am I a nurse or home maker???

Specialties Private Duty

Published

I have been a lpn for 16 years now, and have worked in many facets of the induatry. I am curently a home health nurse for a private duty agency. Is it me or do these insurance companies, and employers expect us nurses to become home makers while on duty for the families. I had one case with a 2 year old vent patient, his single mother brought in 2 bags of laundry and said they needed put away as if I were to do it. I said to her "you'll get to it soon" and jokingly told my case manager. I was told sometimes as nurses we are to take over parental duties also. Also, when did I go to school to be a dietician or chef? I am expected to prepare all meals while on duty. Should the meal prep not fall on the family and as a nurse I have no problem warming a meal, but to plan and prepare the meals are not my responsibility. As nurses we have set guidelines as to what we are permitted to do by law. And as nurses we shiuld set our own guidelines in the home setting as to what we will not be made to do that we wouldn't do in othwr settings. I barely cook at my home. I also am expected to vacuum my patients room and wash the dishes I use to feed the patient. I am sorry, but this is not my job. If a patient requires meal prep and skilled nursing caee it is time we, as nurses make a statement to our employers and these insurance companies that want to skimp and save money, that we have specific training and skills for nursing care. And if meal prep and cleaning need done that it falls on the family, or a homemaker that be paid by the insurance instead of them expecting and forcing us to do it while attending to medical needs. I thought that's what we did, nursing care. Thanks for readung and hope to read some responses.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Imintrouble I suspect a copy of a signed agreement may not always be included in the client's home chart, especially with the trend toward EMR. Generally they contain a section identifying the PCG who must agree to be responsible for covering hours in the event the agency can't staff the case and a section stating that the nurse isn't responsible for family housework or babysitting siblings.

As far as doing "CNA tasks" or "RT tasks" I had a real 'you know you're old school when...' moment as I've never considered either anything but a subset of nursing tasks even though hospitals now split the care into different job categories.

So much of this is dependent on the characteristics of the family and their relationship with the nurse. I've gladly washed dishes in the sink if they are there, folded a basket of family towels etc but leaving a kitchen full of mess and being expected to clean up after able-bodied relatives is a different story.

Specializes in Peds(PICU, NICU float), PDN, ICU.

The problem with doing the family dishes is that they quickly tend to expect it. It also makes the family resent nurses that stick to their job description. Plus doing anything outside of what insurance is paying you for can get you in to trouble if something happens. Or if you got injured doing the dishes...maybe a broken glass or something. If you slice your wrist with a broken glass on the job, I'd wonder if you would still be covered since its not a job you are supposed to be doing. Then they would ask why you weren't caring for the pt. Of course we are capable of watching a stable child and listening to a monitor while washing dishes...I don't want it to come across the wrong way. But it could lead to being questioned about neglect. These agencies are too quick to throw us under the bus. It feels good to go above and beyond for an appreciative family. But as a nurse who has come behind nurses that have allowed themselves to be a servant instead of a nurse, its not fair to the next nurse.

If we all went in and did the same job within the same parameters, the families wouldn't push us to do more. But when they see one nurse do one thing and another nurse doing smoother thing, they learn to play nurses and get as much as they can out of us.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

SDA I actually agree with you and caught a fair amount of flak for it in the "nurses aren't maids" thread I linked to.

An example of what I mean would be a grandpa carrying his dinner dishes in while I'm washing the patient's things and looking hopeful.. I'll say 'give 'em here..' He appreciates it and it adds very little time. I don't use baby monitors very often. I get nervous when I don't have eyes on the patient.

Specializes in Peds(PICU, NICU float), PDN, ICU.
SDA I actually agree with you and caught a fair amount of flak for it in the "nurses aren't maids" thread I linked to.

An example of what I mean would be a grandpa carrying his dinner dishes in while I'm washing the patient's things and looking hopeful.. I'll say 'give 'em here..' He appreciates it and it adds very little time. I don't use baby monitors very often. I get nervous when I don't have eyes on the patient.

Its such a fine line. I wish there was a PDN certification and classes so we could all be in the same page. But these agencies don't want us to know much except what they tell us. They don't tell us up front what the ins companies want. And they don't help us by telling the family we can't do certain things. I think that would solve many of our problems.

