A new puppy!!

JustBeachyNurse, LPN · Sep 2, 2014

Vent mommy as one of our resident family experts do you feel that care/training of a patient/client's new puppy should be done by nursing? Perhaps a HHA?

I will let a family dog out if my patient & I can do it. I will help my pedi patient fill a water bowl or give the dog a treat. But letting the dog out/in is not expected on any of my cases with dogs. Helping my patient is therapeutic as it works fine motor and each is thrilled when the dogs listen (these kids have awesome dogs that can hear my good cognition but nonverbal) to them.

ventmommy · Sep 2, 2014

I have mixed feelings on this. We had and still have pets in our home. I definitely appreciated nurses that cleaned up overnight hairballs but I didn't expect it and didn't mind if one said "Kitty puked last night in the ___ and I put a paper towel on it."

If we had a seizure dog, then absolutely, yes, I would expect the nurses to be willing to work with the dog and open the back door so he could go out, do his thing and come back. I would not expect nurses to feed/water unless I wasn't home.

For a therapy dog or pet dog for someone with no family is where I have my conflicted opinion. I absolutely understand the positive impact that even just a regular old pet has on the life of a disabled or sick person. I hate that nurses might be the only option to provide care but if the pet is improving QOL of the patient, then I kind of support it even though it's definitely not something that is a nursing duty.

PS - Mini horses do have some ADA rights. I love minis! They are so cute.

cubrnjvm, MSN, RN · Sep 19, 2014

I was always trained not to do ANYTHINg that was not included in the 485. Report that there is a dog and you have to take care of him ( her) as well, just in case.

ventmommy · Sep 19, 2014

How can you possibly not do anything not on the 485? My son's doesn't say anything about hygiene, diaper changes, ordering supplies, stocking supplies, checking the go bag, etc.

I checked with two parents of children with service dogs. One child has trach/vent and the dog is for seizures. The child is neuro intact. It does not say on the 485 that the nurse is responsible for the dog but it's part of the rules/responsibilities that the parents gave to the agency. At school, the nurse is responsible for picking up poop and giving the dog water. At home, the parents do it unless they are asleep or not home. The dog is responsible for alerting the caregiver that the child is about to seize so that the nurse or parent can take appropriate action.

The other child is blind and hearing impaired. The dog knows sign language! He does not have a nurse but I thought you might be interested. At school, the teachers and his aide are responsible for picking up poop and giving the dog water. At home, the parents and the aide are responsible.

Girlafraid13 · Sep 19, 2014

I had to take care of a cat once but as a caregiver not a lvn. I hated emptying the litter box. I left soon after.

**Elektra6, ASN, BSN, RN** · Sep 23, 2014

My patient got a Rottweiler puppy! Luckily she is very smart and gentle. She's one now and will escort me to my car when I leave! I don't have a problem filling an empty water bowl or letting her out/in. The client lives with his family and they take care if her.

CloudySue · Dec 30, 2014

Update on the puppy... Well, it's 4 months later and I'm so fed up w this dog. I'm admittedly not a dog person but this dog is really out of control. It went to behavior school for weeks and all it can do is sit... some of the time. It chews on my feet so I always have to keep my feet up. It doesn't understand "no". It doesn't respond to its own name. It needs attention all the time and I've nearly stepped on or tripped over it hundreds of times. I still feed it, play with it and pick up its poop off the wee-wee pad, it's a part of my duties because this client requires total care for all ADLs, and I've made my peace w it. The job is nice otherwise so I'm ok w the status quo. Until...

The puppy got spayed last week. It came home the same day. The family just assumed I'd be performing this dog's post-op care since I'm the only person up all night anyway. I was uncomfortable with this arrangement but they didn't ask me how I felt about it. I decided to go with the flow. I fed this dog baby food from a syringe and looked after it all night. The next night I showed up and the mom reports that the dog has had diarrhea and that she's made messes everywhere including getting all over her fur. The mom picked up the dog and told me to lift the tail and look at its orifice, thinking it was clogged, what did I think? I told her I don't know dogs, or post-op care for them, maybe she could call a friend who knows, or maybe the vet? Then she said she was going to bed, left the client's apartment, back through the garage where the rest of the house is. So ok, I'm stuck with a sick incontinent dog. Great. My discomfort worsened. I don't mind poop in general, but cleaning up after a sick dog was not my purpose in this household. I was starting to feel taken advantage of.

