Nurses aren't maids!

[AnaCatRN]

I'm sorry. I really, really need to vent. I work for a pediatric private duty nursing agency, and I'm an RN. This is what I wish I could say to my new patient's mom: Why the heck would you ask your child's new night nurse to do her laundry?! When the hell did they put laundry questions on the NCLEX? Oh, yeah, they DIDN'T because NURSES AREN'T MAIDS! I'm not your kid's nanny, I'm a healthcare PROFESSIONAL - just like a physician. You wouldn't ask your pediatrician to do your kid's laundry, so you better not ask the nurse to do it, either! It's not 1950, anymore, Sparky!

Of course, I didn't say that. To be nice, I folded the kid's clothes tonight, but then I sent off an email to the clinical director at the agency complaining profusely about this insulting request. I mean, seriously! Where do people get the brass testicles to ask a nurse to do a maid's job?

Why do people automatically assume when they get private duty nursing covered by the state or their insurance that whoever is paying for it also thinks it's cool to provide you with housekeeping services? Isn't that insurance fraud? THe state doesn't want to pay for someone to do your kid's laundry. You can't ask me to do that! Not only is it DEGRADING to ask a healthcare professional to do laundry, it must be abuse of services. I hope to God above that no one at my agency told this woman that nurses do chores, because I will go all the way to the top of national corporate management if someone did. This better be an unfortunate misunderstanding on my patient's mom's part as to what nurses do and DO NOT do.

Has anyone else had to deal with this? I had one other patient's mom ask me if that was something we do, and she totally apologized for asking when I politely told her no. This new patient's mom guided me to the laundry room to make sure I understood how the machines work because she is assuming it's totally in my job description to do laundry. She didn't even ask, she just started out with "when you do her laundry..." Excuse me?! I clean the kid and his or her medical equipment. Nothing else! I'm not a home health aide (whose job it would possibly be). It's just not *my* job to do household chores!

OK, vent over. I feel a little better. Thanks for letting me vent.

[Not_A_Hat_Person, RN]

I've had cases where the parents have dropped a basket of clothes in my client's room and said "If you get bored, could you fold these?" The LNA/HHA care plan includes "Laundry PRN." If there's truly nothing going on, I'll fold clean laundry and put it back in the basket. I'll put dirty laundry in the hamper. However, I'm not there to do laundry.

[nursel56]

I agree we keep the immediate environment neat and organized and clean re-usable medical supplies, but things like mopping floors and doing entire loads of laundry are not in our job description as I mentioned in my previous post. The agencies here are chosen by the patient/family in the Medi-Cal system. The state does not contract directly with the agencies. My observations only apply to Medi-Cal, Medi-Care, not private insurance companies.

People need to understand that we aren't being selfish, lazy, or snobbish when we draw the line on housework because first of all, if nurses do things that are specifically excluded from skilled nursing hours as a means to curry favor and the family giving you "perks" such as going home 4 hours early or giving you their unused hours for the month, you contribute to the ability of that family to manipulate the system. Does this really happen very often? Yes, it does.

I won't even get into the sexual favors aspect that AnaCat alluded to -- and all I will say is that yes, it happens. Makes me want to throw up to think about it, but it is what it is.

When the next nurse comes along, thinking about doing things by the book, he or she will quickly be made aware of what the real deal is - and if you don't like it -- don't let the you-know-what hit you in the --- on your way out.

Therefore it is unfair to my fellow nurses to engage in that game. It's a corrupt use of public resources when families use their hours as currency for extra favors. Of course, this is not written in stone for people who are not trying to game the system!! I've done quite a few above and beyond tasks but it must always come from the understanding that it is not an expectation, but a courtesy.

A few things families have tried to insist the nurse do: clean globs of dried formula off the bathroom walls, clean all the bathrooms in the house, act as a waitress for their dinner party, and insist that a nurse do all the OT/PT excercises at the patient's school when the district has hired a 1:1 aide to work with them.

[AnaCatRN]

I agree we keep the immediate environment neat and organized and clean re-usable medical supplies, but things like mopping floors and doing entire loads of laundry are not in our job description as I mentioned in my previous post. The agencies here are chosen by the patient/family in the Medi-Cal system. The state does not contract directly with the agencies. My observations only apply to Medi-Cal, Medi-Care, not private insurance companies.

People need to understand that we aren't being selfish, lazy, or snobbish when we draw the line on housework because first of all, if nurses do things that are specifically excluded from skilled nursing hours as a means to curry favor and the family giving you "perks" such as going home 4 hours early or giving you their unused hours for the month, you contribute to the ability of that family to manipulate the system. Does this really happen very often? Yes, it does.

