Asked not to come back to work for the family?

[LPNmomtobe]

I am very upset right now, shaking my head and trying to figure what the real reason is...just need to talk to other PDN that may have been in this situation or something simialr.

I work as an pedi home care LPN. Been with this family for almost a year, work one day a week for them for 6 hours. Had a great realtionship with parents and other nurses, and of course the child. I am not in anyway saying I am excellent nurse, but I pride myself in knowing when I am taking care of a child, I do it 100% and never cut corners. The child is 12 and very disabled, can not walk, or talk, has alot of resp issues, seizures and can change very quickly. There has been quite a few times where I actually thought he was not going to make it much longer, that is how sick he would get, and than it would set him back for a couple of weeks.

Well in Feb I let the family know that I was expecting at the end of Oct, but planned on working right up until the baby was born. They seemed ok about it. I never called in, even had gone in a couple times when I felt awful, like a head cold, cause I knew they depended on the nursing ( they had 24 hour nursing) Every morning I would go in, report was he was up most of the night, struggling with certain issues, most resp, and by the time my shift started, he was in the deepest sleep he could be in, and mom saw how I could not get him awake, but I would still sit him up in bed and try to get him awake, however he would sleep my whole shift if I let him, but I would ususally get him up in bed, sitting up, doing CPT, singing to him and of course doing all the bed bath, mouth care and so forth. Always got him dressed, repositioned every hour, sometimes more, let's just say very attentive to him. Mom did mention she wanted me to learn the their lift, and I could either do it now with the nurse that came on after me, or after I had the baby, I said that was fine, not an issue at all. That was two weeks ago, and last week the nurse who does the training was out, and yesterday, totally slipped my mind as the child had some pretty major resp issues during my shift, so I was focused on making sure my report was very detailed and I did not leave anything out. Mean while, mom never said anything to me about this when I was there and even there finishing paperwork a half hour after my shift ended, I would have totally appericated it she came to me and gentle reminded me if I can go over the lift with so and so right now since your still here, and I totally would have.

Instead I get a call from my nurse superivsor saying the family has asked for me to not come back, when I asked why, she said cause mom feels you leave the child in bed alot. I was shocked, even she was shocked, cause she said mom told her she talked to me about it and I still made no effort...I told her excatley when and what talked to me about it and than she knew about the other nurse being out....I feel horriable cause mom is there my whole shift sitting on her computer in the kitchen and it would have been great if she came in walked me through there lift ( child is attached to TPN and is 100lbs) and how they want the pumps to be placed and so forth. I am all for learning and learning to do more. My case manager said the family had nothing but great things to say about me as a nurse and my nursing skills, but felt I was no longer a good fit.. Again still super shocked.

My husband feels it is because I am 7 months pregnant, and they know I am going to be leaving at some poitn, but I don't know...I just feel really defeated right now and feel horriable. I have only been a nurse for a year and I am very much by the book, but this is the first time something like this has happened to me. I guess I could see if I called in alot, or I did not take care of my patients, such as forgetting meds, or treatments, or not picking up on serious issues starting...but something as simple as getting him out of bed and more so when he usually stays in bed until my shift ends, that is how it had always been and not until two shifts ago I was talked to about the lift.

Anyone experience this in PDN and how do you end up feeling better instead of feeling like a crappy nurse.. ?

[Pranqster]

that sucks, it would have been nice of them to have spoken with you first. good luck with your pregnancy!

[nursel56]

Sorry that happened to you!

I've been working in PDN for around 7 years now, and I've learned that the only thing I can count on is the families doing and saying things that make you say "huh?"" - where did that come from?

The take-home lesson being that they often behave in unpredictable ways, and many of them can't bring themselves to tell you face to face what their issues are, so they act like everything is fine, and then call your agency.

There's a marked tendency for families to view you as something more than their child's nurse, so that their expectations align more with a friend or family member. They become possessive sometimes, and some of them feel betrayed when you assert your right to live your own life.

Since I don't know them, I can only surmise that when you told her in February you were expecting, she began the psychological process of separating at that time. Your husband may be on the right track there.

It's important to realize that most of the time it's not you.

The only bit of advice I can offer is that next time, be a little more proactive even when the parents seem uncommunicative. That will be no guarantee to fix all problems, but as you've now discovered - people do keep their concerns to themselves until you've reached the point of no return.

Don't let this affect your self-esteem too much. Believe me, I've been where you are at times, attempting to make sense out of a situation that seems to drop out of the blue. There's my two cents, best wishes, and congrats on the impending birth of your baby!

