Home health nurse working as a maid?

Specialties Home Health

Published

Hello! I hope everyone is safe during this his time.

My dilemma is I work for a small home health agency. I love the company and the hours, as it allow for me to study for my RN ( currently an Lpn).

Well one of my pt while she’s sweet and her family is OK. The things I experience there is starting to bother me. They have this motto as if your job is in my hands sort of thing. Like you have to do whatever, plus they down talk the other nurses which also upsets me. I tell them to let the manager know their concerns.

But these are some of the scenarios. My pt is 30, has a Trach but does everything else, smoke, drive, walk, can cook.. everything.

Somehow she doesn’t want to do anything. I make her bed and take out the trash for the whole house and will wash dishes occasionally.

She babysits her nephew who’s one. The baby will be up ( while my pt is sleeping) asking for food and drink. ( mind you I can’t eat while there because the baby and my pt begs for my lunch)

She will have her nieces and nephews over and they’ll make a mess, her and her family expects for me to clean up, vacuum and wash dishes.

The baby has a poopy diaper ( they expect for me to take it to the trash) they live in a apartment complex so it’s a walk.

If someone in the family is sick they bring them to me? For me to assess them. I ask them to f/u with their PCP.

Then my pt and her mom will talk about all of their financial issues in front of me.

My pt asked me to buy her $240 pair of shoes

$150 birthday cake.

shes always asking for things and to come to my home.

My pt is a lesbian I have nothing against LBGT.

but she makes comments like “ set me up with a girl like you” or sits to close to me and tries to touch my hand.

when family is over she’ll say things like it’s clothes in the dryer or things like she’s giving commands. Asks me to organize her closet and drawers.

Like I said it’s only two cases right now and both are full. What should I do? Am I being too harsh and over the top ?

Specializes in retired LTC.
On ‎4‎/‎13‎/‎2020 at 12:41 AM, mzsuccess said:

Excuse me? Just because I’m an Lpn you think those lines can easily get blurred. I am a nurse and was hired as a nurse. ?

mzsuccess - please know that in no way, shape or form did I ever mean to insult you. Sorry if my response was misunderstood. Rather my post was meant to support your position as a NURSE. It was YOUR concern that you were expected to perform multiple non-nsg tasks, including for persons NOT your pt. I, too, had fault with those aspects of your post. Indeed, your post title identifies "MAID" tasks, not one of a licensed nurse (RN or LPN). You didn't exactly elaborate what nsg tasks/skills that you did in THAT post.

Just a curious point - what does that pt's Care Plan outline as your duties? Domestic duties are usually assigned to NON-professional staff.

Also I'd be REEEEAL curious how your employer bills for your hours.

Subsequent postings by PPs, caliotter and KatieMI, also seem to reflect my thinking. Just to repeat, some unscrupulous agencies will differentiate their staff skill-set as skilled (RN) and other (LPN and CNA/HHA). In my neck of the woods, SKILLED nsg services are usually reserved for RNs. Just the way things are. Even though LPNs are perfectly capable of expanded roles. And my concern was also to determine what your signed job description defined. Job descriptions can be very vague, but they could have snookered you into some tasks not typically requiring a license (ilke anybody can toss in a tub of laundry).

And as others have so clearly commented, Medicaid fraud is a BIG concern here in which you may be an unwitting, manipulated pawn.

Think about it - would this pt be able to have a paid job (assuming if some needed accomendations were made)? What kind of income is she receiving? Besides her homecare being paid for. SSD/SSI? How did she get a driver's license - that's to say that she really DOES have a driver's license? (I realize you can't outright ask her!) With all that babysitting, sounds like running a day-care job under-the-table.

As to her medical status by her physician - this could be a big put-on, deliberate or not. If MD were investigated, could he be caught up in a well-planned attempt by this family to milk services out the system?

Also, YOU are a victim of sexual harassment - not the perpetrator. Again, it can be very easy for a pt to make claims and then it's a 'she said, you said' situation Guess who'll have to fight to protect herself?

I'm sorry you misunderstood my stance on your post. I WAS supporting you. There's way tooooo many red flags here in a bad situation. Like others have said, document well, notify your management (in writing for your record copies), and polish up your resume to get moving out of a suspect work situation.

* Sorry, I couldn't get back sooner. My computer got temperamental.

3 Votes
Specializes in Peds/outpatient FP,derm,allergy/private duty.
10 hours ago, KatieMI said:

Heh, you never heard what a human being can tell you to prove himself having "emotional disability" and thus get a sheet of paper allowing him to take his pet everywhere free of charge. Especially when he suddenly remembers about that sheet of paper at 4 AM before flying across the country at 8 AM (2 hours drive to the airport) and so rushed to the nearest ER, together with the Fluffy and a bunch of hamsters.

The most exiting thing in the World is searching for a runaway hamster in 50-beds busy ER at 6 AM, I'm gonna tell you ?

Oh, my. I want to laugh, I want to cry, I want to say nobody really gets the soul of private duty nursing unless they've seen it for themselves.

Stories? I've got a million of 'em-- but most are so bizarre and unique I fear the HIPAA monster might come looking for me. That time my patient lost a contact lens and ordered me to find it and drop it in the water used to clear the suction tubing because oops forgot my contact lens paraphernalia. . .?

