Welcome: New Private Duty Nursing Forum

Thank you Brian I think it's a great idea. I have done Private Duty and enjoyed it and I am currently doing Home Health and enjoy it as well. I find both very rewarding and yet very different. A different philosophy in both areas even though both jobs are done in the patients home. Thanks for the new thread!

Wow! I just realized that there is a private duty (PD) forum now! That is great! I think PD often has special and unique issues. We need a forum! Working shifts at a time in private homes caring for what is generally a severally disabled patient has many implications that you do not encounter as much in other settings. Families struggling to cope. Different families can cope in different (sometimes polar opposite!) ways. Psycho-social family dynamics. Nurses who don't maintain a proper professional boundary can contribute to the dysfunction. Etc.

I was just reviewing some of my old posts, and gee, it sounds like I don't like PD very much. I guess I just tend to post when I need to "vent". I really do like PD! I need to work on being more positive. This March I have been doing PD for 3 years. I am much happier that I was at the hospital. The pay is less but I have my sanity back and am much less stressed - especially in comparison to the hospital.

I switched to a new private duty case back in September, and the family is the complete opposite of what I was used to on my previous case. There is a real "team spirit" approach to caring for their disabled daughter. The family shows me common courtesy and appreciation, often in little ways, but it means a lot. It wasn't quite like this on my past case...And I feel overwhelmed by how well this family treats me. It is not that the previous family treated me bad (they didn't!), but I didn't feel valued or appreciated.

Anyhow...it is great to have our own forum!!

I am glad you started this new forum. I have been in private duty for 1 year and have faced some of the difficulties that the other nurses have faced. I just can't understand how 1 - family members, even ones who LIVE in the homes with the patient, are so callous to their condition and care. They worry more about your presence/intrusion of their home than the care of the patient. And secondly, how the patient can sabatoge their care. Obesity, incontinence, pressure ulcers, frustrating yes but you just don't give up, keep fighting and make POSITIVE changes!!!!! So that's my frustration in the field. But I really like the 1-1 nursing, the schedule and the flexibility. Thanks for listing, LC

I'm a new nurse working on a MSP floor in a hospital. It is OK but im considering going to home health for awhile after I'm done with my year. I hear so much about the money being less but as a new nurse I'm not really making lots of money anyway. Quesions I have are really is it that much less pay, is it more accomidating then the hospital when you have small children, and is the paperwork really as terrible as I hear?

That's really great that you are doing home care. I have since I became a nurse....I have a child who also has had home nursing for her entire life. I have learned alot from the nurses who have taken care of her....and I carry that over into my care with my patients myself.
I learned always have an open mind and never judge, and also it's much more laid back than say a hospital nursing position. "Go with the flow" so to speak..... and when you are told to "keep professional boundaries" it is true for the most part, but this is the real world....so if you didn't become close to some patients/families, you wouldn't be human......
Also, I always have to bite my tongue when I hear nurses complain that do home care nursing how "the mom/dad left me all alone with the patient" or "they always leave when I get there"......well...that's why we are there & are paid to be there, and that may be the parents/caregivers only chance to have a break........gosh it makes me want to laugh because I used to fly down for 3-4 days to visit my husband every month nearly before we were married, used to go on vacations, etc and that was that....as long as ther was nursing coverage and there was someone who could be contacted in my absence in case of an emergency, then who cares!....
Yes, you will have some families who are "different" and you will wonder "why" on some things they do....but that's what makes life interesting isn't it? Not all people mesh, so to speak.....
I love doing homecare nursing....I don't think I would ever want to work in a hospital....so just keep an open mind and enjoy providing that 1 on 1 care patients deserve...... it's a great field to be in for nursing!

I was wondering if you are available for work? I think your outlook is just right. I am glad to hear there are nurses that do private duty and believe what you believe in. But don't forget to listen to the parents. That is where I have learned all my knowledge. The nurses seem to change the ways the parents originally teach them. That has caused problems. But nothing that can't be fixed if you really like your job. I have a great job where I work. And we need help too. Wonder if you know any available nurses who think like we do? Would love some feedback. Thanks and keep going!

Hi! I am a pediatric private duty nurse and enjoy taking care of these special needs children. You not only take care of the children but are very much involved with the parents and their family too. I have worked med surg, nursing home, NICU, and home health with the adult population but this is what I love doing. The kids that I have come in contact with and have taken care of have a special place in my heart. I have been thinking about starting my own company in the area that I live in. I have looked into several things as far as licensing but don't know exactly where to get started? Does anyone out there know if I would be able to get licensed and just contract out my services to start out with just myself and then expand?

I know that here in Texas you have to go through the Department of Aging and Disability Services, and an RN who oversees a business, and a have a secondary nurse I believe RN/LVN.

But most all before all of that get a business plan and go to Small Business Association in your area, which will help you with free seminars, books and usually onsite help in your area. I believe they are subsidized by state or national tax dollars. Then after the biz plan (highly recommeded...then form your company, etc.,

Realize that starting a business is a 7 day a week job pretty much when you start out. I nearly started a similar private duty biz with the elderly, but backed out due to the committment and fear of loss of $$$.

Brian,
Thank you for initiating a thread specific to the forum of private duty nursing. The relational experience and generalist requirements of the private duty nurse are unlike any other nursing position and certainly deserve a forum all their own. Thank you!
As I read through the postings to familiarize myself with the current issues under discussion I noted that many of the frustrations involved the lack of family involvement in care and the apparent indifference to care of the patient. I have provided private duty care for patients as both a staff nurse and as a director for a total of 16 yrs now and have specialized in mental health nursing.
Patients and families having to manage chronic conditions, often mutiple debilitating progressive conditions, for extended periods of time are forced to develop coping mechanisms that allow them continue on day by day with the reality of their situation. CMS instituted new measures requiring the assessment of patients for depression on regular intervals for just that reason http://www.cms.hhs.gov/HomeHealthQualityInits/ .
Our patients and families need us to invest our selves by using empathetic listening to aid our patients to self empowerment so that they can begin taking control of their disease process. The American Nurses Association Code of Ethics (2001) required that nurses provide compassionate ethically based care for the patient and their family. As nurses we all want this same goal and strive for excellence daily, attempting to avoid the crisis of burnout or moral distress.
Imagine the anguish of those involved with a patient who may be angry or sullen, or even at times abusive to family. I suffered a stroke in October of last year and must admit that recovering from the debilitation has been one of the most mentally challenging and exhausting feats of my life. It has opened my eyes to a new degree of compassion for patients faced with health complications that are chronic. My heart goes out to the nurses and the patients and families struggling in these situations. The nurses called to care for these patients are so special. To all of the nurses in this position, remember that the fifth tenet of the Code of Ethics (2001) stated that nurses owe the same duty to themself as they do to others http://www.nursingworld.com . SO take care of yourself!
greeneyesrn