Do you think there's a power struggle?

[HisTreasure, BSN, RN]

Being both a nurse and a therapeutic foster parent has placed me in a unique situation. I hear a lot from both special needs parents and nurses-- each with their own perspectives on private duty home care, and each having a legitimate reason for feeling how they feel. Lately, however, I've felt very uncomfortable in the "special needs parents" category because the more I hear/read, the more I realize that PDNs aren't really respected. I get a lot of

• I fired the nurse
  
• I'm the boss and they need to listen to me
  
• They think they know it all
  
• I hate having nurses here
  
• I have cameras in every room because I don't trust nurses, they do XYZ
  
• Nurses are incompetent
  
• Doctors are incompetent
  
• I don't trust the nurses with my child
  
• The stupid nurse did ABC and I am so livid...!
  

And it bothers me because for every 1 person who says they appreciate their nurses and the services they bring to the table, there's 4-5 complaining about/fussing about/degrading their nurses. Almost as if the nurse is a property or a slave, rather than a person with a legitimate license. I don't know...

Lately it's been hitting me harder than ever because I am back in school, I am working full time, and we are in the process of bringing a new special needs child into our home (hopefully) and I will again rely on nursing. I learn a lot from these special needs moms and they are very knowledgeable about conditions, resources, and support groups which I find invaluable in helping me be a good special needs parent. On the other hand, I feel like I'm betraying my nursing community by hearing these words and not doing anything to stick up for the profession.

Don't get me wrong. In the past I've had some run-ins with some of the nurses in my home and I had some honest to goodness frustrations but I never felt the need to throw around terms like "I fired the nurse" (I never HIRED the nurse, the agency did. I just accepted them unto the case, and when it wasn't a good fit I asked that they be removed from the case). The term "fired" seems harsh to me. I never outright distrusted a nurse; I had baby video monitors but it was never because I thought the nurses were inherently evil or felt they needed to be babysat. In sharing some of my concerns with a special needs mom who also happens to be an RN, she told me that I would never fully understand because I'm not a "real" special needs mom- "[i'm] one by choice"- and to birth a child with these needs takes away power that parents try to regain wherever possible. If feeling like they have control over whomever is in their child's life, even if they don't have control over the NEED of having these people in their child's life helps them, then so be it. Even though she was a longtime, well educated nurse she didn't understand why it might bother me how other parents speak about nurses. In her POV she was a SN mom first, then a nurse. So, is she saying I'm a nurse first and then a SNs mom, just because I didn't give birth to the child??? I digress.

It makes me feel almost dispensable and unappreciated as far as PDN goes, and definitely prevents me from picking up cases as a fill-in, even when asked by parents whom I consider "friends" because I know what is said about nurses behind closed doors. I also know that some of those same SN parents come on this site and watch what nurses say about them and it seems unfair because they go back and talk about nurses and use words vented here against us in making new rules and policies. And when nurses speak up in defense of the profession it becomes an "us versus them" debate and that's neither productive nor helpful. I feel torn. Does that make sense? Have you heard such things? Do you ever feel unappreciated? Do you feel like everything is a power struggle (damned if you do, damned if you don't)?

[SDALPN]

Well written. I try to put myself in the shoes of a parent when I work. But at some point they seem to feel entitled and act as if we are slaves. I can't understand treating any human being like that. It's not easy for someone to be in your home constantly. The parent is in control of their own home and should make it an environment that works for everyone involved. If they put their control issues into that, I think it would help. I have said in other posts that I strongly believe these parents need counseling. Not to day there is something wrong with all of them, but even having someone to talk to about the adjustment would help. They could voice their frustrations to a neutral party who would could validate their complaints or tell them they're ridiculous. Plus they could work on the issue that is making the parent be so ridiculous.

This is off topic, but I've considered being a therapeutic foster parent. It would be nice for a board to be added here for nurses that are or are considering a program like that. And maybe that would help with working through issues as well.

[caliotter3]

I run into the things described in the OP on a daily basis. The first sentence out of my current client's mother's mouth when I met her was a direct insult. The agency told me point blank that they want the income from the case and they expect me to keep things running smoothly, as if I have the power to prevent this woman from calling the office more than once a day and disrupting their work flow. Their excuse for not giving me a different case is that "all of their clients act this way". The alternative for me is to remain unemployed, something that I do not find acceptable.

