Not sure what happened

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    I have only been working with this new client for about 2 months and I thought it was going well. I even asked the agency for more hours, then i get a phone call this morning saying that the family has asked that I do not come back. Was also told it was not my nursing skills that it must have been a personally conflict. I really do not know what happened. I worked there last night, spoke with the mom this morning and nothing was said to me. Does this happen alot in home health? I have only had my nursing license for 4 months so I am new to the field. Any help on understanding what happened...
  2. 10 Comments so far...

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    Hey, I am not only a nurse but a mother who relied on home health agency assistance while in nursing school. I actually was like the family on the other end for you. I don't want you to be offended or upset; hopefully this will put your mind at ease.

    When having an agency come in, it is important the the nurse blends into the family as to not interrupt the dynamics. I am not saying that you did anything wrong. It took us 4-5 nurses to find our match (that's including one who slept, one who stole my pain pills). Definitely don't take it to heart; every good HH nurse has their match family; this one just wasn't yours.

    As long as you respect their home and care for the patient as appropriately ordered, you've done great.

    Oh and I think its common; the clinical supervisor told me that it happens a lot.
    systoly likes this.
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    It happens all the time. Many family's are used to playing musical chairs with the nurses as they please. I had been on a case full time for over 6 months and then received a call saying my hours had been cut in half and given to the weekend nurse. I chose not to continue with that case at all as if they didn't have the decency to talk to me directly then I could not continue being their nurse.

    I am happy to be free of private nursing and the manipulation by the families
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    Happens very, very often. Sometimes totally out of the blue. Lots of the time the family is looking for people of their culture or with some other trait in common. They are smart enough to make up lies about the nurses they get rid of so the agency does not give them any strife about discrimination and so that they do not have to take any responsibility for the working relationship.
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    Thank you everybody for your replies. Because this is no fault of my own would I be able to claim these lost hours to unemployment?
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    Homecare is a tricky thing. It sounds like you didn't do anything wrong, so don't feel bad about it. Some families are pickier than others-I've worked with families who would never ask a nurse to be removed, unless a serious misktake/error was made (understandable) to those who basically forced nurses to leave on their own accord by being so nasty that they felt they had no choice (for example, vandalizing their car, yelling at them, and outright discrimination for being of a different culture or race). Hang in there, there truly are some great families out there. And I disagree that you have to "blend in" perfectly with the family. I feel if you are providing safe, excellent care and are respecting boundaries (such as allowing private family time, acting as a professional, etc), it really isn't fair of a family to judge you based on this. We are all different and unique :-) Just my 2 cents.
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    I have to agree with sophistomommaRN that it sometimes is hard to blend in with a family. Over the years we dumped a nurse that changed alarm settings so they weren't "bothered" as frequently, a nurse that was talking/texting/gaming incessantly, a nurse that was extremely condescending, a nurse that royally screwed up, a nurse that came to work so tired I feared for my child's safety, a nurse that I simply did not like (her skills were okay, her documentation was so-so, her personality sucked). Every single nurse knew, from me, why he/she was being asked to leave.

    Home nursing is a hard field. I know that there are a lot of lousy families to work with. We have a nurse that works another case where she is physically abused on every shift by a 6-year-old girl. We have two nurses that both work the same case for another family where they have to sit on the floor outside the child's door. I know several of our nurses work other cases where the house is filthy and infested with creepy-crawlies. To me, those nurses must be saints because I couldn't deal with all that. I try very hard to give my nurses the absolutely most pleasant working environment that I can because they are taking care of MY CHILD! I don't understand why some families treat the nurses like crap.

    Some families know absolutely everything there is to know about the child and all his/her equipment. I do and I train my nurses on everything in my son's room. I know that there are other families that could not tell you the first thing about their child's diagnosis or equipment.

    There are parents that resent the nurses and use their "power" to fire them at will. You may have done nothing wrong. Some nurses will badmouth each other to the parents and vice versa. I try very, very hard to not complain about a nurse to another nurse. Our DON knows that her cell phone number is on my speed dial. If I can't address it, I know that she will.

    I'm sorry that neither the family nor your DON told you why the family didn't want you back. That was pretty lousy of them. Hang in there, you will find a case that is a good fit for you, the child and the family!
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    I am sorry about your concern about lost hours; I wish that I knew something about the subject. This was one reason why my husband and I always went through guilt and shame when concluding that we needed to let a nurse go. I agree with staceylynn, rn, home care is tricky and has its own stresses.

    @ caliotter3, I never even thought about the fact that some families may use these tactics to remove a nurse from their case. That is outrageous; the nurses come to help and care for the patient! We tried to be a facilitating family, as ventmommy described, and make the nurses as comfortable as possible while maintaining normal household function.

    When it comes down to it, in home care, the family is your patient also. If the "family patient" is combative or resistant to care, the nurse's job is that much harder. I hope that you are able to find a family that is great to you if you stay in home care.
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    Quote from tjmschet
    Thank you everybody for your replies. Because this is no fault of my own would I be able to claim these lost hours to unemployment?
    Unfortunately no since technically you are not out of a job you still "work" for your agency but are just not "on assignment" right now.

    In the past I've found I was usually out of work for about 10days before they found me another case. I moved on before I got my one year since I got tired of the the feeling secure and getting used to a regular wage and then suddenly not being able to pay any bill one week.
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    As for unemployment, most agencies have you sign a clause saying that due to the variable nature of home care, they can't guarantee hours. You are still employed.

    These are the reasons I've gotten when I'm asked to remove a nurse from a case: She is always 5-10 minutes late, she talks too much about her personal problems, she signed that she did ROM exercises but I was watching from the kitchen and she never did, I had to stop back at the house to pick up my cell phone and she was brushing my daughter's teeth while she was reclined in the bathtub and wet/cold, she has a bad attitude, she was on her cell phone arguing with her husband all morning, she texts all the time, she was on the internet looking for a new car all day (some of these were reported to the parent by the child that was being cared for... some nurses forget that because a child is disabled, some can still communicate) She never cleans up after herself. These are just the few I can remember at the moment.

    In almost every case it is because the professional boundaries have been repeatedly crossed moving that 'line' back further and further until either the caregiver or the family becomes uncomfortable. I can usually review our 'code of ethics' and show the nurse exactly where the problem began to occur. It's a very fine balance of keeping it professional yet not treating a family like their home is a hospital and the nurse knows more than the parent. There are also times when there is no good reason given. It's never easy to find you aren't wanted back but try to learn from the situation and move on.

    Kyasi


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