Private Duty Annoyances

  1. This is just to gripe because I'm upset. I started doing private duty (as a private contractor) and had originally agreed to three days a week. Of course, at the end of the shift I was working Saturday the night help called in. I was scheduled to work 24 hours the next day so by staying all night and then the next day I would have been there 48 hrs.. I called the staffing agency and they told me to let the family know I was going to have to go home. Well, the patient (who is very whiney) starts complaining I can't stay here by myself! I know they didn't tell you to go home! So, sucker I am, I stayed the night. The next morning I called the staffing agency and reminded them it was not legal to work more than 24 hours in a row and they told me if her family was not going to come sit with her she would have to sit by herself. So, I left.

    This patient has family next door who WILL NOT come to sit with their mother, even though it was supposed to be explained to them when they got this Medicaid service that 24 hr care could not be guaranteed and there has to be a willing and able family member who will take over care of the patient if a shift cannot be covered. The patient has a big strong teenage grand daughter but said her mother wouldn't let her miss church to come stay with her (it was Sunday morning). And the daughter who won't miss church also has a heart condition and can't come take care of her mother, even though all you do is literally SIT with this patient all day, nothing strenuous at all. And it's funny that she can't come sit with her mother because of her heart but she regularly goes shopping and runs up and down the road all day in her vehicle...

    Anyway...
    I left and even though I came back 6 hrs. later the family was absolutely furious that I left the patient. They all say there is a nurse who regularly stays a lot longer than 24 hrs. and that I'm lying about it being against the law to do more than 24. I was personally told by someone from the state board of nursing that it most certainly is against the law.

    Then, the busy body (who is a single person) who the family brags on for staying up to 60 hours at a time tells me not to leave the patient like that again when I see her later in the week. I don't apologize and I say if the family doesn't want the patient to be by herself THEY can come sit with her. After all, I have three small kids and an invalid husband and I don't really have a choice about whether to leave for days at a time or not. So she backs down after that and says she understands.

    The family hates me but the patient thinks I'm wonderful (even though she was mad at me because I left.) And since I don't have any other real job prospects at the time I guess I don't have much of a choice, either. So, when the family does stop by for five minutes they sneer at me and I sneer back. But I hate working in conditions like this.

    It is causing my stomach to hurt. It seems like you will either be walked on or make yourself look like a selfish uncaring ***** if you stand up for yourself. The family could care less I had responsibilities at home and was not going to abandon my family. And I was also told by the state board of nursing that home care is different from the hospital or nursing home and that after you have been at the patient's home a reasonable amount of time it IS NOT abandonment to leave. Nurses I tell this to don't believe me, though.

    I do have one nurse there who is sympathetic to the situation, though, and says she has left before. I still wish Scotty would beam me up.
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  2. 17 Comments

