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Does your pt/pts family love you like “family?”

Private Duty   (558 Views 12 Comments)
by dholly2015 dholly2015 (New) New

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Hey guys! This is a long read but I’m hoping some of you have some experience with this sort of thing. I’ve been thinking about this for quite some time and here’s where I am. I have been working with the same medically fragile child in her home for over a year now. She has a whole host of issues including but not limited to: trach, vent, GB, PD and HD, developmental delays, etc. I have been loyal and dedicated to this child/family and like many nurses, placed this child/family above my own. 

I work nights and have been working nights since the beginning. When I first started I loved my job, my kiddo, and the family. 

For the majority of the time, I was working extra bc the family had no one else to work nights. I have become very familiar with this pt, her needs and how her needs have changed. I treat and love her like she is my own. (Maybe that’s my problem). 

In the beginning, I thought I got along great with the family and thought they truly cared about me as a person. There used to be kind gestures of them baking cookies and bringing me a few. Over the last couple of months, the PCG has become very distant and overly critical of me.

I’m still not sure why but about a month ago I had reached out to my agency to let them know that moving forward I was no longer going to be able to work a certain day or the week. We are on an XY schedule and me asking for this one day off every week equates to 2 days a month. I gave agency a months notice, sent emails and called several times. Until this week they did not have anyone and I reluctantly agreed to continue to work it so pt would have coverage.  I also talked to PCG about it. Last week I told her that “I love the pt very much and thought of all of them like family.” She said, “Well that’s good bc we want all our nurses to care about her that way.” 

Ouch....that really hurt. I realized at that moment last week, that this family does not care about me as a person but only sees me as a commodity. I’m dumbfounded that as a fellow human being, she didn’t even bother asking me if I was okay or anything as to why I needed that day off. Maybe I’m being overly sensitive but since then, everything has changed. 

Often times now I find myself in the situation where the PCG “steps on my toes” or micromanages me. She has since been overly critical of everything I do, when she comes in the room she will not speak to me. If I try to have any conversation with her, she ignores me. She blames be for things that have nothing to do with me. She made it clear she was upset bc I “wasn’t spoiling her like I used to.” (I used to go above and beyond the call of duty: pts laundry, organizing supplies, deep cleaning, etc. until I realized that she did not care or value me). 

I'm honestly disgusted with the whole situation. I’m upset bc I allowed myself to get too close and feel really foolish for doing as much as I did for a person that’s now treating me like poo. I’m now “walking on eggshells” bc I feel like I may get the boot and I don’t know what happened or what changed. She admits and acknowledges that I love the child and take good care of her. 

I am continuing to do some of the things I used to do but not everything. Just to be clear, how I feel about the PCG will no way influence how I care for my patient. That will NEVER change. I would just appreciate any advice, feedback, or similar stories from you guys! 

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7 Followers; 3,225 Posts; 21,182 Profile Views

This is why we have professional boundaries. Now you know. Frankly, I would ask to be moved to another case. This has the potential of going south rather quickly. All it would take is an anonymous call to the BON from a disgruntled parent to turn your life into a living  hell. Also, document the heck out of your interactions with the parents. I mean word for word in quotes. Incident reports as needed and involve your manager pronto. A care conference may be in order to ferret out what her issues are. Next time just do your job, care about the patient as a human but that is all and get your emotional needs filled by more appropriate means. And quit beating yourself up about it. 

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3 hours ago, dholly2015 said:

I have been loyal and dedicated to this child/family and like many nurses, placed this child/family above my own. 

This is not with harsh intent, but you need to know that there are many nurses who do not place their work above their own family.

There is a crucial difference between upholding one's appropriate professional duty to a patient (as per our Code of Ethics) and loving them/placing them above self and loved ones. The latter is not required in order to uphold the former. That's where you went wrong. 🙂

 

20 minutes ago, Wuzzie said:

Next time just do your job, care about the patient as a human but that is all and get your emotional needs filled by more appropriate means.

OP, spend some time contemplating the above. This is not a chastisement--it's just something that all nurses would do well to think about. Patients are not there for our emotional fulfillment and we have no business asking them to be that (i.e. we have no business thinking of them in that way). Not only is it in everyone's best interest for nurses to realize that, our lives can be much fuller and happier when we don't rely on patients to provide such an intimate and necessary part of our lives. You are a person separate from this patient/family and separate from your identity as a nurse, even.

Don't stress too much about having made this (emotional) mistake. Many of us have to learn it in one way or another through either big examples like this or just smaller realizations along the way.

I agree with @Wuzzie, personally I would quit the case pronto. At this point that is probably in your own best interest on many fronts, including for your emotional growth and well-being.

Move on--do it cheerfully, not resentfully. Best wishes to you!

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Kitiger has 40 years experience as a RN and specializes in Private Duty Pediatrics.

