have to pee).
This thread actually infuriates me.
If you are a new nurse and you reading this please take a few things into consideration:
- When your patient is sleeping, you are not just "sitting around doing nothing", you are monitoring your patient with the nursing skills that you learned in your years of experience and in school.
- Insurance companies, medicare and medicaid will NOT pay a nurse to do custodial tasks (laundry, housekeeping etc..) if you are doing them while on the clock then you may be considered to be playing a hand in insurance fraud.
- You are a nurse, you are a medical professional, you are there to take care of the patient, the laundry/dishes/vacuuming is not a medical task.
- Don't try to be super nurse. Doing the laundry and the dishes will not make the family like you, they will just begin to view you as a servant (and many families already do).
- Clean up after yourself, keep your patient clean as possible, keep the medical supplies organized and tidy and do a good job as a nurse.
I have never taken a private pay case. However, I would NEVER take a case that had housekeeping/laundry etc on the 485 (would have to be private pay as insurance companies, medicaid and medicare in the USA will NOT pay for custodial care). To heck with that, I did not bust my a$$ in nursing school to clean someone's home.
Thank you, JBN and BTDT. After (too)much thought, I've come to the same conclusion. It's not about me, and my satisfaction or lack thereof. After being with this family for so long, I'm really understanding boundaries in a way I never anticipated. Thank you very much for your input. I will leave as a professional.
Truly, this case has taught me about the need for boindaries in nursing like nothing else could. As you both have posted before, families can turn on a dime. I guess I didn't think this would apply to me... Until it did. Lesson learned. At a relatively low cost, based on some stories here.
Just walk away. It's not worth it. Work your last shift and be done.
Nothing good will come with trying to explain to the family. You only are obligated to discuss leaving the case with your employer. The family will figure it out. I'd make it clear with the agency why you are requesting to be removed from the case.
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.
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