[caliotter3]

In this case it is reasonable to assume that the family made the decision once they found out you were pregnant. Not too much you can say about that. About the only way you can forestall future occurrences is to think of situations where the clients could find fault, and address those situations whenever you work. Document it. But even being proactive can not stop the family from deciding you won't be coming back. Your goal should be to always look for the next client and have your ducks in order for that time that you find that the agency really is holding this against you. Agencies tend to tell the employee that it is ok when the family rejects the employee, but sooner or later you will find that they are discussing you behind your back in unflattering terms and you aren't getting the opportunities for work that you need. This is the real disadvantage to the family sending you back to the agency. Part and parcel for doing this type of work.

[SDALPN]

Very typical of these types of families. I've seen it happen over and over to the best nurses. These parents (not all) have no understanding of our job and boundaries. They act like its to much work to fix a minor problem and that its easier to just get another nurse. If they complain and get rid of you they get a little power trip. It could be because you are pregnant, but it may have happened anyway. I always ask for a history on those things from other nurses on established cases. Certain families always go through nurses faster than others. They are usually unhappy with their lives and themselves so nothing makes them happy and they take it out on us. They told your agency that you are a good nurse...so its them, not you. A good nurse means you did your job right. Its so hard to find a reasonable family. They just need someone to blame for their own problems. I have heard families talking about requirements they want for nurses and they almost never have anything to do with whether the nurses are good or not. I've seen nurses let go by families because of their weight, the car they drive, their religion, their minor non-contagious health problems, because the nurse wasnt talkative enough when they wanted a friends and not a nurse, when the nurse talked too much and the family didn't want to be bothered for report, when the family wanted a procedure done wrong and the nurse refused, when the family liked drama and played nurse against nurse until the nurses stopped playing their game and the family got bored and let them go. The list goes on and on and they are all ridiculous. I've seen plenty of nurses let go for bad nursing. But usually its the family. The best thing to do is work with a few agencies at the same time and spread your work between families so if you are let go you only lose a shift or 2. If you float you will eventually run in to a good family, then you can take your chances and pick up more shifts with them. But those are rare. Its easy to take it personal, but try not to let it bother you. Its part of PDN. The only thing that still amazes me is how many families out there that are like this. Its sad how miserable they are.

[ventmommy]

First, congratulations on your pregnancy!

I hate to say it, but I would have had you not come back the very first time you came to my house with a head cold. This child sounds like he was severely compromised and already had severe respiratory issues. I certainly would not have needed your highly communicable germs in my house.

Pregnancy status is a protected class of employee in many states. It's possible they couldn't say "we don't want her anymore because she's pregnant" so they had to make something up. You can't even be sure if the mom made it up or the agency made it up.

You were only there 6 hours/week. It's possible that they got another nurse that is already in the home to fill those hours so they wouldn't be left in a lurch when your baby was born.

[LPNmomtobe]

Thank you everyone for your thoughts on this, I am feeling much better about it and realized that I was going to have to leave at some point, but just hard when they can't talk to you about when they can clearly talk to you the whole shift about other stuff..and than to have it be something so simple like taking him out of bed at a certain time...but oh well. Thank you vent mommy for your response, and u know as a mother myself of a medical complex child, I agree 100% with I should not have even gone in that day, but anytime I I interview with a family I ask them what they preferr as far as when to not come in. I know for my son, any type of GI bug could set him back. Mom made it very clear that unless u are on your death bed, she wants the nurses there. She knew I had a small head cold starting my shift, I was filling in for a nurse the following day and asked her if she wanted me to call any of the other nurses to see if they could fill in, cause I was super nervous I was going to give him something, but she said no, and told me she really needed me there tomorrow regardless cause she had a meeting to go to. I felt awful and clearly should have and wanted to call in, but she kinda of warned me she would not be happy if I did. She has had nurses come in with stomach bugs and fevers and care for her child. So trust me I would not have gone in that time, but I was afraid she might let me go if I did call in. I do appericate everyones take on this.

[ventmommy]

Wow, she is definitely NOT putting her kid's needs ahead of her own!

It does suck when you can't talk to the family. On another post, I wrote that for small things, I went straight to the nurse and had a friendly chat. For most things, a nice conversation goes a long way. She could have merely said something like: LPNmomtobe, I know that ___ sleeps a lot during the day but I still would like him to be in his wheelchair/stander/seat/highchair/floor sitter/whatever for at least ___ hours a day. Thanks."

[Adele_Michal7, ASN, RN]

I had this happen a few times (and other PDN nurses I know as well.) I know it's hard, but try not to take it personally. It's the nature of the beast. Parents in PDN do and say crazy things... That's for sure.