[CloudySue]

Further down on this board we had a similar topic going, called "Online support groups = trashing nurses" or something like that. I had been on a FB closed group because it pertained to my specialty. I had hoped to gain some extra knowledge and insight, and while that was the case part of the time, it really ground my gears when it would turn into a bashfest on nurses, which happened quite often. I got in the middle of a discussion where the caregivers were fuming about nurses calling 911 in certain circumstances where it was clearly ordered in the MAR and 485, but the caregiver wanted to "veto" the order. They were really throwing out some rough criticism, others chiming in and relating to their own situation where the nurse didn't listen to the caregiver, but insisted to stick to the MAR. I started to explain that we are bound legally by our license to follow doctors orders and if they want the final say on calling emergency services, all they have to do is ask the doctor to change the wording of the order. I reminded them that our license dictates that we must follow doctors orders, and if we didn't, and something bad were to happen, we're the ones liable, and stand to lose our livelihood and unable to support our own families. Well, I got dogpiled. I wasn't trolling, and I was wording my responses respectfully, but wow, I was really judged harshly and disrespected by people I didn't even know, playing the "Well, you do not have a special needs child so you don't know how it feels, so you have no right to tell us anything" card. I have respect and empathy for people who have it rough in life, but I don't think highly of people who feel entitled to treating others poorly because of it.

[Adele_Michal7, ASN, RN]

Kiyasmom- we need more like you. :)

Sent from my iPhone using allnurses.com

[systoly]

i'm starting a phrase response book

I fired the nurse - how's that working for you

I'm the boss - just because you're bossy doesn't make you my boss

they think they know it all - yep

I hate having nurses here - not as much as we hate to be here

Nurses are incompetent - I feel the same about quarterbacks *

Doctors are incompetent - so you wouldn't mind addressing me as Doctor then

I don't trust the nurses with my child - you know you have the right to take

care of and provide for your child all by yourself without any assistance from anyone

* I have never played football in my life

[Alnitak7]

When a nurse or caregiver is in a client's house, they're a team. The combination of the nurses training and experience and the family's knowledge of their loved one requires all to have humility and to treat each other as equals.

Nurses do not have to mindlessly obey and/or agree with clients or family members.

"I would rather not rub your grandma's legs because......" does not require a rude interruption and should not be interpreted as some stubborn childish reaction.

[ceebeejay]

This issue is the single most disturbing thing I have found in PDN. I have a hard time with the statement that you don't understand because you aren't their mother? Do adoptive parents understand parenting less than parents that gave birth to their children?

[Adele_Michal7, ASN, RN]

i'm starting a phrase response book

I fired the nurse - how's that working for you

I'm the boss - just because you're bossy doesn't make you my boss

they think they know it all - yep

I hate having nurses here - not as much as we hate to be here

Nurses are incompetent - I feel the same about quarterbacks *

Doctors are incompetent - so you wouldn't mind addressing me as Doctor then

I don't trust the nurses with my child - you know you have the right to take

care of and provide for your child all by yourself without any assistance from anyone

* I have never played football in my life

Love it

Sent from my iPhone using allnurses.com

[ventmommy]

As an adoptive and foster parent, we are just as much moms as any other mom that births a baby. Nonsense like that irritates me to no end. Adoptive parent or bio parent, no one WANTS to have nursing care because no one WANTS their child to be suffering so much that they need nursing care. The only difference is an adoptive parent knew what they were in for when they adopted their child. At some point, biological parents need to move on with their steps in the grieving process. I know many SN parents that really should be in some sort of counseling because the "it's not fair, I have no control, I didn't want this" as excuses for pity parties, bullying, whining and inappropriate behavior is tiresome. This is one reason I feel that all PDN agencies need to have LCSWs on staff. An LCSW can assess the mental health needs of the family and point them to some resources. Are there incompetent nurses? Absolutely. Incompetent doctors? Absolutely. That doesn't mean that every nurse and doctor is incompetent. I have never "fired" a nurse. I have told the agency why a nurse can't return to my home. It's up to the agency to decide if that's a firing offense. Am I the boss? Eh, that's iffy. It's my house so things get done my way. But I also made darn sure that the 485 and doctor's orders were written exactly how I liked things done so there wouldn't be any orders v. mom issues.