  3. by   caliotter3
    Your stomach is hurting you and your entire post says how you are already aware that this case is probably not going to work out for you in the long run, unless you get "used to" letting this family walk all over you. This "attitude", to some degree, or another, I found to be quite common in health care. The families will push the edge of the envelope further and further, as long as they are accommodated. The more nurses and agencies that put up with their behavior, the more they push it. No matter what the long term outcome, I urge you to start documenting the overtime as well as when you leave and who you reported off to, and continue to bring up the issue with the agency (since they have some input). And if I were you, I would be vigorously looking for another position.
  4. by   Cattitude
    families like this are really annoying. not pc to say but it's true. if they don't want to be there why on earth do they think you want to give up your own family time to be there???
    [color=#483d8b]
    [color=#483d8b]bottom line, they're crazy, lazy, and boorish. do your job and do your best to ignore them. it's not too much longer until maternity leave anyway right?
    [color=#483d8b]
  5. by   DutchgirlRN
    Been there, done that. I've been stuck as long as 36 hrs at a stretch and the agency didn't give a flip. I truely liked my patient and he was very kind and understanding and let me sleep, take a shower, eat his food, etc...
    but it is extremely nerve wracking to never know if the next nurse will show up. I stayed for the patient. When he died, 2 years later, I got the heck out of private duty. Some patients only have private duty for a specific amount of hours a day and you can leave when your time is up because there is no replacement to wait for. Maybe you can change patients. I couldn't so I understand your frustration.
  6. by   traumaRUs
    I too must add that you can only be abused by this family if you allow it. Its not like they take your car keys, is it? When your shift ends, leave. Its already been approved by Medicaid that this patient can have 24 hour care if its available. At the end of your shift, if a relief is not there, then the care is not available. End of story.
  7. by   KellieNurse06
    wow..that's terrible! I have home care nurses coming in to care for my child & I am taken advantage of by them alot ( kind of the opposite of your situation)..some don't even show up or go away all the time or work when they darn well feel like it is convenient to only them & don't care that I have to work myself.. but that's a whole other story......lol..... Yes, I agree ; you shouldn't have had to stay especially under those circumstances....and did the oncoming nurse call out at the last minute???? I know emergencies can happen at the last minute but I agree when someone calls out at the last minute that is not right........can you do have a chat with that nurse???
    The agency that has my child used to have to have the office staff go out to cover call outs ( all the office people were nurses too) ...they don't anymore for some reason......mayber because they have so many patients now that it's not possible.
    That family should sign a contract or something that they will be there when nursing isn't just to cover yourself. As for them sneering at you.....don't let them intimidate you that way........sounds like they have their own issues impo.........If this person cannot be alone then why were they sent home to begin with ????? I know nurses can't be guaranteed 24/7 but it sounds like the family just can't be bothere that's all.
    If you want to get out of that place can't you tell the agency that the family is causing a hostile working environment for you???? I would also fill out an incident report as well for that.......my home nurses have incident reports and that is one of the things on there that I have seen on the papers they have to fill out in cases like this with this patients family..........you shouldn't have to be jeered at because they don't want to take responsibilty......Well good luck! I'd also find another agency to work for if they are like this to their workers....... that's just ridiculous....:uhoh21:
  8. by   Jo Dirt
    Quote from traumaRUs
    I too must add that you can only be abused by this family if you allow it. Its not like they take your car keys, is it? When your shift ends, leave. Its already been approved by Medicaid that this patient can have 24 hour care if its available. At the end of your shift, if a relief is not there, then the care is not available. End of story.
    I did leave. What I take exception to is being treated like a selfish heartless patient abandoner. Of course, I can leave if I don't like the way the family treats me, but I shouldn't have be put in a position where they have a chance to treat me like crap because they don't want to be bothered.

    I say the agencies should take more responsibility to see the patient and family UNDERSTANDS this.

    I feel the rage build up when I think about it.
  9. by   Jo Dirt
    Quote from KellieNurse06
    wow..that's terrible! I have home care nurses coming in to care for my child & I am taken advantage of by them alot ( kind of the opposite of your situation)..some don't even show up or go away all the time or work when they darn well feel like it is convenient to only them & don't care that I have to work myself.. but that's a whole other story......lol..... Yes, I agree ; you shouldn't have had to stay especially under those circumstances....and did the oncoming nurse call out at the last minute???? I know emergencies can happen at the last minute but I agree when someone calls out at the last minute that is not right........can you do have a chat with that nurse???
    :uhoh21:
    She called in an hour and a half before the shift ended and it was the fourth time in a row she had done that.

    I DREAD this weekend...oh gee whiz.
  10. by   RN BSN 2009
    That's awful.. but as previous poster stated, show them the black and white! Paper talks...
  11. by   KellieNurse06
    That's awful mama.......wow...4 times in a row???
    I have come to realize that people just don't give a crap any more....and lots tend to have the "it's all about me" mindset..unfortunately. I would ask her next time you see her...gee...is everything ok, are you feeling ok? I was really concerened because you've called out 4 times ina row..or 4 times in a short time span........ You can put her on the spot in a way she won't get unless she has a conscience...then she'll feel guilty.....and if she gets called on it she probably won't do it again for quite a while........if she says she's been sick or not feeling well...you can start asking alot of questions about s/s...lol See she may not be expecting anyone to say anything.......so I would if it were me ... mean what can you lose??? She's already put you in a bad spot .........
    I have one nurse actually at my house for my child...who has been "on vacation" every other month for a whole month...I kid you not....and even actually had the gall to say " I never worked 3 days in a row in my entire life"...........well excuuuuuuuuse me! Us little people do have to work sometimes 5 days a week......and she actually told me I should go away on vacation before I start my new job...(which could be anyday now) and where , prey tell am I getting money to go & finding care for my child on last minute notice???......Can we say ignorance at it's finest???? She even went away for a month after only being here for a month at my house when she started working here......
    So trust me......I know how you feel about people calling out........it sucks!
    I myself have good work ethics......must of got it from my mom....I never call out sick..& if I do you know something is seriously going on......... I think alot of people these days just don't care period.......and it's sad!
    I would also say to whoever calls to tell she isn't coming...so who's coming & what time can I expect them???? They should have a rule that calling out can be no later than eight hours before shift starts unless it is a true medical emergency........
    Let us know what happens with your co worker......
    Last edit by KellieNurse06 on Feb 24, '07
  12. by   Cattitude
    Quote from kellienurse06
    i have come to realize that people just don't give a crap any more....and lots tend to have the "it's all about me" mindset..unfortunately. i would ask her next time you see her...gee...is everything ok, are you feeling ok? i was really concerened because you've called out 4 times ina row..or 4 times in a short time span........
    you sound like the perfect family member:smilecoffeecup: . but you know both sides. i think you gave good advice. i too would casually say to that nurse something about "are you ok?".