I feel exactly like you do with the other things you mentioned. The fraud, the dishonest caregiver/family member racket, etc. Even when I deliberately try to focus on those people who truly need us I can't banish it completely.

2 Votes

Hey!

Her Care Plan is centered around her having a Trach that she cleans and change all the time. The reason I know is because while I was doing it, she told me I was the only nurse that cleaned her Trach, the others would let her do it herself.

So I’m confused, does a Trach require a skilled nurse if a PRN is able to perform tasks by her self?

And she DOES have a driver license.

2 hours ago, amoLucia said:

Specializes in retired LTC.

mzsuccess - TY for the comeback response.

I'm NO authority on homecare reimbursement & all that stuff, but I do believe that once a pt is independent in a skill, they're supposed to be dc'd from skilled service. Has she ACTUALLY demonstrated satisfactory skill??? Not just you hearsaying "others let her do it". If you can document that she can do the task that should be the determining factor. I think so. How/what have the other nurses been documenting? And just curious, how much time does she get daily/weekly?

I'm assuming she's covered under Medicaid. She prob qualifies for some kind of services for homecare but then that all depends on how 'needy' her domestic care is.

Bottom line is that you're a NURSE, not a babysitter, literally and figuratively.

Sounds like too much something 'hincky' is going on. Best you seriously consider moving on. You are part of big picture if the doo-doo hits the fan.

1 Votes
17 hours ago, amoLucia said:

mzsuccess - TY for the comeback response.

I'm NO authority on homecare reimbursement & all that stuff, but I do believe that once a pt is independent in a skill, they're supposed to be dc'd from skilled service. Has she ACTUALLY demonstrated satisfactory skill??? Not just you hearsaying "others let her do it". If you can document that she can do the task that should be the determining factor. I think so. How/what have the other nurses been documenting? And just curious, how much time does she get daily/weekly?

I'm assuming she's covered under Medicaid. She prob qualifies for some kind of services for homecare but then that all depends on how 'needy' her domestic care is.

Bottom line is that you're a NURSE, not a babysitter, literally and figuratively.

Sounds like too much something 'hincky' is going on. Best you seriously consider moving on. You are part of big picture if the doo-doo hits the fan.

She has demonstrated the skill, the first week she would actually do it herself. I would chart refused. Not sure what other nurses charted. But I finally got her to let me do it because I needed to assess for irritation or infection.

But I definitely will do something soon because I don’t feel like a NURSE here.

She asked to come to my home the other day because she and Mom got into it. She said other nurses would let her anytime it happened. I told her to call her brother. ✌?

But the reason the lines are so blurry here is because the manager constantly crosses them by buying gifts and going out for drinks.. that’s a whole other story.

I was on the phone with pt doing a virtual appt and the MD was talking to her in this weird baby voice and she was exaggerating saying she had a fever. I was like no your temp is such and such... the headache.

1 Votes
Specializes in retired LTC.

Nope nope nope! Too many RED FLAGS!!

My documentation would have included the refusal but I MOST DEFINETLY would have covered her ability to do the task herself. But did she do it well enough that she was not deficient?? That's still skill-able

You're right about too much prof boundary lines being criss-crossed. And if your management is a part of it ... NO WAY!

I'm no psych nurse, but there's a problem that the pt is a LIAR, LIAR - PANTS ON FIRE! That will get you in trouble esp with her inappprop advances.

Nope! Time to get out safely.

2 Votes

When the MD talks to her in a baby voice and the agency manager goes out for drinks with her, you know it is a lost cause. There are more rotten fish around this agency and its clients than a rotten fish factory could produce in a year. One of these days a nurse who did not have the sense to get out of there when they could, will pay the price, and it won't be a pleasant experience. You should let that nurse be someone else.

4 Votes
Specializes in retired LTC.

You know what's ingratiating here is that there most likely is Medicaid Fraud going on.

But unless OP were safely OUT of the pix, her career future and poss safety could be at risk.

As nurses, there is that obligation of mandatory reporting. Not only for cases of pt abuse & neglect, but also for suspected fraudulent practices. Medicaid fraud cost all taxpayers $$ but it also prevents the system from spending its limited funds to helping those who REALLY need assist. NOT the scammers.

Most states have an Ombudsman Office for the Institutionalized Elderly. There are also Depts of Health and Depts of Social Services. Dept of Labor for labor issues. But I do believe there's a Dept of Insurance that does forensic insurance investigations. But DOH can start preliminary complaints investigations. It's a phone call.

2 Votes

Isn’t this private duty, rather than home health?
I don’t mean that you should have to do housekeeping, etc. But it sounds like you are there for a whole shift everyday, rather than intermittent visits to multiple patients?

2 Votes
Specializes in Neuro.

Nope, I'd be out of that nonsense asap.

2 Votes
Specializes in Travel, Home Health, Med-Surg.
15 hours ago, Zippy83 said:

Isn’t this private duty, rather than home health?
I don’t mean that you should have to do housekeeping, etc. But it sounds like you are there for a whole shift everyday, rather than intermittent visits to multiple patients?

Sounds like private duty which IMO is even more reason for OP to get out of there and fast, it certainly doesn't take all day to perform trach care!

2 Votes
Specializes in oncology, MS/tele/stepdown.
On 4/12/2020 at 5:45 PM, BSNbeDONE said:

Quit.

^This was the answer before you added more details and it is still very much the answer. Good luck.

2 Votes
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