I won't even get into the sexual favors aspect that AnaCat alluded to -- and all I will say is that yes, it happens. Makes me want to throw up to think about it, but it is what it is.

When the next nurse comes along, thinking about doing things by the book, he or she will quickly be made aware of what the real deal is - and if you don't like it -- don't let the you-know-what hit you in the --- on your way out.

Therefore it is unfair to my fellow nurses to engage in that game. It's a corrupt use of public resources when families use their hours as currency for extra favors. Of course, this is not written in stone for people who are not trying to game the system!! I've done quite a few above and beyond tasks but it must always come from the understanding that it is not an expectation, but a courtesy.

A few things families have tried to insist the nurse do: clean globs of dried formula off the bathroom walls, clean all the bathrooms in the house, act as a waitress for their dinner party, and insist that a nurse do all the OT/PT excercises at the patient's school when the district has hired a 1:1 aide to work with them.

Exactly! There are home health aides. If they need non-skilled care, they should do it, not licensed nurses! The only reason some agencies require or have rudely brainwashed nurses to think that it's ok to ask a nurse to clean is because dumb nurses let them! We have to stop it! I'm not doing grunt work for the tiny pay I get (or any pay, because if cleaning was something I was willing to do for a living, I would have become a maid and saved myself a LOT of money by not going to college)! I have a license! My putting up with the tiny pay is because I only have one patient, it doesn't mean I'm stupid and can be treated like a dog! If the parents want a maid, they should get a maid! I said before, for an ADULT patient who lives ALONE, it might be appropriate to expect some housekeeping, but NOT for a child. Parents don't get to put their feet up because some dumb schmuck nurse is willing to be taken advantage of and play maid! I'm a healthcare professional. not a menial laborer. ALL nurses deserve respect. It is NOT ok to say "you work in home health to keep kids out of institutions, you're not a real nurse, so you should just shut up and realize you don't deserve the same pay, benefits, or respect that a hospital ("real") nurse gets!" And yes, that IS what some of you have implied here! We are nurses, not domestic help!

[AnaCatRN]

I've had cases where the parents have dropped a basket of clothes in my client's room and said "If you get bored, could you fold these?" The LNA/HHA care plan includes "Laundry PRN." If there's truly nothing going on, I'll fold clean laundry and put it back in the basket. I'll put dirty laundry in the hamper. However, I'm not there to do laundry.

Yes, the home health aide plan says that, because home health aides clean. It's not something that should EVER be on a nursing plan!

[AnaCatRN]

I don't see where the problem is. If you don't like the case, don't take it.

I shouldn't be asked to clean. Why doesn't anyone understand how demeaning it is to ask a professional to do that? When was the last time a physician was expected to do a patient's laundry?!

[AnaCatRN]

I forwarded the problem to corporate because someone at the agency tried to tell me it's in the employee agreement I signed, and I re-read the agreement. It most certainly does not include cleaning or laundry. I'm THIS CLOSE to quitting, which truly sucks, because I love my job and my patients. I've never been asked in this past year working for this agency to clean or do laundry, and they dropped the patient who assaulted me. I thought this agency was a good one, and that they value nurses. Sigh...

[nursel56]

I forwarded the problem to corporate because someone at the agency tried to tell me it's in the employee agreement I signed, and I re-read the agreement. It most certainly does not include cleaning or laundry. I'm THIS CLOSE to quitting, which truly sucks, because I love my job and my patients. I've never been asked in this past year working for this agency to clean or do laundry, and they dropped the patient who assaulted me. I thought this agency was a good one, and that they value nurses. Sigh...

In my neck of the woods I can really see a difference in how I'm treated by agencies compared to 2004 when I started and in-home nursing care had a huge demand and a small supply. They bent over backwards to make sure we were well-treated. Now, pressures in the job market at large have put many more nurses in this field than we had before. They hire new grads and pay them bottom dollar. It's damn depressing to be thought of as a disposable commodity but -- money talks b******* walks.

I hope you're able to find something else, because as you brought up before - there are many times if it was just you and your patient and you doing your job everything would be fine!

[systoly]

I shouldn't be asked to clean. Why doesn't anyone understand how demeaning it is to ask a professional to do that? When was the last time a physician was expected to do a patient's laundry?![/q

I don't know any physicians providing 1:1 care for a whole shift

I'm saddened that you feel it is demeaning for a professional to clean for someone (non professional?) else.

Of course the nurse is not there to perform cleaning duties as this would indicate a mismatch of level of care needed vs provided. I also don't do family's personal laundry, not because I'm above it, but because it's just not appropriate.

I cannot remember how many times I have cleaned up dried formula (left for me by the family) and other messes.