    [color=#483d8b]but to mm, don't let this family guilt you into staying. and don't let them have you feeling badly either. that's their goal, to make you feel so bad that you'll stay.
    [color=#483d8b]i've gotten over that stuff after doing hh now for 4 years. i used to really be a sucker for quite some time. i just have a big old mushy heart and had some trouble saying no.

    [color=#483d8b]then it had an effect on my own health and sanity and i had to start taking care of me. mm, you are pregnant and stressed and i know from a lot of your posts that you have had it with nursing. so please take care of you and don't let these inconsiderate types push you even further away.

    [color=#483d8b]as nurses we can find a way to set limits so that we can still enjoy our career, help our wonderful patients, and take care of ourselves.
  13. by   KellieNurse06
    Lol Cas.....not really I do spoil my nurses only because they are coming into my home caring for my child.....and believe me..my mom used to live with me..and is mentally ill...so she'd be a real *eyotch to the nurses........so I truly truly know how mam feels about those family members.....it sucks!
    I however....have a fresh pot of coffee on for the nurse when she comes on (each shift mind you) if I make dinner or anything...I also make it/offer as well to them, If I go to the store, I always ask if they want anything.........I have great nurses.......only the newest ones are the ones who sort of need to snap out of it....you know? (the one whose always going away & the other one who is over the top with md calls) the others ( I always joke:the movie) heck I even had one one time who didn't have a babysitter for her baby so I let her bring the baby to work with her......so how much of a pushover was I???

    lol...the ones that have been here for a long time....and it's because they love working at my house because it's so enjoyable...( not being sarcastic either)
    I even have one who worked here for 5 years, ended up getting a full time job with the state because she needed benefits...but she does an occassional Sunday (like today) because she loves coming to my house so much......... and some nurses who had to leave for other reasons sveral years ago still stay in touch with me because of the same reason.......and all of them say the same thing to me....they wish more homes they worked in were like mine is because we make them feel comfortable & enjoy coming to work. Heck I even mail the nursing notes for them at times...and I even fill out the new tx & med sheets....they all tell me I am too kind to them.........so I truly know how both sides feel.......I hope I don't have to deal with the BS mama is right now....because that must be horrible. Well she's going on leave soon anyway, right? Maybe she can just take a different case altogether when she comes back to work........
    Last edit by KellieNurse06 on Feb 25, '07
  14. by   sharlyb
    You have my sympathies for this challenging situation. Having done a fair bit of home care and private duty nursing over the past 27 years as a nurse as well as presently working in home care hospice I can relate well to the dynamic you have described.

    There are two key issues in this situation that I think you would do well to focus on:

    A. The agency told you that it was OK to leave.
    B. The state board of nursing told you that it was ok to leave.

    That would be sufficient for me. The way I see it, this family is manipulating you. They are playing on the fact that, unlike them, you feel a sense of commitment and caring.

    My suggestion is that you (calmly and politely) tell the patient and family that you will leave when you are scheduled to leave. Then do it.

    If the family acts enraged, let them rant. Refuse to allow yourself to be pulled into their negative dynamic. Do not let yourself become entangled in the net of negative dialog. Repeat the basic message if necessary i.e. I will leave when my shift is over. You don't need to explain anything or make excuses. If you do you will only be treated with disdain and viewed as weak and manipulatable. What the family or patient choose to do about the situation is their responsibility. They clearly have resources that they can tap into. You have been assured that it is not patient abandonment to leave. You have a responsibility toward your own family. Let the patient and family say what they will. You will only be manipulated if and when you allow yourself be drawn into their dysfunctional dynamic. People like this will not find it easy to keep any nurse. If you allow your sense of needing this job to dominate, you have given them full control over you. In the end you will most likely keep the job and your sanity if you stand your ground.

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