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11 hours ago, JKL33 said:

Patients are not there for our emotional fulfillment and we have no business asking them to be that (i.e. we have no business thinking of them in that way). Not only is it in everyone's best interest for nurses to realize that, our lives can be much fuller and happier when we don't rely on patients to provide such an intimate and necessary part of our lives.

JKL, you are spot on.

OP, we can enjoy the good feelings we get when caring for a client, but we should not depend on the client - or client's family - to supply us with those good feelings. It isn't fair to them, and it isn't good for you.

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If you expect all families, or even any families, to treat you other than as a commodity, then you have unrealistic expectations for working in extended care home health.  If I were you I would carefully consider whether or not I would want to change from this case and even from this agency.  I can almost assure you that your feelings of simply being someone that all involved "use" are not going to dissipate the longer you stay there.  Try to handle your boundaries better on a different case.

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Hey guys, 

I had intended to respond earlier but I want to say “thank you” for everyone’s responses. This experience has been very valuable and I learned a lot about myself including: setting/enforcing boundaries and loving myself enough to take care of me before others. I think I had lost sight of much of this until the last few months. 

Oddly enough I recognized that I did not have adequate boundaries with family members either. I had initially established boundaries and considered this pt as only a pt BUT I foolishly removed them completely overtime. Perhaps I thought I had to do more than what my job entailed bc I was afraid what I provided at nights was not enough. In hindsight, I know that was NOT true. (That part is something I’m continuing to work on in personal level, too.) 

I have reflected a good bit in the past several months and recognize that it is time to move on. Maybe I needed to hear others confirm what I was already thinking? I am planning to remain here for the next month (tops) and then moving with my family to a new area. 

Anyways, thanks guys for your insight and advice on the situation! 

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DesertwindRN is a ADN, RN and specializes in NICU, PICU, Peds, Pediatraic Home Care, Infusion.

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Strongly recommend that you give notice to your agency of your plan to change client care and ask that they not share this with your current client until you are off this case.  I also agree that it would be in your interest to take yourself off this case ASAP.   It’s a good idea to have one or two additional pts to be assigned to so you will have plenty of work and this will help avoid crossing that professional boundary.  

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Kitiger has 40 years experience as a RN and specializes in Private Duty Pediatrics.

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3 hours ago, DesertwindRN said:

It’s a good idea to have one or two additional pts to be assigned to so you will have plenty of work and this will help avoid crossing that professional boundary.  

This also prevents you from going from full-time to nothing just because you're off one case.

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22 minutes ago, Kitiger said:

This also prevents you from going from full-time to nothing just because you're off one case.

Unfortunately, the company I work for only assigns 1 pt on a regular basis unless there is a hospitalization or something. I do not have any doubt that they will and can find something for me, as night nurses are SO hard to come by in my area! 

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Kitiger has 40 years experience as a RN and specializes in Private Duty Pediatrics.

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It also is not good for a family to have only one nurse. What happens when you are ill? The family either gets no nurse or a nurse that they don't know, and one who doesn't know their child.

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3 hours ago, Kitiger said:

It also is not good for a family to have only one nurse. What happens when you are ill? The family either gets no nurse or a nurse that they don't know, and one who doesn't know their child.

They don’t have just one nurse. I was one of the original nurses when pt was assigned to our company. Finding consistent and reliable night nursing care has been the biggest challenge for the family. They just got someone to work opposite of me about two months ago. 

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nursel56 has 25+ years experience and specializes in Peds/outpatient FP,derm,allergy/private duty.

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Hi, dholly

On 10/22/2019 at 1:18 AM, dholly2015 said:

Hey guys, 

I had intended to respond earlier but I want to say “thank you” for everyone’s responses. This experience has been very valuable and I learned a lot about myself including: setting/enforcing boundaries and loving myself enough to take care of me before others. I think I had lost sight of much of this until the last few months. 

Oddly enough I recognized that I did not have adequate boundaries with family members either. I had initially established boundaries and considered this pt as only a pt BUT I foolishly removed them completely overtime. Perhaps I thought I had to do more than what my job entailed bc I was afraid what I provided at nights was not enough. In hindsight, I know that was NOT true. (That part is something I’m continuing to work on in personal level, too.) 

I have reflected a good bit in the past several months and recognize that it is time to move on. Maybe I needed to hear others confirm what I was already thinking? I am planning to remain here for the next month (tops) and then moving with my family to a new area. 

Anyways, thanks guys for your insight and advice on the situation! 

Hi, dholly! I don't have much to add to the great advice already given-- other than what you've experienced is extremely common and that private duty has boundary pitfalls unlike any other areas of nursing. 

On the plus side-- you recognized it early on. We always have to be vigilant, because the family will use a variety of means to manipulate nurses. It may not be a conscious decision on their part. 

I have, and I imagine other nurses in PDN have been told "you are like family" until they encounter that "family" will turn on you suddenly and that is no fun at all. 

Best wishes to you!

 

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