Do we do everything

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.

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.