How are the families in PDN

ArwenEvenstar · Aug 22, 2009

Search through previous threads/posts to see what families are like. They can be very different. When a family has a severely disabled child (or adult) this affects the family in many ways. You are likely to see some dysfunctional coping. I've seen some families step back and distance themselves and let the nurses take over. Other families may hover around and be super involved in everything. Some families can be very "needy" - they will take all you will give and more. Etc. It is so important for the nurse to keep a professional boundary or things can get out of hand pretty quickly.

Yes, I just bring my lunch. You take breaks, but they may not be true breaks, as your break may be interrupted if the pt needs suctioning or whatever. But once you get used to a case and know the care routine, you should have plenty of down time.

caliotter3 · Feb 20, 2010

I worked for one family that was great. Intelligent, educated, professionals who acted like they had some common sense. They took an active part in the care of their child and were adults about everything. Other than them, throughout almost 20 years of doing hh, every family has displayed some degree of dysfunction, from mild to so severe, one could not remain with the case. There comes a point where you can no longer chalk up the bad behavior to situational dysfunction stemming from the illness of the family member. Most learn to take advantage of their "victim" status and their behavior shows it. Some have even vocalized an understanding of this fact. These people actively manipulate the home health agency if one is involved, and any and all nurses who come in contact with them.

ArwenEvenstar · Feb 25, 2010

I worked for one family that was great. Intelligent, educated, professionals who acted like they had some common sense. They took an active part in the care of their child and were adults about everything. Other than them, throughout almost 20 years of doing hh, every family has displayed some degree of dysfunction, from mild to so severe, one could not remain with the case. There comes a point where you can no longer chalk up the bad behavior to situational dysfunction stemming from the illness of the family member. Most learn to take advantage of their "victim" status and their behavior shows it. Some have even vocalized an understanding of this fact. These people actively manipulate the home health agency if one is involved, and any and all nurses who come in contact with them.

Caliotter - Some may find your answer cynical or perhaps cold-hearted towards the familes, but I totally and completely agree with your thoughts!! Thanks for the frank, honest, and realistic post. While private duty is "easier" than the hospital in many ways, it has its own set of unique stressors and frustrations!

Besides the families (with dysfunctional coping and/or purposeful victim mentality), nurses must also take some of the blame for allowing themselves to be manipulated. In my years of doing private duty, I never ceased to be shocked by nurses who totally lacked a professional boundary, and just lacked assertiveness and "common sense" with these families. Yes, it can be tough to stand your ground but it is the professional and appropriate thing to do to ensure that the patient gets proper care. If nurses as a whole could be counted on to maintain a professional boundary, the behavior of these families would be nipped in the bud and not continue. "Slap me once, shame on you. Slap me twice, shame on me."

caliotter3 · Feb 25, 2010

I agree with you 100% Arwen. The family pushes several of the nurses around to get what they want over the years. When an individual nurse stands up to them and insists on doing something properly, they get rid of her/him. The agency aligns itself with the rear end of the family members, disposes of the nurses like used trash, and the cycle continues. I don't really consider myself to be too cynical or cold hearted, just observant over the years. I wonder why I shouldn't be able to meet my living expenses because my employers don't have the moral fortitude to stand up to foolishness. I have figured out that their attitude is the reason why so many of them today demand that the newly hired nurse provide them with a copy of personal malpractice insurance coverage. It doesn't take a genius to connect the dots.

**Elektra6, ASN, BSN, RN** · Feb 26, 2010

They're all different (just like the families you encounter in hospitals or LTC). Some are grateful for your care and some take out their frustrations on you because they can't communicate with the patient or other family members.

anangelsmommy, ADN, BSN, RN · Mar 1, 2010

I can tell you that i had nursing for my own child for 14 years. I hope I was one of the Intelligent educated that didnt take advantage of course I have to say that to us it seemed that most of the nurses had personal problems, no offense to nurses but many of them had spouses or boyfriends that either were substance abusers or abused them and why do I even know that you ask??? right because they were with me for years and I became friends with many of them and I know way too much about their personal lives. But I think the thing I learned about most of them is that they seemed like the kind of people that wanted to fix people, very kind and very loving but fixers that werent fixing, you know? and unfortuanately they did bring their problems to work many of them and I got to deal with that too. One too the point that when she was divorcing her husband that was stalking her I was wondering if he was going to come to my house and hurt my child while she was watching him....not what I should have been worried about at the time.

