Do we do everything

[working bee]

I work in homecare as a RN, I work 8 hour shifts inside a patient home. Sometimes I feel like I'm a HHA. Is there a limit as what we can't do as nurses. Because some families try to abuse our services. So what aren't supposed to do?

[Libby1987]

Doesn't your agency provide guidelines for job duties and expectations?

[working bee]

Everytime a nurse train me to a new case. They washing clothes, folding clothes everything the patient wants you have to do it, especially the family too. there is a patent that I have he is disabled and has contractions. And always on the floor, I have to move is feet and hands and head every five minutes. Is that normal? Or should I leave the case

[caliotter3]

You obtain the client/family expectations on your first visit or your orientation and from having read the 485 prior to going to the case. Some agencies will spell out in great detail what household duties the nurse will do. In general, I tell my clients that I am there to provide the skilled nursing care that is requested on the 485 first. Secondary to that, I keep the patient's area clean and tidy. I may or may not be able to do laundry, for the patient only, as long as I am not required to be in view of the patient at all times. I tell them I can not do any of those housekeeping activities as long as there is nursing care that I am neglecting. As for the range of motion exercises for the disabled, contracted patient, what does the 485 say? Once a shift, twice a shift, every five minutes? You can diplomatically limit this task to what the 485 says, or, if he demands that you do it every five minutes and you are not physically up to it, you can ask to be reassigned to another case and inform your supervisor why. The supervisor may be able to intervene, but don't rely upon that.

[KelRN215, BSN, RN]

You should NOT be doing laundry or dishes or cooking for family members other than your patient. If, say, your patient soils himself or vomits during the shift, you can put those clothes in the laundry. If Mom just wants to go out shopping instead of doing laundry today, sorry, no. If the patient needs a home health aide, have him evaluated for HHA hours. If the nurses are doing home health aide duties instead of nursing care, he's going to lose hours.

[working bee]

My plan is to leave the case because I don't think it's fair that the patient continously ask me to move his hands, feet, and head every five minutes. I dont kno if he does this on purpose or if he needs attention. My client is 11 years old. I have get up and get on the floor to do these. Even when I suction him I have to kneel down to do it cause he is on the floor. So know I use another chair cause of my back. But thank you so so much guys!

[caliotter3]

I had a young child about this age that engaged in demanding behavior. He made no effort to try to hide the fact that he was doing it to manipulate the nurse and that it was great sport for him. Since the parent fed into this behavior, I did not stay long on the case. Not all children needing care are taught by their parents to act this way, thank goodness. Hope you find a better case.