heartbroken

[blissmissrn]

Hello to all nurses. Your insight will be much appreciated. Please help me sort this out. I worked in the same home for over a year and became very attatched to the client. The mother thought i took very good care of her child. It seemed we got along well except for what I consider unreasonable scheduling requests. Such as I work every Saturday night instead of every other. And wanting me to change my work days and times at the drop of a hat. Wanting me to work on my weekend off ect. I was gracious in meeting most requests. When I had to say no,she became angry and got in my face saying well then she would find someone who would and she wanted what she was entitled to. She called the angency requesting other staff to meet her needs. Of course I feel very hurt and used and now suffer the grief and loss of not ever seeing the child i so much enjoyed and bonded with. The agency said this kind of thing happens alot. It would have been nice to know that to begin with. This was my first position in home care so I did not know what to expect. i think I learned some valuable lessons but the hard way.Perhaps it is best to diversify and not work full time in the same home so you don't get so attatched to the child. Also, the family tries to take advantage because they feel you are their nurse. They seem to not understand that it is primarily a business/professional relationship and you work and are paid through the employer and have to follow their rules and guidelines. It all becomes too personal. And when your nursing care is free/at no cost to the family, the tend to view it as an expectation,an entitlement, and do not see the full value of what they are recieving and that someone is paying the cost such as the taxpayers, including the loyal nurse taking care of their child. In short, as long as they are getting everything they want,all is good and in the end they really don't care about you or see that others have the same needs in life that they do. They just want what they want when they want it and then more,more, more. I am sure this is not true of everyone. This was my experience first time out and it really hurt. it would be helpful if the agencies would brief you on these things in the beginning. i don't want to get that close to any child or family again. Thanks for listening by reading and responding. i am having a really hard time getting over this. BlissMissRN

[nursel56]

First of all, many hugs to you {{{BlissMiss}}}:redpinkhe. For whatever else we may say about attachments and manipulative families , the fact is you are grieving now, and you are hurt by the parent's brush-off now. Accept that these are your feelings and work through the grief without making value judgements about it.

I started working in private duty after many years in other areas of nursing, and it turned out to be something I never could have imagined!! No one told me about the possible pitfalls, either. What you've described are classic and widespread issues all of us have faced at one time or another. This experience need not put you off the field altogether, but you will certainly go forward wiser for what has happened.

When I started I worked in a home with more than one person needing nursing care, so they gave me lots of tips to help me avoid some of the icebergs. The most fundamental thing we need to understand is that they are always, always in survival mode, and most have learned the buttons to push to get the maximum benefit to themselves. It may come out as flattery, or threatening or guilt-tripping.

When I say this it isn't out of anger or hostility, either. If I had a chronically ill child I couldn't possibly take care of myself without outside help, I'd probably develop some of the same adaptive behaviors. In my mind, it doesn't help anyone if we allow families to expect, and believe that they have a right to take over our lives, or play one nurse against the other. After doing this for six years, I've learned I must maintain firm boundaries. I must not let families pull my emotional chain.

Creating distance can be hard at times, but it gets easier, especially when you fully realize there is never "enough" that you can give. They just aren't wired to think of our well-being or our stress level. You need to do that for yourself.

Anyway, I wish you the best in your future, and healing for the hurt you are going through now. If you would like to PM me with any other issues you may have, feel free!(I think you need 15 posts before you can do that, tho). :)

[caliotter3]

Well you said a lot of it in a nutshell. Better get used to it, because this is the norm of how you might be treated and not the exception.

[ArwenEvenstar]

I feel your pain Blissmiss! Sometimes I think of private duty as nursing's best kept secret and other times as nursing's best kept nightmare!!! So many complex psycho-social issues with these families. If you give an inch with these families, they will take a mile. They will take all you will give, and more! A firm professional boundary is so imperative.

You stated that the families "seem to not understand that it is primarily a business/professional relationship and you work and are paid through the employer and have to follow their rules and guidelines." I agree totally!! Unfortunately, however, I also found that nurses were often as much of the problem as the families! In 4 plus yrs of private duty, I encountered so many nurses who totally lacked a professional boundary, essentially socially integrated into the family, became their close friend, lost all objectivity, caved into all whims....and this caused so many very serious problems!

You sound like a great nurse with good professional boundaries! If more nurses could maintain a firm professional boundary, I think many of the problems we encounter with private duty would be eliminated because the family would see a consistent front and would see that they could not push the nurses around!! Unfortunately, my experience was that professional nurses who keep a boundary are far and few between. I came to the conclusion that something about private duty seems to attract unprofessional, co-dependent nurses, with no boundaries! Sigh. Sorry I am so cynical.

You also state that "it would be helpful if the agencies would brief you on these things in the beginning." I totally agree, and have posted on this before. I think all agencies should have some type of mandatory in-service on the psycho-social issues you typically see with these families, and emphasize the critical importance of the nurse maintaining firm professional boundaries. But no...they send you in "blind".