major vent... schedule flexibility in hh/pd? yea, right!?

Specialties Private Duty

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Specializes in med-surg, teaching, cardiac, priv. duty.

This is a vent! Major vent! In home health/private duty, one is suppose to have nice schedule flexibility and freedom, especially compared to some other nursing jobs. Yea, right. It is suppose to be that way, but this is yet to be my experience! Why has my experience been the opposite?!??!! Am I the only one? I could never go back to the hospital setting, yet I do miss one thing about the hospital - I had much more schedule flexibility, getting time off was never a problem, and there was good communication about the schedule. Wow - I miss that! But ONLY that! haha...

I have just about had it with my current agency!! The total incompetence and lack of professionalism overwhelms me. If you need time off they act like it is a huge deal and hassle you. They contradict themselves regarding policies. For awhile when I put in for time off I would put it in writing, have them sign it, and kept a copy of it so I would have PROOF that I notified them. I started doing this because more than once I notified them and they did nothing about it and claimed I never told them. Well, things seemed to improve (so I thought) and I did not do this the last time. You would think I would have learned!?! I gave them almost a 2 month notice that I needed a week off, and again they did nothing and knew nothing about it!!!! It almost seems like if you call in about time off, that they just don't want to deal with it, so they just hang up and pretend the conversation never happened!

It seems if you need time off and you want the family to have coverage in your absence (because you are a thoughtful and responsible nurse!) that you must tell and remind the office repeatedly, and tell the family as well so the family can hound the office too. It should not be this way!!!!!!!!!!!!!!!!!

I dislike communicating directly with families about needing time off....Because...I have had so many experiences with demanding families who make me feel guilty/bad. I have no problem standing up to neediness (I have backbone!!) , yet it makes me feel horrible! It is stressful always having to be firm, take a stand, and maintain a boundary. Ya know? I prefer for all schedule communication to go through the agency!! Meaning - I tell the office when I need time off and they let the family know and make the alternate staffing arrangements. Then I don't have to deal with the family's reaction! The agency is suppose to be the go-between and deal with this! Yet, as mentioned, the agency is not a very good go-between! Once, when I called in needing a personal day for an urgent personal matter , my agency asked me if I'd called the family to tell them! I was like "What?! That is your job!!!" Good grief....

The first agency I worked for was better in some ways - they treated you more professionally in certain respects. But they had issues too. I was the only qualified nurse on a certain case for a long time. One of my first questions, being new to PD at the time, was "Hey, what if I'm sick, take a vacation, or need a personal day? I'm the only nurse. WHO will replace me?" They told me that the family understood this, and the family would care for the child themselves when I was off, and they told me to be free to take time off and this was not a problem. Yea, easy for them to say sitting in the office. This family was a piece of work. Very demanding!! They expected me to never take a day off. If I took time off they would FREAK out. Literally! I could tell some stories... Once when I called in sick, the office called me at home to see if I'd be back the next day because the mother was FRANTIC and beside herself!! The pressure was intense for me. Maybe this was partly my fault for taking things so intensely, but that is my personality. I kept asking the agency to find back-up coverage for me on this case, and they would claim that there was no one!! They told me more than once that PD nurses were hard to find especially for high-tech cases......Yet my current agency seems to have a lot of nurses!!

From my experience, the best nurses for PD cases are ones who rarely/never take time off, and like to work not only regular hours but overtime too. This matches well with demanding families and incompetent agency employees. If you don't need time off there is nothing for the agency to mess up and the family is happy. But that is not me - I need time off! My husband is a nurse at a hospital and he gets 5 weeks a year off. He takes all of it off. It is never a problem. Yet, for me making piddly pay at an agency doing private duty, I have various hassles!!! Something ain't right!!!!!!!!!!

I can't believe I typed all this...should I click submit?!?!

If only you could get rid of these problems by clicking submit. Strange, but it seems to me that I used to feel the opposite about time off. I thought the agency catered to people who took off for various reasons while I plugged away every day. If I were you I would go back to the written notice. Sad you have to do this.

Specializes in Med/Surge, Private Duty Peds.

sorry you are having a terrible time getting off! go back to the paper signing if you need too. some days i miss the hospital, mostly my co-workers, but not the stress and i had fight for my time off. just the opposite for me now.

hope you can get it worked out!

Specializes in med-surg, teaching, cardiac, priv. duty.

After posting on another thread....I thought I'd give a quick update. It seemed hard to get around the "office guys". But I finally decided to talk to a nurse supervisor. Dang - I should have done that LONG BEFORE!!!! Duh!! (Not sure why I didn't....it just seemed like the "office guys" were the only people around.) It was wonderful to talk to the nurse supervisor. She totally "got it" and responded appropriately to my frustrations. During our conversation she said "hold on a minute" so she could shut her office door and talk frankly to me. Among other things, she verified that the staffing guys are indeed rather idiotic. It was so very validating!!!!! She also told me that since the family on this case is so very demanding about having nurses, that the staffing guys hate it when a nurse takes off and thus give a big hassle. She was not at all surprised that when I give a big notice of needing time off, that they would seemingly know nothing about it. She said they likely purposely pretended I never told them because they did not want to deal with it. Grrr....

My advice....If you are having issues/problems of any type on a case, do not even bother talking to the office guys. They lack professionalism and just do not "get it" no matter how you explain a concern to them. Talk to someone over them - like the nurse supervisor.

I have switched to being just a prn fill-in on different cases. I am hoping this will break up the monotony of always working the same case, and I won't have to get tangled up in dysfunctional/demanding family issues. And this should also give me more schedule flexibility since I will not be a regular on any case. I am not working at all for awhile and enjoying the break! yeah! Something had to give. I think, to a certain extent I was a victim of bad circumstances (demanding families/idiotic office staff). BUT I think it is also just the nature of private duty, especially as evidenced by recent other posts!!!!! Ya know??

I've said enough...Brevity has never been my strong point!

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