Pediatric patients...parents are KILLING me!

Specialties Private Duty

Published

Ok I have to rant and I know some of you feel me! I am BEYOND sick and tired of being taken advantage of by my pedi parents. They just flat out don't take care of thier child and expect you to do everything. And WHY am I here taking care of your child when you and your husband are here just lounging around the house, running errands, and going out to eat? Why am I here if YOU are here? You come in every few hours to see how your child is doing and then out the door u go! Why am I here stuck sitting in a small room for 8 to 10 hours while mom is at work and dad is sitting in the recliner ALL day playing XBOX? Why are you throwing a damn fit when I call you an hour before my shift and tell you my daughter is very sick and I have to cancel my shift...because you are going to be home all day but now you can't go to your yoga class and meet a friend for lunch. OMG, you have to take care of your own child! What a horrible thing it must be not to have a nurse there to be a parent so you don't have to! UuuuuGgghhhhh these parents are ruining my desire to do private care. TAKE CARE OF YOUR CHILD!

Specializes in LTC & Private Duty Pediatrics.
I'm not in this field, but I was wondering what the job description is when a nurse cares for a peds patient in home. Is it total care? Does that mean total responsibility for the child during your shift, as though the parents aren't there (even if they are in the other room)? Would families expect the same of a home care nurse of an adult patient or Alzeheimers? Interested in details before I explore this career option. Thanks!

Hi there:

- Job responsibilities depend on what's in the child's plan of care.

- I am used as the night-shift floater, and responsibilities and work load depend on each individual client's needs. Care also depends on whether the child is going to school in the morning or not.

- Many parents will do the child's bath in the evening, prior to my arrival. In the morning, if the child is going to school, I have been asked to give a quick bed-bath ... primarily, to remove any traces of urine smell (all of my clients are incontinent), and to remove some of the body odor associated with tube feedings. Kids who have been on tube feedings for 4 or 5 years have a "burnt chocolate" odor. Some parents prefer a quick sponge/bed bath in the morning prior to school to hopefully mask/remove the odor. Other parents don't seem to care/notice.

Some client's have medications and breathing treatments. Some are on vent/trache/g-tube have frequent bm's or voids, and need constant care.

I will do the child's laundry if asked. I don't mind folding a load of towels. But I will not do the family's laundry or do their dishes, or clean their kitchen. Certainly, I will make an exception if mom is running super late or something comes up.

Most cases, I probably work/chart about 1 to 1.5 hours on the case, and then study/etc. the rest of the time. Most are in the 3yr old to 18 yr old range. Complications range from the very simple (post surgery for something) to the very complex (post stroke or post cerebral infection or muscle disorders). Some can eat, most are on tube feedings. A few are neurologically intact (can talk), most cannot. Some houses are ultra-clean. Some houses haven't seen a dustpan since the Civil War. Most parents are extremely appreciative. Some are a pain in the rear-end.

If I don't like a case, which has only happened once in 4 years, I just move on.

I don't take care of medically fragile kids under 6 months of age (especially newborn premies). Instead, our agency gives those cases to experienced PICU/NICU nurses.

Pay is pretty pathetic. We get around $25 to $28 an hour via agency (RN). There are no shift differentials, vacations, or benefits. However, the work is super easy (compared to a hospital), and there is a lot of downtime at night. Most kids sleep through the night (if not sick). I average around 40 to 50 hours a week. Could work more if I wanted to.

I also have a gig with an agency specializing in LTC. In the event I get cancelled (kid gets sick, parents go on day-trip, etc), I call the LTC agency and work an evening/night shift or two with them. The pay rate is much better for LTC ($35/hour agency), but the work load is much, much harder. No study time at any of the nursing homes I go to (even on night shift, we are too busy in the nursing home to do any studying).

All in all, it's an easy way to earn money while going to grad school, or if you are a retired hospital nurse looking to make some extra $$$.

Hope this helps.

1 Votes

Good Morning All,

I am a grandparent who stumbled across this sight in search of a private duty nurse to help my family when nurses schedule out or call out and the agency is unable to fill the shift because of his specialized needs. I used to think of nursing as an "essential personnel" position but I think that pertains to hospital nurses.