Then my client tells me that in about an hour, I have to take off the cone of shame around the dog's neck and get her to eat kibble out a bowl. (The soft food was giving her the diarrhea so she had to switch back to kibble.) However, I was instructed to be careful that the dog doesn't bite out her staples. Well, that freaked me out and I drew the line right there. I asked her if someone in her family could take care of that job, as I didn't think I could prevent that and didn't want to be responsible if something went wrong. That dog is quick as lightning and impossible to control. I feel like Rocky chasing the chicken when I try to catch that dog. I was pretty sure that if the dog wanted to bite out her staples, I couldn't stop it. So my client texted her sister (home from college) and she took off the cone and fed the dog.

The next day I got a text from her that because her mom cannot guarantee her that family members will be home every night to care for the dog, she had no choice but to take me off the schedule until the staples come out. (She has two sources of aid for caregivers, and she has uncertified aides who she hires herself with no agency.) She says I can come back next week. My educated gut feeling is that mom, who is not a fan of animals and has a low threshold for tolerating grossness, just doesn't want to do extra work for this dog at any cost, and has convinced my client to use the aides.

My clinical services manager and nursing supervisor both agree with me that veterinary post-op care is NOT my job, that as long as there are able-bodied adults in the family, they should be able to work it out amongst them. I'm glad my agency supports me but I lost a LOT of hours nonetheless. My agency was not able to replace all my shifts last minute. My husband has been incredibly supportive, he's glad that I drew a line in the sand and stood my ground.

Your thoughts please?

Red Kryptonite · Dec 30, 2014

I agree that you already gave more than could be expected and your instinct to protect yourself was right on. I would have refused to do any post op care at all.

JustBeachyNurse, LPN · Dec 30, 2014

The agency needs to step in and draw a line in the sand especially with an untrained dog and the veterinary/medical care. It's an unsafe environment if the dog is an ankle biter and not "toilet trained". My last straw (and I'm a dog person) would have been the incontinence. That's not a service or comfort animal it's a wild puppy that lacks training and discipline...clearly the wrong breed/dog has been selected.

On a different example a family got a pet from a breeder a Maltese-poodle-shaggy-small-weenie mix?. Reasonably calm. Knows name. Excellent with client but a family pet. Passed obedience trainingCalm enough that client (spastic quad with minimal ability to move BUE and grasp) was able to grasp the retractable leash and "walk" the dog with me pushing the chair and supervising. No one thought to try before. Mom came home and was ecstatic taking dozens of photos obliging me by cropping me out so it looks almost like the dog is walking her in the wheelchair unless you notes glimpses of my unique printed scrubs. Family cleans up. The most care I enable is helping client "walk" or cuddle dog and facilitate giving pup a treat.

Another case the most I do is let dog in/out if I'm not otherwise busy and perhaps help my patient pour dog food or water if the preschooler is so inclined.

caliotter3 · Dec 30, 2014

Don't understand why you would stay there. Taking care of the dog is unreasonable and not what you are being paid for.

NightNurseRN13 · Dec 30, 2014

I am a lover of all animals, but under no circumstances would I accept responsibility for a family pet. It takes away time spent with my actual patient. If the family doesn't have time to take care of the animal themselves then they shouldn't have gotten it in the first place.

CloudySue · Dec 30, 2014

Don't understand why you would stay there. Taking care of the dog is unreasonable and not what you are being paid for.

I will admit why I have put up with that dog- $$$$$. It's a 12-hr shift and I was working it 5 days/week. I can deal with routine care for a healthy dog. Actually there's more to it than that, I've been w the ct for 4 years. I have (had?) a wonderful rapport w her and the family, and truly, I never imagined they'd cut me off at the knees like this without warning. It's a sobering reminder to me that no client, I mean NO CLIENT, is incapable of throwing a nurse under the bus if it suits their needs. I always had this in the back of my mind, but I broke a cardinal rule of PDN and trusted her and them. When I go back, I'm going to start backing off on the relationship. It's just business. They made that clear.