New to Private Duty, starting two new cases! Advice?

Specialties Private Duty

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Specializes in Home Health,Dialysis, MDS, School Nurse.

I have done mostly Home Health ( short visits ) and nursing home work and have taken a new job with a company that provides pediatric home nurses. I will have two homes, a 12 year old girl with Rett's and a 2 year old girl with downs. One is a 10 hour day, the other a 6 hour day. Mom will most likely be home, but one is preg. and will soon be busy, the other also has other kids. Any advice for my first few shifts?? I know it will take awhile to get comfortable with the family, but what are some things I can do to help? What are some things you have found helpful to bring with you? What do you bring for lunch/snacks? We have to chart something every hour - is this normal? Thanks!!

Specializes in NICU, ICU, PICU, Academia.

Yes - take your own food, and silverware and cup, too. Are you working days or nights?

My BEST tip for you is to let the parents know from the get-go that THEY are the authority on their child, and that YOU want to learn all you can. The great thing about these types of jobs is that you get to do all the little extras you might nit have time for in other jobs. 'Fluffing and buffing' I call it. And hourly charting? No biggie - you'll have plenty of time. Really. :)

Specializes in Home Health,Dialysis, MDS, School Nurse.

My hours will be days and will alternate between 7am-5pm or 1pm - 6pm. I am very excited about having lots of time to spoil these little girls!!

Specializes in Pediatric Private Duty; Camp Nursing.
I am very excited about having lots of time to spoil these little girls!!

Be sure it's ok w the parents to "spoil" them. I have a case where the mom is very adamant about NOT rocking and cuddling the client (baby) all hours of the night to get her back to sleep. Although we have all night to do it, she can't do it when there's no nurses scheduled some nights. You'll be there during the day, but same idea. Be careful not to get them used to special treatment that parents are not willing to maintain.

Just follow their lead. Some parents disappear and expect you to do it all. Some do all the nursing care themselves and expect you to be there as a babysitter to play all day. Some might micromanage you to the point where it becomes toxic. And some are easygoing and fantastic to be with. Always find out their shoe policy, on, off, slippers, etc. and always ask first if you can use fridge, microwave, which bathroom to use, etc. and don't get sucked into doing their housework. Some parents might think they got a free babysitter/housekeeper. I do not mind cleaning a client's private bathroom or emptying the ct's trash can, but if it's community areas, NO!

Specializes in Pediatrics, Emergency, Trauma.

Be sure it's ok w the parents to "spoil" them. I have a case where the mom is very adamant about NOT rocking and cuddling the client (baby) all hours of the night to get her back to sleep. Although we have all night to do it, she can't do it when there's no nurses scheduled some nights. You'll be there during the day, but same idea. Be careful not to get them used to special treatment that parents are not willing to maintain.

Just follow their lead. Some parents disappear and expect you to do it all. Some do all the nursing care themselves and expect you to be there as a babysitter to play all day. Some might micromanage you to the point where it becomes toxic. And some are easygoing and fantastic to be with. Always find out their shoe policy, on, off, slippers, etc. and always ask first if you can use fridge, microwave, which bathroom to use, etc. and don't get sucked into doing their housework. Some parents might think they got a free babysitter/housekeeper. I do not mind cleaning a client's private bathroom or emptying the ct's trash can, but if it's community areas, NO!

^and add NO HOMEWORK help! :)

Specializes in Peds.

Yes, be careful with some of the families because they WILL try to take advantage.....give them an inch & they will take take take.....and some of them can be really nasty, and treat you like a second class servant.....Sometimes if you do things above & beyond, and out of kindness & courtesy for your patient, the family will get it in their heads that ALL the nurses should be doing the exact same things.....and when you try to explain things such as what they are expected to be doing as the family with the patient that is not your responsibility they will get nasty......it will drain you believe me. They will try to pull the old " we were never told that" routine...so beware! I have worked for many families and have only dealt with one family who has just worn me down to the point that I feel like an abused whipping post...everything explained is challenged with " I want proof" etc etc etc......I think they are angry because sometimes shifts just aren't able to be filled, and they ( the family) somehow think they are "guaranteed" coverage, which when they signed their admission papers it clearly states the company does not guarantee coverage every shift BUT will do their best to fill shifts. Yeah it's really ridiculous how they think this...then treat the nurses like garbage because they are mad at the agency.......like a kid throwing a temper tantrum...... You'll see, you WILL have a family like that at some point.....It really makes you want to say " why did I ever become a nurse".......lol...... Good luck! When you get in with a great case you will love it....most nurses end up staying for a very long time when they find a good case & the family is great......