I found it very interesting hear many of the judgments made on families on what they should or should not be doing. In our situation there are four other children along with our child with a heart condition which as you know caused other problems. We have gone through a few nurses for various reasons - sleeping because they were coming from their other job repeatedly calling out with little or no notice. We have a core of nurses that are dependable and seem to really enjoy their job. We are an active family and have organized our child's day yet some nurses want to stay in his room all day even when asked to bring him into the family room, let's go outside let him get some sunshine and fresh air. When the request was not honored and we moved him ourselves the nurse was forced to come out of the room unless she wanted to be there by herself. We have nursing care because it is needed. No family wants an additional 5 plus people in and out of their home every week, but we have a child with special medical needs so we do what we have to do trying to provide as much of a normal environment as possible. We take him to the mall, on vacation, to restaurants, to the other children's school activities and sporting events. We cannot travel alone with him so a second person must be next to him in the car. The needs of the four other children cannot be ignored, we do not want him resented by his siblings and thus far he gets super love from them. His parents are often exhausted and need any extra sleep they can get.

We do realize this is a job and nurses have families and concerns of their own. So we don't complain when the nurse shows up with curlers in her hair and sometimes is on the phone all day dealing with her family issues, or is habitually late throwing off his schedule. We know this is not a perfect situation for either party but we try to make the best of it without being judged by people that you let into your home. Our child will need home care for awhile and I just pray that his condition improves to the point that nurse care is minimal. We want a normal household but we know it will be our new normal.

1 Votes
Specializes in LTC & Private Duty Pediatrics.
Good Morning All,

I am a grandparent who stumbled across this sight in search of a private duty nurse to help my family when nurses schedule out or call out and the agency is unable to fill the shift because of his specialized needs. I used to think of nursing as an "essential personnel" position but I think that pertains to hospital nurses.

I

I hope that you initially confronted the nurses regarding their behavior. Some families are too quick to terminate nurses. We are not mind readers, and do not always know what the family/parent(s) are thinking. Every family has their own specific needs/desires.

For instance, most families would like us nurses to wash our hands upon entering the home. However, some families find it utterly repulsive for nurses to wash their hands in the kitchen sink and would rather have us use the restroom sink for hand-washing. Some families want shoes left on, others want shoes taken off.

Regarding sleeping on night shift. Yes, most of us work multiple shifts. Sometimes, we do nod off. I'm hoping you are not holding that against us. Blatantly passing out on the couch is another thing, and must be addressed.

If you really want to correct the situation, demand that agency pay your nurses a decent wage. Did you know that the pediatric pay rate to agencies runs between $65 and $115 per hour, depending on the child's needs. Nurses only get around $24 to $25 hour with ZERO BENEFITS.

Did you realize that a four year public college (nursing) degree runs close to $80K (tuition alone) here in Pennsylvania (re: Penn State, Univ of Pittsburgh), and you want us to work for $25/hour with zero benefits, and zero tuition reimbursement ... and then you want to know why we are tired/beat up because we are working 60+ hours a week.

Seriously, get off your rear-end and advocate for better wage conditions for your nurses.

Specializes in Private Duty Pediatrics.
I hope that you initially confronted the nurses regarding their behavior. Some families are too quick to terminate nurses. We are not mind readers, and do not always know what the family/parent(s) are thinking. Every family has their own specific needs/desires.

For instance, most families would like us nurses to wash our hands upon entering the home. However, some families find it utterly repulsive for nurses to wash their hands in the kitchen sink and would rather have us use the restroom sink for hand-washing. Some families want shoes left on, others want shoes taken off.

Regarding sleeping on night shift. Yes, most of us work multiple shifts. Sometimes, we do nod off. I'm hoping you are not holding that against us. Blatantly passing out on the couch is another thing, and must be addressed.

(My bold) Sorry, I can't agree with that one. Part of my job is to come to work rested and ready to do a good job. I understand that some nurses need to work a lot of hours, but that isn't the family's fault.

SirJohnny also said that families should lobby for the nurses to have better pay. I wouldn't put that on the parents; they have too much on their plate already.

He is right that families have their own specific needs/desires. My agency has a list of questions for the family that is posted in the chart with their answers. This covers things like uniforms or street clothes, whether it's OK to use the microwave, who is allowed in the house ...

By the way, my agency points out that nurses are supposed to wear shoes (OSHA requirement), but the agency will provide disposable shoe covers for the nurses if the family so desires.

