I didn't get any formal guidelines either but I was so darn lucky to be assigned to a home with more than one person in it that was in need of nursing care, so I learned many things from some of the veteran private duty nurses who had been years in the field.
Every home, every family, and every client/patient is unique so it's almost as if each case is a "job" in itself with all sorts of possible variables in age, involvement with/concern for the person in need of the care, what they expect you to do, where to sit, etc etc. A good orientation is something I've always insisted on. Don't let them "oh it's easy - you'll be fine"
Make sure you get a chance to review the Plan of Care. The agency should have a copy in the office and one in the home.
Everybody will tell you this but it bears repeating because it's so easy to get sucked into a dysfunctional family dynamic - always keep your professional boundaries
. Repeat nothing you hear from one family member to another, for example. It sounds innocuous, x told me to tell you that y did this and. . .I just politely tell them I won't do that. I might let them dictate a note or I will set the phone up for them, but acting as a go-between will usually bite YOU in the backside! This sort of game can be played by other nurses on a case as well, unfortunately.
As for the housework situation. I don't, and I don't think the other nurses should clean up after the entire family. This is difficult, because it becomes a bargaining chip in a tight job market. Most agencies say
the nurse is not there to babysit siblings, do all the family dishes and laundry etc., but some do that anyway to curry favor and make sure they are always the first nurse called for.
Just 3 days ago I heard one of the parents in a home I've been in happily for a long time, "why can't the nurse scrub the kitchen floor all she does is just sit there
" to his daughter and oops!
I guess he thought I didn't understand Spanish! I'm still honestly feeling hurt about that, and also really
as all of his children's care is paid for by other people and I've proven my worth as a nurse time and time again. I guess they don't understand that. The point (other than a mini-vent) is he may have been genuinely confused by other nurses who clean-up after able-bodied relatives when the admission paperwork they signed clearly stated that was not part of our job.
What I do:
1. Wash dishes I use for the patient, wipe counters, put dishes away.
2. Disinfect, wipe down surfaces in the client/patients immediate area such as bedside tables, etc and whatever the DME (durable medical equipment) is ventilator, suction machine, g-tube supplies, etc. Refill supplies - catheters, suction catheters, trach care sets, etc.
3. Soak, wash rinse non-disposable items like vent and suction tubing, humidifier chambers, suction cannisters, etc.
4. Take out trash from waste areas in the immediate area of patient.
5. Soak or handwash stained/soiled clothing and linens, or washing machine if it's convenient to do so and you check with the family first.
That gives you an idea, but you'll find most of the time the family has already got their routine down pat and they will tell you what they need. You will find that sometimes they will have rituals that make you say "whaa---?" but they've been doing it their way forever, and you have to be flexible within reason. Hope this helps! Good luck!