private duty nursing?? - page 2

by ArwenEvenstar

35,319 Views | 29 Comments

I have been a hospital staff nurse (RN) for 14 years and I am VERY burned out. I need to get into a new area of nursing and i am considering several options. (such as home health, utilization review/case management, mobile field... Read More


  1. 0
    How did your interview go?

    renerian
  2. 0
    My interview went well...I start next monday (march 7) with my first Private duty nursing case. The same nurse has been on this case for the last several years but she is retiring, so that is why this position opened. It is in a private home with a little girl with multiple medical problems. I have not been to the home yet, but the agency told me they live in a beautiful home in a nice area. They told me they are a very easy-going family, and I won't have to worry about the family being "difficult".

    During the school year, I will be with her from 2pm till 8pm Monday to Friday. In the summer (no school) I'll be with her from 7:30 am till 5 pm, also Monday to Friday. LONG hours in the summer!!! But since it is temporary I can handle it! The 2pm to 8pm is PERFECT FOR ME! I hate mornings, am a natural night owl, and have worked either evenings or night shift for years now.

    I feel very positive and excited about this... In fact, the whole situation seems almost too good to be true! I feel like a "gift" has been dropped in my lap. I was VERY BURNED OUT (stressed out to the max!) of hospital nursing, and am so looking forward to this change of pace.

    Meanwhile, the last few nights I worked at the hospital I have told various nurses of the new position I am taking...some have wished me well and are happy for me, but others have been sordof critical...saying I'll be bored and unchallenged. Such as,
    "You'll only have one patient?? That sounds boring."
    "I wouldn't know what to do without 6 or 8 patients. I like to be busy. I wouldn't want a job like that...I wouldn't feel challenged."

    These comments, to be honest, really surprised me. It wasn't what I was expecting.... DO ANY OF YOU OTHERS WHO DO PRIVATE DUTY NURSING ENCOUNTER REMARKS LIKE THIS?? Do they act like you are a "lesser" nurse because you only care for one??

    As stated above, I feel really excited and positive about this and the change of pace. After 14 years of hospital staff nursing (running around with my head cut off, overloaded with work, never being able to leave feeling like my patients truly got PROPER care, etc) - I am ready for a job that is a different pace. I am excited that I will have the time to actually give a patient PROPER care!!!!!!!! I am excited about getting to know ONE patient and their family, instead of caring for hundreds of patients over the course of time. And if there are moments of boredom...after 14 years of INSANITY at the hospital, I welcome it! :hatparty:

    Well, this is a LONG post!! So sorry! Laura (Arwen Evenstar)


    Quote from mgallant
    Good luck! let us know how it goes! Mary
  3. 0
    Yes I have heard people say negative comments on private duty and home care in general. I have had patient's several time says, I left home care as I could not cut it in the hospital LOL. Big different between not being able to cut it and running from scarey legal issues or exhaustion...

    I am glad you posted how your interview went. So many times people ask for advice and never post on the outcome so you don't know what happened.

    I am glad your pleased with your new direction in nursing. That is all the counts.

    renerian
  4. 0
    I did just 3 days for PSA and I hated it. You are basically a babysitter with higher rate of paying. it is very hard a) emotionally - kids are really sick with little hope to ever get better and parents are exhausted, b) physically - you do have to carry kids around because unlike adults, even if they are sick, they do want to play, c) intellectually - you are not learning anything, you do not have contact with anybody except parents who are often not even home...It is very routine care...I would suggest gettring into either clinical trials or hosptal administration.
  5. 0
    I worked private duty on one case and could have stayed for years, unfortunately I became dreadfully ill and had to leave the case. The primary nurse/case manager has been with this client for over 15 years now and has no plans on leaving until something forces the issue. She worked private duty previously in very well to do homes and likes this venue very much. There are pros and cons. One thing I liked was that the client's family treated us like employees, had their CPA cut our checks, and took care of all the taxes, etc. We were pretty much covered. They paid all the necessary stuff that any household worker needs to have paid to be legal. The good parts of home health care without the hassles of dealing with the agency that is sometimes a hindrance rather than a help. I do not agree that this works out for every situation though. You have to be very careful who you go to work for, and what your parameters are. It is easy to be taken advantage of.
  6. 2
    Hi! I noticed that my original post from 2005 got revived and was posted on just recently in 2007. I have been doing private duty for almost 3 years now and I feel like I have found a real nitch. I've worked two different cases now and thought I'd make some comments.

    Private duty is not for everyone. Yes, you are essentially a high-tech babysitter. Some may find it boring. But that is exactly why I like it! I love the non-chaotic, casual, boring, low-stress (comparatively speaking - there are some stressors which I'll comment on below) atmosphere. On my present case, there is only about 10 to 15 minutes of work for every hour. (Yet, my patient is getting excellent care! That is simply all there is to do.) The rest of the time I just sit there and do whatever I want. I read books and write letters (a hobby that I enjoy). I LOVE the fact that I am getting paid to read and write for pleasure!!

    I'd say the main con or stressor of private duty is the possibility of dysfunctional coping on the part of the family. Families can react in very different ways to having a severely disabled loved one. The two families I have now worked for are polar opposites!! The main reason I left the first case I was on and moved to a different case, was that I could no longer tolerate the family. They were very needy, demanding, with unrealistic expectations. They were unappreciative. I initially replaced a nurse who had not maintained a proper professional boundary, and this had made things worse. I loved my patient dearly, but had reached the end with the family.

    The new family on my new case is the complete opposite. They are helpful, appreciative, and very realistic about the care of someone disabled. It is a refreshing change! In fact, after being treated rather poorly by the last family, I feel overwhelmed by their respect and courtesy!

