Private duty rant... - page 2

by smurfynursey 1,907 Views | 16 Comments

Hi all... I am sorry to rant...but this bothers me. I worked a private duty case last night with a child that I have been with for about 2 months. When I got report from mom she said she hadnt had a bm in 3 days and gave... Read More


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    It is our policy also to call the MD for any problems we find. However, we do allow the parents who say they will do it the chance to call first. We follow up with the parent to see if there were any medication changes and to see if they actually called within a reasonable time. If they didn't, then we do. But I have found the parents who are on top of things and say they will do it actually do. And they also understand our agency requirements for follow up on a problem and don't get angry when we call them to see if there are any new orders.

    Ventmommy, you sound like the kind of parent I would love to work with in my agency. I can't say that about many of our pediatric parents.

    Kyasi
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    Quote from ventmommy
    Nurses that don't notify me of things that are on my list of things or nurses that don't document or nurses that don't let me know when something is off, do not last long in my home nor long at the agency we use.

    I also do not allow nurses to call my child's doctors. I am the parent. I am to be notified and I will handle it.

    The nurse before you acted inappropriately and would never again be allowed in my home.
    This is an interesting issue. I can fully understand ventmommy's position, but there are laws and guidelines the nurses have to follow as well. It probably depends on what state you're in as well as on the urgency of the situation.
    To be in compliance with delivering prudent care, in my state, I'd have to contact the Dr.'s office myself. This doesn't mean I couldn't contact the parent first if time wasn't critical, but I cannot act on directions, orders or instructions not received first hand from the Dr. Fortunately, in my area, the Dr.s are very cooperative and I seldom have any trouble getting the doc on the phone himself. I cannot even take an order off a Rx label anymore.
    Now, if there's a fax machine in the home, and the Dr. writes an order that expressively states all nursing staff is to contact mom only and not the Dr. or any other care provider or emergency service it gets interesting again.
    Not_A_Hat_Person and juzme like this.
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    Kyasi, You and a couple of other nurses on here sound like perfect additions to our nursing roster!

    If I say I am going to do something, I do it. In all these years, I don't think that a nurse has ever alerted me to something that I did not already know about.

    Obviously, if there is a med change, I have the nurse call the office so that her paperwork is squared away.
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    Thanks Ventmommy....

    In my state, if we can get a RX number on a med, we can accept that as a MD order. So if a child had increased congestion, the nurse calls the office and reports the problem. If she says that Mom is going to call the MD or will be taking the child in for an appt later, I give her time to do that. Usually the parent will call to report that an antibiotic or new medication was started, give us the RX number and details. We can then write an order to fax to the MD to sign. The nurse can give that med prior to the MD signing that order though. The key is 'follow up' with the parent. Obviously, how we handle it depends on the severity or how critical the situation is. But this is for the parents who are on top of the situation and who like Ventmommy, know what is going on.

    Some parents, sadly, don't give a rip and won't follow through. We know who they are and in those cases, we always make the call. They are usually the ones who don't want to be bothered and would rather someone else take the responsibility. Either way, our charting shows the problem was handled by either the parent or our office and was properly followed up on, which ultimately is what any auditor wants to see.

    Kyasi
    Last edit by Kyasi on Mar 29, '11
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    I agree, I am stuck in a case now with a very demanding mother, with a wicked control streak. Yesterday the little guy was vomiting his NGT feed out of his nose and mouth, I stopped the feed, informed the mom and wanted to call the MD, because he just upped the rate/hour, mom would not call and turned the feed back on about 1 hour later, I could just hear the congestion building up in the baby's nose and throat, patient is vented, anyway, she goes out at 3 o'clock to run to the store and comes home at 8pm, i have been on this case for 1 week and this happened 4 times already, I am very uncomfortable at this place, Yesterday she ranted at me for about 20min because I couldn't find the shirt she wanted him to wear, this woman is nuts, I am calling my agency at 9 o'clock to inform them of the situation. I am new to home care and am afraid for my license.
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    I'd be afraid too! Leave if you feel your license would be in jeopardy. Don't let this first case turn you off to home care entirely though. My first case (25yrs ago) was awful but I've had many wonderful cases since.

    Kyasi
    mb1949 likes this.
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    Quote from Kyasi
    I'd be afraid too! Leave if you feel your license would be in jeopardy. Don't let this first case turn you off to home care entirely though. My first case (25yrs ago) was awful but I've had many wonderful cases since.

    Kyasi

    Thanks so much, thats exactly what I did this morning, this was too scary,


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