Specializes in Pediatric Private Duty; Camp Nursing.

I recently got "fired" from a case after one shift... families usually get a call from the services manager when a new nurse starts, and the mom was saying "no" to all these nurses the first month her son was home from the hospital. She was rejecting nurses right and left without a fair chance. It was an overnight shift and the family was mostly sleeping, so I have NO idea what her problem with me was, looking for Mary Poppins I guess. Now they cannot find enough people to staff that case and she's shocked and angry the agency isn't doing their job.

One thing to consider is to never judge a book by its cover. In my experience, often it is the families of lesser means who treat me warmly with appreciation, like family, while families living in luxury McMansions tend to regard me in more of a servitude role. Not always. But I see a tendency.

Specializes in Peds.

Wow, CoudySue, the family I mentioned is poor, so that really shocks me even more so.....I can totally see the wealthy families acting like that...the one I mentioned used to be super appreciative and would practically trip over themselves to show their appreciation.....I literally have said it's like someone flipped a switch because it's like going to a totally opposite house than when I used to be there.....it's really bizarre.... I just try to bite my tongue because this family actually has me scared they are trying to find any reason start trouble out of their anger & frustration, and they are directing it towards the nurses who are there to help .......it amazes me because with the way they are acting no nurses will ever want to work there.....I actually am distancing myself.....oops not available....yeah I don't get paid nearly enough for this nonsense, and it amazes me because every single place I have ever worked the families raved about me, wanted me full time permanently.....I have never been treated so horribly ever at a place I have worked....they actually used to say they would only keep a new nurse coming to work if "I" thought they were goo enough, so I would go over on MY own time to meet the new nurses and tell them that nurse was fine ( why I have no idea) then I get this nonsense now........*sigh* When I never work there again they can think why.....i'm slowly distancing myself out of there, hopefully I will not be back there within a very soon time frame.....I am literally worn down from the stress they have caused

Specializes in Pediatric.
I recently got "fired" from a case after one shift... families usually get a call from the services manager when a new nurse starts, and the mom was saying "no" to all these nurses the first month her son was home from the hospital. She was rejecting nurses right and left without a fair chance. It was an overnight shift and the family was mostly sleeping, so I have NO idea what her problem with me was, looking for Mary Poppins I guess. Now they cannot find enough people to staff that case and she's shocked and angry the agency isn't doing their job.

One thing to consider is to never judge a book by its cover. In my experience, often it is the families of lesser means who treat me warmly with appreciation, like family, while families living in luxury McMansions tend to regard me in more of a servitude role. Not always. But I see a tendency.

YES, I've seen that happen a lot. I've done private duty for 2 years and its common. Also want to agree with the people that said being your own EVERYTHING. You'd be surprised at how picky and territorial some families can be. I completely understand it, especially in families with sick children. They probably feel like life is out of control and sometimes that translates into taking it out on the nurse.

Number one piece of advice would be to never get comfortable in a home and to not get too close.

Specializes in Home Health,Dialysis, MDS, School Nurse.

Thanks for the replies! I live in a small town, I am 3 hours from the home office and these 2 cases are the only ones open around me. So I guess I hope they work out or I'm out a job. :) I did one shift last week and it went really good. I just have to get a routine down, and my mind set changed. I'm not used to having a job where there isn't even so much as a pop machine around, and when I'm looking for supplies, I feel like I'm snooping! I'll get used to it though, I'm sure.

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