    My closing advice, it is VERY important to maintain a proper professional boundary in these cases!!!!! If you don't, you will easily get pulled in and stop seeing things objectively, and you won't even realize it! A firm professional boundary is imperative. If you think you'll have problems with this, do not do private duty. I had to deal with a lot of "issues" on my first case that were partially created by nurses who lacked a professional boundary.
    Ellie S. and dance4life like this.
  7. 0
    Quote from ArwenEvenstar
    Hi! I noticed that my original post from 2005 got revived and was posted on just recently in 2007. I have been doing private duty for almost 3 years now and I feel like I have found a real nitch. I've worked two different cases now and thought I'd make some comments.

    Private duty is not for everyone. Yes, you are essentially a high-tech babysitter. Some may find it boring. But that is exactly why I like it! I love the non-chaotic, casual, boring, low-stress (comparatively speaking - there are some stressors which I'll comment on below) atmosphere. On my present case, there is only about 10 to 15 minutes of work for every hour. (Yet, my patient is getting excellent care! That is simply all there is to do.) The rest of the time I just sit there and do whatever I want. I read books and write letters (a hobby that I enjoy). I LOVE the fact that I am getting paid to read and write for pleasure!!

    I'd say the main con or stressor of private duty is the possibility of dysfunctional coping on the part of the family. Families can react in very different ways to having a severely disabled loved one. The two families I have now worked for are polar opposites!! The main reason I left the first case I was on and moved to a different case, was that I could no longer tolerate the family. They were very needy, demanding, with unrealistic expectations. They were unappreciative. I initially replaced a nurse who had not maintained a proper professional boundary, and this had made things worse. I loved my patient dearly, but had reached the end with the family.

    The new family on my new case is the complete opposite. They are helpful, appreciative, and very realistic about the care of someone disabled. It is a refreshing change! In fact, after being treated rather poorly by the last family, I feel overwhelmed by their respect and courtesy!

    My closing advice, it is VERY important to maintain a proper professional boundary in these cases!!!!! If you don't, you will easily get pulled in and stop seeing things objectively, and you won't even realize it! A firm professional boundary is imperative. If you think you'll have problems with this, do not do private duty. I had to deal with a lot of "issues" on my first case that were partially created by nurses who lacked a professional boundary.

    I enjoyed reading this and hearing that three years later you have found your niche. I myself absolutely LOVED private duty. I took care of a lovely girl for 3 years and would have stayed with her until my retirement age if I could have, but she passed on. The family were some of the finest and most loving people I've ever met. After that, other families that I dealt with had some of the same issues that you spoke of and I moved on to another area of nursing. But I will always look back at my private duty nursing job as one of the best and least stressful nursing jobs that I've ever had.
  8. 0
    I have been in private duty nursing for almost a year now. I ABSOLUTELY love it!! I am losing one pt due to family [ hers] issues. The POA is bi-polar and refuses to medicate self. She watches us with a camera in the room and tells us how to do our job. [Literally, instructed me on how to give a fleet's enema. You know, left lateral position etc :angryfire :angryfire ]

    I care for two young males. One is 19 and has trisomy 9 the other is 14 and has trisomy 8. I have very little spare time for reading etc. The 19 y/o will sleep and he likes basketball. When I work nocs I put him to bed. The 14 y/o likes pro wrestling. His fave is "Undertaker". I am supposed to do all the moves that his rivals do. Of course I don't do anything dangerous. We have so much fun. Last Sunday we walked outside and I introduced him to trees. Unknown to me, he is afraid of trees. we will work to overcome that fear. I actually got him to touch the trees and to stand under them so he could see how tall they are.

    As far as losing skills, I think that I have gained skills. The 19 y/o has a new HHN that has two machines. One is the regular HHN machine. The other one hooks into the first machine and delivers 10 lbs of pressure to force the medication into his lungs. It attaches straight to his trache. He also has something called a percussion vest that he wears while he is getting the neb tx. It precusses his lungs to help prevent pneumonia.

    I don't think I will be leaving any time soon!! :heartbeat :heartbeat
  9. 0
    Hi All! I have a couple of questions for anybody able to answer. How have you gone about getting these patients and how do you determine what to charge for an hourly rate. PDN is something that I am seriously interested in doing but am not quite sure how to go about it.
  10. 2
    to answer and update this thread. i work through maxim health care and was contacted by one of there nursing recuiters.

    i had spent the last 4.5 years as a staff lpn on a very busy med/surge floor with a pt load of 5-9 very ill pt's. i worked night shift, couldn't get on a day shift position and was getting so burned out.

    long story short, i was able to accept the position offered to me and my very first pt was a 19 y male that i took care of 4 evenings a week from 3-9. i coudn't not have asked for a better first pt to start my pdn career with.

    now, i have 8 week old that has a rare genetic disease, a trach and g-tube. i work less than 25 miles from home, monday-friday 8-4 or 8-6, depends on the day.

    she is an only child to a very pleasant young couple who are so happy to have a nurse that comes and takes care of their little one.

    so far, i haven't had any problems and i really seen any happening, which could change, one never knows.


    i am able to come to this family from both a nurse's view and a from the veiw of a mother that went through much of the exact same emotional issues.

    my only child was born 16 premature and i can so relate to the emotions this couple is going through.


    this job is not that demanding, stress levels are so low and i get to make a difference in my pt's life.

    i don't think i will ever go back to hospital/bed side nursing.

    i hope this helps, also, sorry this is so long and kinda jumps around.


    i also posted my resume on monster and other site along with word of mouth.

    good luck to you !!!
    dance4life and DMBFAN4EVR like this.


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