anyway I digress....I worked for about half the time they watched my son and then we had other children, we took my nurses on vacations - to the beach to the mountains, you name it. but i dont think that you will find that is the norm unfortanetly. I work for some very sweet familes, they have very sick kids and they are caring and they will do anything for you because you are taking care of their child and there are others that you can't wait to go home and hug your own kids because they just dont know how lucky they are....

as for lunch, I never eat as well as I should, I try to eat my bigger meal before I go to work and bring easy to eat things like yoghurt and sandwiches and munchy stuff. I have never had a family that didnt let me eat or drink or warm up food or anything like that but I have heard of them.

I have had a rottwhiler eat my sandwhich - but she is a sweety too and then she loved me up after! and the family wanted to buy me dinner after which of course i refused! some people just are very sweet! in fact this mom will bring you all kinds of places, she takes her child to do pottery and all types of art therapy and she is really cool. See you might luck out and get a good case.

best of luck to you,

angels mommy

ArwenEvenstar · Mar 2, 2010

By Anangelsmommy: "most of the nurses had personal problems, no offense to nurses but many of them had spouses or boyfriends that either were substance abusers or abused them and why do I even know that you ask??? right because they were with me for years and I became friends with many of them and I know way too much about their personal lives. But I think the thing I learned about most of them is that they seemed like the kind of people that wanted to fix people, very kind and very loving but fixers that weren't fixing, you know?"

--During my years doing private duty, I really started to wonder about the nurses. As mentioned in my other post, many seemed to totally lack a professional boundary or just basic professionalism in general! I'm not really sure who is more to blame - the families or the nurses - for the problems we encounter. I've begun to think that something about the nature of private duty nursing seems to ATTRACT nurses who are co-dependent!! Yes, like you said many of these nurses were indeed kind, but their lack of a professional boundary did not fix anything but made the situations much worse. As you worded it, "fixers that weren't fixing".

Anangelsmommy - Here you had the stress of a sick/disabled child, and then you had to deal with nurses telling you way to much about their personal lives. I am so sorry! Another important reason why maintaining a FIRM professional boundary is so important. I was polite and "friendly" with the families I worked for, but I always kept chit-chat to a minimum and only shared basic facts about myself. It is better that way all around. It is just too easy to get too friendly, and find yourself all tangled up with the family dynamic, and before you know it all objectivity is lost and risky nursing decisions are being made...

anangelsmommy, ADN, BSN, RN · Mar 2, 2010

arwenevenstar

you know I have to say that I myself am starting to question the whole DRAMA of home care nursing. some of the cases are lovely. just like you said, you create boundaries, you keep chitchat minimal and everything is fine but there are some cases where there is no end in site to the drama and I just dont need it in my life. I am being told that all nurses need to attend a mandatory meeting to talk about professional boundaries etc. I am in school full time and I have a project due, a presentation to do tomorrow and an exam review for an exam I MUST get a good grade on, I cannot attend this meeting....I think it is time to say good bye to this drama filled case. You know what I mean? Then the compassionate part of me says, yes but if you dont do it who will? they lose nurses right and left. But I just think that this kind of drama isnt good for my sanity. I dont want to get into the details but it looks like you probably have had a few too.

anyway I am starting to wonder can I even do this, I was hoping to find a few cases near enough to home that I just do my job, and go home. Yuo know? I dont want the rest of the crap (dont mean to offend) but I dont want monthly meetings because someone isnt following protocol on the case or is scheduling outside of the agency etc etc or whatever. I dont have time for it. If this isnt going to stop, I am going to have to go somewhere else. I need off the case, I guess I am afraid the mom will freak when the agency tells her. notice I said agency - not me!!

angels mommy