1 Votes

I have been working as a peds home health nurse for 3 years. the family is great and the parent work really hard and I totally understand the parent need a break from the special needs child. I started taking care of this child when she was one and a half and couldnt walk. I played games with her as she grew. she started walking with a walker by 2 1/2 and by 3 she could walk but we have to hold her by her hands or shoulders if not she will fall. So basically we carry most of her weight when she walks. Now my problem and annoyance comes when this girl is no longer vent dependent during the day, so everything I do is g tube feeds every four hours and bath time, and occassional suctioning. after that it is go go go all day. when her brothers come home she wants to play tag, hide and seek, or just run around but since she cant do that herself guess who is holding her and breaking her back to walk and run her...yes this nurse. If i dont do it she starts screaming and crying, I can control her more when we are by ourselves but when the parents are home, if they dont say anything, I am basically a robot to the point where I am dripping sweat. I feel stuck because things shouldnt be this way but they are a great family. Oh and night shift is worse because now she is four years old and if we are in summer vacation and her brother are out of school they are up and going until 12am or 1am. What the heck people!!

Specializes in Private Duty Pediatrics.
I started taking care of this child when she was one and a half and couldnt walk. I played games with her as she grew. she started walking with a walker by 2 1/2 and by 3 she could walk but we have to hold her by her hands or shoulders if not she will fall. So basically we carry most of her weight when she walks.

Why are you bending over to hold her up when she has a walker? Perhaps her desire to keep up with her brothers could motivate her to use the walker more on her own?

I see what you mean. she does use her walker but she cant walk or run as fast as she would if I am holding her. So she knows the walker hold her back to some point and she knows if the nurses walk her its easier for her to play games like tag and hide and seek.

Specializes in Private Duty Pediatrics.

Tough love coming from her mother would help. Very likely, if she would use the walker more and more, she would get faster and better at it.

I am a nurse manager for a PDN agency, we are there to provide skilled nursing care in the home or school. Most of our clients are pediatric and are on medicaid because most insurances do not cover PDN service. A few have private insurance that cover PDN but those are few, their reimbursement rates are not much better. Our reimbursement rate from the state is 42.35 for a RN and much lower for a LPN. There has not been an increase in the reimbursement rate from the state for 10 years. We typically pay our nurses 25. with insurance, PTO and holiday pay. If you do not want benefits the pay is 27.

Also clients are authorized for so many hours of skilled nursing service in the home, school or treatment appointments depending on an assessment and scoring that is submitted to the state. There has to be a need such as gtube, vent, trach, seizures etc.

Not all homes and nurses fit each other. I try not to judge a family as I am there to care for the client, I feel that finding common ground is important for a relationship to work in the home. We also have a no sleeping policy for our nurses in the home. Hands down less stressful than institutional nursing aka hospital, long term care, etc.

1 Votes

As a private duty nurse I actually prefer my parents to leave the house or find something to do within the home. I do not like to be micro-managed. I had one family who had THREE cameras, yes three and they would watch me on camera while they were in bed. Then the next day, mom would come out and comment on something I may or may not have done the previous day. This family wanted vent weaning (ok that's my job although the child had copious secretions and couldn't tolerate the wean), PT, stander, AND go over letters. numbers, and colors in Spanish. I tried. Until I fell running like a chicken with my head cut off. In the end, mom and I had a blowout where I ended up telling her 1. I do not even speak Spanish and do not know letters, numbers and colors in Spanish. 2. I am not teacher. She should hire one. 3. I am not PT/OT and am not comfortable handling her very fragile child in the manner she would like me to and finally, 4. Mom, I am a nurse and with all due respect, I think you may have me confused for a nanny.

NOTE: The child was vent/G-tube, fragile bones, age 5 but severely delayed and unable to communicate. Mom had trouble with her baby no longer being a baby. For example: she wanted me to bathe him on a changing table. The child's legs would dangle off the changing table and he could roll over! So of course this was one of the topics we argued on.

Needless to say that was my last day on that case. I went through all the necessary channels and had permission from my agency to have that conversation with mom. I had given the agency a heads up after I had fallen, telling them to bring in another nurse for me to train as this arrangement will not last much longer. I received a new case (family) the very next day and have been with my new family since. :)

1 Votes

Private duty nurses get paid about $20-25 an hour with NO benefits (most agencies) FYI. Also this is about the parents who do not work and lay around the house all day playing x-box.

How much do you get paid per hour to be a private duty nurse? Is it safe to assume you make at least $30/hr and get benefits. Babysitters get paid $7.50 per hour, this is for complete care including diaper changes. What is the point of having a private duty nurse if the parents are going to do every thing the nurse is suppose to do while the nurse sits around watching? The parents go to work so that they can keep the insurance which pays you to come take care of the child.

If I was making $30 an hour and got benefits I would not care what the parents was or was not doing while I was working my shift, and frankly it would be non of my business what the parents were doing unless they were harming my patient.

Private duty nurses get paid about $20-25 an hour with NO benefits (most agencies) FYI. Also this is about the parents who do not work and lay around the house all day playing x-box.

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