Home-health

Nurses LPN/LVN

Published

  • by NurseSC
    Specializes in Homehealth.

Hello fellow nurses! I have been in private home-health for many years. Most situations have been fine. However, recently I am with a family that has expectations of the nurses to clean and organize their house!
 

The other nurses have done it and one is currently doing cleaning non stop. And of course I am not the favorite because I will not be their maid. I am not sure how to handle this situation at all. I haven't had an opportunity to address it. The Dad has implied things a few times but it wasn't enough for me to say "I am here for the child only". How awkward right? . Also, they go on vacations and I am out of work and now this too. It is very frustrating. Anyone else had any similar situations? If so how did you handle it?  Also, my clinical manager definitely backs me up. She said if it's not on the care plan you aren't responsible. Advice please! 

Peachpit

206 Posts

I would request an in person meeting with the family, yourself and you clinical manager or whoever you report to so there can be a discussion/rediscussion of expectations from both sides. Your manager should've already stepped in and spoken to the family about these expextations as well as the other staff who are doing the clean. Unfortunately these others nurses have set the stage so to speak. that is one thing about home health of any type - boundaries need to be set at the start of care and remain consistent or these situations crop up. 

 If the family or your manager refuse I would start looking elsewhere or let them all know you would like to be removed from the case. That you are a nurse for the child period. Don't waiver, don't give in. If they can go on vacations they can hire a maid, a one time cleaning service or do it themselves.

 

You will have to speak to the home health agency RN and explain to the RN what is going on. If the RN can't fix the problem please follow the chain on command. Remember to use your voice; your voice is your tool. Please read your job description as well. If the agency doesn't help you as a nurse contact me. 

toomuchbaloney

12,515 Posts

Specializes in NICU, PICU, Transport, L&D, Hospice.

I agree that you must stick to the plan of care.  If you injure yourself in some way doing things outside of the plan of care, you would have trouble collecting worker's comp. If you broke or damaged client property while engaging in work that was not covered in the POC, you open yourself to liability.  Your employer's liability may be increased when employees are working outside their outlined professional duties.  

If the family wants general house work chores added to the POC, the family needs to make that a formal request in a team meeting.  That way, they are part of the discussion which will exclude most of that work, the direct care staff then are not taking the heat from the family.  Families sometimes bounce through agencies trying to get their wants and needs met.  

Good luck.  

 

zeebee14

5 Posts

Specializes in Pediatric Home health.

I worked in pediatric home health for six years and never cleaned a family's home. I would clean up any areas where my patient may have made a mess with toys or whatever, but I wan't sweeping the floors or anything, unless maybe there were crumbs from my patient eating or something. I was allowed to do any cleaning associated with my patient, so dishes from meals they ate or their clothes or wiping down toys, things like that. I was also expected to organize their supplies, like diapers and trach supplies, when they were delivered. But I would never have cleaned the whole house, and certainly never anything that didn't belong to my patient.

NurseSC

6 Posts

Specializes in Homehealth.
zeebee14 said:

I worked in pediatric home health for six years and never cleaned a family's home. I would clean up any areas where my patient may have made a mess with toys or whatever, but I wan't sweeping the floors or anything, unless maybe there were crumbs from my patient eating or something. I was allowed to do any cleaning associated with my patient, so dishes from meals they ate or their clothes or wiping down toys, things like that. I was also expected to organize their supplies, like diapers and trach supplies, when they were delivered. But I would never have cleaned the whole house, and certainly never anything that didn't belong to my patient.

This is my first time experiencing this expectation to this degree. I also take care of my clients area and clothes. Not a problem. The other nurses have set the house cleaning expectation I am afraid. I think they see I am not going to clean their house for them and seem to be OK with that. They also have the expectation of watching their other kids. Home healthcare needs boundaries but it is difficult sometimes. Keeping it "business" is easier said than done.

NurseSC said:

This is my first time experiencing this expectation to this degree. I also take care of my clients area and clothes. Not a problem. The other nurses have set the house cleaning expectation I am afraid. I think they see I am not going to clean their house for them and seem to be OK with that. They also have the expectation of watching their other kids. Home healthcare needs boundaries but it is difficult sometimes. Keeping it "business" is easier said than done.

 

If someone is going above their scope of practice, that isn't your concern. Continue to work for YOUR client. It would be best to ask the RN in charge of your case to talk with the other caregivers because it makes you look like you aren't doing your job when you know you are doing YOUR job for YOUR client. Remember, YOUR client is the keyword. Remember Your Voice Matters and You Are Needed. If you aren't comfortable asking the RN to speak with the other caregiver, respectfully ask them to change your client. Remember, you're a rockstar, you matter, and your voice is needed because nothing will ever change if you don't speak up. Someone will always be taken advantage of. If you don't speak up, the next generation will have to fight for things they shouldn't be fighting for because the generation before them didn't do their part. So Speak Up 

NurseSC

6 Posts

Specializes in Homehealth.
Vandella Jackson said:

If someone is going above their scope of practice, that isn't your concern. Continue to work for YOUR client. It would be best to ask the RN in charge of your case to talk with the other caregivers because it makes you look like you aren't doing your job when you know you are doing YOUR job for YOUR client. Remember, YOUR client is the keyword. Remember Your Voice Matters and You Are Needed. If you aren't comfortable asking the RN to speak with the other caregiver, respectfully ask them to change your client. Remember, you're a rockstar, you matter, and your voice is needed because nothing will ever change if you don't speak up. Someone will always be taken advantage of. If you don't speak up, the next generation will have to fight for things they shouldn't be fighting for because the generation before them didn't do their part. So Speak Up 

 

NurseSC

6 Posts

Specializes in Homehealth.

Thank you for that wonderful advice and kind words of encouragement. You are absolutely correct. My client is well taken care of and that is all that matters. It is definitely getting better there. Hopefully it continues. 

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