Most of the patients I've had do not live in well kept homes. Some families just don't know any better, some lack motivation and some never learned regard for others. I try to educate and motivate. I've never been able to raise cleanliness to a level that would be acceptable to me in my house, but I have seen improvements in most cases. There are some who respond by leaving an even bigger mess and some who flat out dismiss everything I have to say.

This is where I can decide if I want to leave the case.

I know you probably don't consider me a professional, but irregardless of title or credentials, it is never demeaning

to serve another person.

[AnaCatRN]

I shouldn't be asked to clean. Why doesn't anyone understand how demeaning it is to ask a professional to do that? When was the last time a physician was expected to do a patient's laundry?![/q

I don't know any physicians providing 1:1 care for a whole shift

I'm saddened that you feel it is demeaning for a professional to clean for someone (non professional?) else.

Of course the nurse is not there to perform cleaning duties as this would indicate a mismatch of level of care needed vs provided. I also don't do family's personal laundry, not because I'm above it, but because it's just not appropriate.

I cannot remember how many times I have cleaned up dried formula (left for me by the family) and other messes.

Most of the patients I've had do not live in well kept homes. Some families just don't know any better, some lack motivation and some never learned regard for others. I try to educate and motivate. I've never been able to raise cleanliness to a level that would be acceptable to me in my house, but I have seen improvements in most cases. There are some who respond by leaving an even bigger mess and some who flat out dismiss everything I have to say.

This is where I can decide if I want to leave the case.

I know you probably don't consider me a professional, but irregardless of title or credentials, it is never demeaning

to serve another person.

First of all, I do serve others by being a nurse. I have *NEVER* complained about or thought it beneath me to clean a patient, help with bathing, or tackle a severe code brown. Please do not think I'm *THAT* nurse who thinks I shouldn't do the "dirty work" of nursing! And yes, I do consider a HHA a professional. While I understand you and I provide different services, and cleaning up after the patient (not the family) may be appropriate for you (if that is what you were trained to do, it's something in nursing school we were told to refuse to do when working in home health as it is an inappropriate use of nursing skills). I am a nurse, and I should be monitoring vitals and doing things that require a nursing license. As you said, it's about level of care needed, and if the patient needs skilled nursing, I should do it. Unskilled (a misnomer, really, as HHAs have plenty of skills - I was a CNA once myself, so I do not look down on CNAs or HHAs!) care should not be done by a nurse. We should be sent where we are needed most. I also maintain that when the patient is a child, and suddenly the parents don't have to sit around waiting for the feeding pump to say "done," (really, that's all they "need" skilled nursing care for in this case!) they have plenty of time to do the child's laundry (instead of watching tv or going out with friends). See, this patient really doesn't need a nurse and the parents somehow have managed to get Medicaid to pay for me to waste my time and skills being a babysitter and housekeeper. The house is very clean, but I have no intention of taking over the responsibility for keeping it that way. I have had too many families who are really pulling one over on the state to get services they don't really need, which isn't fair to the tax payers or the people on the waiting list who really need skilled nursing! I am above being used like that, as we all should be. But you don't seem to understand that nurses are now taught in school that we are peers with physicians, so that is why I keep bringing up the fact that no one would ask a physician to do laundry. My job is to assess the patient and tell the doctor what is wrong with the patient, not to clean up after them. I'm a nurse, not a nursemaid.

[systoly]

Perhaps instead of "demeaning", you meant to say inappropriate.

[AnaCatRN]

Perhaps instead of "demeaning", you meant to say inappropriate.

Inappropriate to ask, demeaning to expect/demand and use a condescending tone about it. How's that? Honestly, if the new family didn't talk down to me and believe/insist (along with the agency office staff) that is is not only appropriate to ask/demand, but a part of my actual job description (and really, it's not), eventually, I would probably get bored one night and volunteer to do some stuff for them. It's honestly the principle of the whole thing.

I'm much calmer today after hearing back from corporate that they are going to help me resolve this, and after getting a lot of support from friends and family. There are many issues in this problem, and it's not all about cleaning. I am most angry that I see the already strapped state being abused and I'm expected to be a part of it. It really irks me that there are people who think they are just entitled like that and can treat people like crap.

[systoly]

I'm certainly not free from feeling angry when treated with disrespect or when observing blatant abuse of tax money (my share is in there), but I have learned

I feel much better when I approach these situations in a matter of fact way. And don't forget about your most powerful tool - documentation. I would expect that at least the office staff would see the light when confronted with, "... I'm afraid the pt. may lose skilled nursing hours when the state care coordinator reads that a lot of our time is spent performing custodial duties." ...and document you must.