From the parent side, the agencies promised us everything except for unicorns, rainbows and our child waking up and talking. They told us that the nurses prepare the formula, wash all the bottles/syringes/extensions/neb sets/equipment/laundry, order supplies, check supplies, put supplies away, vacuum, clean the room, take out the garbage, keep the "nurses" bathroom clean....

Specializes in Geriatrics, Home Health.

I worked very briefly on a case where the nurse washed, dried, and folded the laundry for the entire family, which included 4 children under 12. I have no problem doing client laundry or preparing client meals, but I won't do it for the rest of the family. I'm a nurse, not a maid.

What medicare does not pay for:Medicare Interactive - Script

Specializes in ortho, hospice volunteer, psych,.

When my mom was dying of breast ca with mets to her brain, pancreas, and liver we had hospice nurses and a few aides to take care of her. All went smoothly until about six weeks before she died. As the ca in her brain progressed, her whole attitude toward me changed drastically. I had quit my job and was there most of the time until it became impossible. I never knew when she saw me if she'd greet me as she aways had, with a cheery 'hiya Babe! Tell me all about your day." or whether she'd scream "Don't hurt me again!" or ask me coldly "What have you come to steal this time?" It just about broke my heart.

The Amish girl (unmarried Amish women are referred to as girls whether they're 2 or 102.) who had worked for my mom came in 3x a week as always an did cleaning, laundry, etc. Then the day came when my mom was afraid of her too. At that point, the nurses and aides just began doing may of the tasks without my asking ad it made me feel awkward but I wasn't quite sure what to do. I was reluctant to bring anyone new into that situation. I filled in as much as I could behind the scenes but my mom got so upset eventually

I almost hated to be there.

I told the nun who ran the hospice that I hadn't asked them to do household tasks and she said not to worry about it, but I did anyway.

SDA I actually agree with you and caught a fair amount of flak for it in the "nurses aren't maids" thread I linked to.

An example of what I mean would be a grandpa carrying his dinner dishes in while I'm washing the patient's things and looking hopeful.. I'll say 'give 'em here..' He appreciates it and it adds very little time. I don't use baby monitors very often. I get nervous when I don't have eyes on the patient.

I would do that too. It comes down to being courteous and kind. We are there for medical care, maintaining medical equipment, keeping a sanitary environment (not housekeeping) but we should be decent and know how to be friendly.

Now here is a scenario, my patient likes to go out on "walks" in his wheelchair. Grandpa who lives in the same house likes to go for walks. The family worries if he goes alone. So, I hold off my patient's walk till grandpa is ready to go. My patient loves walking beside grandpa, I have my cell if he were to fall, everyone is safe and happy.

Specializes in Pediatric Private Duty; Camp Nursing.

I have a case where the older 5-year-old sister has some behavior issues and craves attention, and melts down quickly. I'm on the overnight shift and she sometimes wakes up looking for her parents. She needs to walk through the room I'm in to get to her parents' room. Sometimes when the girl goes in to them before its time to get up, the parents are grouchy w her (and understandably so) and she melts down, causing a household ruckus. So I'll stop her and give her some attention, talk to her on my lap, soothe her, remind her that her parents are sleeping and they'll be happier in the morning if they get the sleep they need. Then I'll go tuck her in again. This just happened about an hour ago! I don't mind doing this although its nowhere on my responsibilities list to deal w the other children in the family. I just do it to be nice, it feels like the right thing to do.

This thread go me thinking of trying to get people to do unrelated tasks. My mom works sews custom window treatments for decorators and told me about the client she is doing work for.

The client tried to get the decorator to wash dishes for her and the installer(guy who puts up curtains) to walk her dog. They refused. I am joking with mom wondering what unrelated task the client will try to dump on her when she goes to the house to measure windows.

Specializes in Peds, developmental disability.

I hit that like button too fast! The nurse is not the child's teacher! I love teaching kids... I homeschooled my own. The parents is the primary teacher. It is like holy ground, and I think it is important not to accept much responsibility in that area.

+ Add a Comment