declining a pt assignment

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I have had 4 cases total since I started this job a few months ago ... one just ended so I currently have 3. I have accepted all my cases with minimum orientation and have not given my agency any trouble. Well, there is a patient assignment I have now that I want to decline. I tried to give it a chance ... I requested an extra orientation day because I wasn't comfortable with transfers yet .... anyways, after two shifts now with an orienter I am positive I don't want this patient case. Here's why: I'm a bit more comfortable with transfers but they are still extremely more difficult than any other patients...but that's not what pushed me to my decision. It's mainly the fact that the majority of this 5 1/2 hour shift is spent COOKING DINNER for the client!!!! And then you spend time cleaning up the mess you made making dinner and doing dishes ofcourse. I don't know how to cook well and my orienter literally just gave me a cooking lesson both times I visited this clients house... she basically made the meals and i helped both times...am i in a cooking class? I'm seriously kitchen challenged and I'd prefer to hone that skill at home and not practice on a client's meal at work. she whips up these awesome meals and is a great cook and tells me you don't "need a recipe" because you can just smell and taste things to know if they'll be a good edition to the meal ...cooking comes naturally to her ... not me. And the point is, I didn't know upon hire that I'm expected to be a chef for most of my shift ... I am an RN and I don't feel comfortable TRYING to cook and I want to spend my time actually being/ a nurse. Is this understandable? I am actually looking for a new job because most of my cases seem more fit for a cna or caretaker and I'm not utilizing many nursing skills ...for example... another client I have I literally just drive to an adult day care. The list goes on for reasons I'm unhappy with this job but I won't list those.

Anyways, is it understandable in the meantime for me to turn down this client because I don't feel comfortable or like it's reasonable for me to cook and clean dishes for most of my shift? I can hardly cook for myself!

(Just for the record, I can't cook either and would feel very uncomfortable trying to do so.)

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Specializes in Pedi.
Medicare pays for all of the services for the clients I work with. I'm thinking cooking is not a part of the bargain ...this has been the straw that broke the camel's back. I'm looking forward to my job interview ... may even see if I can move it up a day or two because I forgot I'm off early enough tomorrow!

Medicare does not pay for private duty nursing services, period. I assure you they are not paying for you to cook for a client.

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Yes private duty (though my agency calls it home health ...ha) stinks. I have been stuck doing laundry as well. I'm sure actual home health is much better. I'm actually trying to get into hospital nursing. This is the only job o could get when I moved (for obvious reasons ...they needed people because everyone leaves). I will Def put my foot down harder for the remainder of my time here which won't be long, that's for sure. It's not worth stressing and being nervous because I'm uncomfortable with a case. And you're right...they DO try to make you feel like you have to do things and keep cases when it isn't so.

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I have an interview in the hospital now! 2 interviews for new jobs ..one of them is not the hospital but it still requires way more nursing skill than I'm doing now. So happy that I may have an outlet from this job very soon.

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Oh sorry! It's medicaid that pays I think ...anyways I'm sure either way you guys are right ... cooking isn't included therefore it shouldn't be required of my agency's nurses. I definitely know that they're not paying out of pocket... pretty sure it's medicaid not medicare, my mistake. And we do get benefits if we average full time hours per month ...but it's tricky because the hours aren't always set in stone or reliable so the very next month you may not qualify anymore for benefits. And apparently the benefits package is expensive .... I haven't signed up yet because I plan on leaving and I'm mostly covered under my parents right now so to me it's not worth paying for the package right now if I'm leaving and if it's known to be expensive.

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NotReady4PrimeTime..how soon did you quit after finding out you'd been paid as an LPN ?

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Medicare/Medicaid can be very picky when it comes to documentation. As a CNA/HHA if I'm working one of these cases I need to document every small detail of what I do for the client. If documentation is not done exact as the care plan they can decide not to pay for a shift.

I'd write every small detail down that you do. If medicare/medicaid sees what you are doing and it does not meet their requirements for nursing care they might take note of it and change it that this person needs Aide help not nursing help.

What does the care plan tell you what your duties are. If there is not cooking on the care plan you can tell the agency that it is not in the care plan and I'm not required to have to do that.

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The care plan mentions his diet as all care plans mention diet. But it doesn't state in the goals and nursing interventions that the nurse is to feed him.

Anyways, I had my first shift alone with him Friday (third shift altogether) and I'm telling my agency for sure this time to take me OFF the case. It's not just the cooking anymore ....the client isn't so fond of me and literally prevents me from doing my job to care for him as he is non compliant and uncooperative with my care. He literally wouldn't let me do anything and his sister, who is the caretaker, would hear him yelling, come in the room, to find I was doing everything right and he was fine and had no (obvious) reason to be distressed and would tell him he's fine and let me do what I need to do. It also put alot more undue stress on my body physicslly when he would fight my care during transfers and i left with a pulled muscle back ...I can't even do my job with him so I'm done. Not to mention he is young and so am I so I feel like part of it could be that he's embarrassed that I have to feed him and toilet him (he's of sound mind with a neuro condition) so I suspected that might be part of his non compliance despite my trying to be professional. All his other nurses have been older women I think.

So yeah when the client won't even let me perform my duties in addition to the cooking thing im clearly not a good fit so I'm telling my agency one final time, a,big fat NO.

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Specializes in Complex pedi to LTC/SA & now a manager.
The care plan mentions his diet as all care plans mention diet. But it doesn't state in the goals and nursing interventions that the nurse is to feed him.

Anyways, I had my first shift alone with him Friday (third shift altogether) and I'm telling my agency for side this time to take me OFF the case. It's not just the cooking anymore ....the client isn't so fond of me and literally prevents me from doing my job to care for him as he is non compliant and uncooperative with my care. He literally wouldn't let me do anything and his sister, who is the caretaker, would hear him yelling, come in the room, to find I was doing everything right and he was fine and had no (obvious) reason to be distressed and would tell him he's fine and let me do what I need to do. It also put alot more undue stress on my body physicslly when he would fight my care during transfers and i left with a pulled muscle back ...I can't even do my job with him so I'm done. Not to mention he is young and so am I so I feel like part of it could be that he's embarrassed that I have to feed him and toilet him (he's of sound mind with a neuro condition) so I suspected that might be part of his non compliance despite my trying to be professional. All his other nurses have been older women I think.

So yeah when the client won't even let me perform my duties in addition to the cooking thing im clearly not a good fit so I'm telling my agency one final time, a,big fat NO.

Did you report your injury? It's mandatory to report within 24 hours for workers compensation(even to cover the evaluation & treatment) plus it adds to document why you shouldn't return to the case

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I had to gasp with delight when I read your post! I really can relate. I took care of a patient who had a housekeeper/cook. She made him wonderful things. His DIL was a great cook also. One day, the cook wasn't there and he asked me to cook him lunch. He would never have a sandwich or a salad. Noooo. He had to have a hot lunch. I told him not to expect much. I was so nervous. I hate to cook. I stink at it, even when I use a recipe. I can do a few things I learned growing up. Other than that, I am totally stressed out the whole time. I would definitely turn that assignment down. It's not a nursing skill to cook so I would say I prefer nursing skills. If I had to I would be honest about how I feel about cooking.

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