Homecare RN needs relief!!!!!

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Hi,

I have no idea where I would post this,so trying here first....

Right now I am a pediatric homecare RN in CT,have been on this case for almost 7 months. I am happy with my job now,esp. after some of the drama I have been through at other jobs!

My issue is sort of two pronged: the case that i am on requires more nursing. The family already works with two agencies,b/c of complication of case,and neither agency has been able to provide the staffing that they need. I work weekdays 9-5,the other agency supplies a night nurse 5 nts/week. The family has tried to recruit nursing via Craigslist after waiting months without result from the two agencies.eac time they find someone through CL,by the time they get to the agency,they are lured to other cases instead of theirs.

I have tried to help out,I actually did 45-50 hr weeks for two months to help them out,also tried to network with another nurse from my agency and bring her in. Unfortunately,she trained three days and split. Now the issue is that I am sort of back to 40 hr weeks,but I have to decrease my hours slightly b/c I need to attend to some personal issues in my life. Even doing the 40 hrs though,Im still feeling a bit of a guilt trip for not helping out as much as I did before. And maybe its me,but I feel like if I am ever sick or need some personal time,I am leaving them stranded b/c there is no backup.

Does anyone have any other ideas as to how to recruit other nurses?? I know that they can post on monster/careerbuilder/etc but it costs $$$. They are trying CL again,too. I would talk to the people at my agency but they are basically useless(another story). I do love the child and the case,and the family really is good to work for(my personal guilt aside).

Any suggestions would be helpful!!!

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Ask around in the hospitals and other health care facilities if you can post fliers on their bulletin boards. Go to the Employment Development Dept. and make a listing with them. Amazing what you can find there. I once got a home health job that was listed with the Employment Dept. Local churches and grocery stores, anywhere that has a public bulletin board. Get your mind together and take your needed time off. Look at it this way, what would the agency and the family do if you were seriously injured in an auto accident and were in the hospital for a month, then went to rehab for three months? They would figure something out wouldn't they? Remember, the contract the family signed has a distinct clause stating that they will assume care when the agency can not provide a nurse. That removes the responsibility from you and places it on the parents, where it belongs. Best wishes.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

This sounds like private duty, not home health.

I question why people orient to the case and don't come back. Thats a huge red flag. If its a good case, nurses are quick to jump on the case and stay on it.

Its also not your problem if the family doesn't have coverage. If they can't find coverage between 2 agencies, something is wrong.

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Thanks guys for your input. i will suggest the employment board thing to the mom.

Cali,I understand what you mean about the responsibility...the family is capable of taking care of the child,thats not the issue...its just that they get stressed out with the gaps in staffing. AsAs I stated, ive done A LOT of OT and extras for them,but now Im kind of getting a gult trip for taking three mornings off for my program...part of it is my fault b/c Ive probably opened up too much to the mom abot things(we're basically the same age) and vice versa.

SDALPN,youre right,it is private duty....I get the terms mixed up. Part of the agencies staffing problem is that the primary hours open are weekends,which are not easy to fill at any time-although Ive offered to adjust my schedule to open up other hrs for people. The other issue is that the child has some neuro issues that are a bit complex-dont want to break HIPPAA and say too much. But he is manageable and not bad to take care of,and the home is a safe,clean environment. Supposedly the other nurses who she found on CL took "easy" cases that were offered to them once they went to the agency.

The reason that two agencies are involved is also prob my fault....I applied to two agencies around the same time,and was ironically offered the same case with both,but the agency that I chose offered benfits and higher pay. I was surprised that they both had the same case,and it was a little tricky to get set up,but I figured it was a no brainer on my part.

Sorry for the extra vent...just under a LOT of pressure...but thanks for any tips!

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All home care, both intermittent visits and extended care, is home health. Private duty is extended care or shift work that is paid for by the client. Not everyone uses this distinction. I also had the thought that new nurses pick up on something that causes them to move on instead of staying at this case. No 'good' home care case goes without nurses for long. You might want to discuss this with the nursing supervisor, provided the agency staff has any interest in getting to the bottom of their staffing problems on the case.

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It would be very easy for the agency to speak to someone about this case and make it clear that they are being considered for this case, and this case only. I have found agencies that are this selective, persnickety, controlling; however, you want to call it. If the agency would stop allowing new hires to move to other cases, the problem would be solved. Flexibility is nice but it is not required. Just see how you get treated if you start drawing unemployment. Then, there is no turning up of your nose if you want to continue to get the unemployment check.

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Specializes in Hospice / Ambulatory Clinic.

I have to agree sometimes you get a vibe about a case in the first shift that can be off putting.

When I worked PDN-extended care the agencies would always coax you to take the weekend shifts on the provision that you could eventually move into the day shift. So that might be a factor.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

If home care covered it all there would only be one forum. Home care is usually visits. Private duty is usually shifts.

Typically the agencies will have a parent sign saying they understand that nursing coverage is not guaranteed. They explain to the parents that the child is ultimately their responsibility. This is one of the problems in PDN. The parents become too needy and dependent on us. Then when we can't be there they panic. If they had a child without special needs and had a babysitter that had to be out for a day, what would they do? The parents always need a backup plan. We aren't there to be babysitters. We are there to provide nursing and to educate the parents.

Getting offered to work the same case with both agencies? Either they had already split the case or one of them didn't have the case to being with. Something doesn't sound right there.

Nurses are human. They will take the "easy" cases first. What I've found is even the cases that seem complex become easy in no time at all. I try to find cases where the parents are reasonable and easy to work with/for. Its almost never the child. I also try for a reasonable home enviroment. But I'll tolerate more if the family makes it worth it. Try being upfront with the nurses you orient to the case.

Its very hard to have weekends staffed. Most people don't want to work weekends. I hate working weekends, but that is what is available right now for me. Talk with the parents and take a look at their schedule. As them what days they need most. Then it won't be as difficult on the days they don't have a nurse. Remind them that no matter what agency they have they will run in to very similar issues. Also remind them that most agency nurses work for more than one agency. So its mostly the same pool of nurses. The grass isn't greener on the other side!

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I started private duty nursing as a new grad in June. Why not contact the nursing department of local community colleges. They could maybe post the information and new grads might come work for you. At my school employers can post jobs for free with the school on their website, and people can apply online for jobs.

Also, how about local unemployment offices? Just some ideas!

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Lots of colleges also have bulletin boards that anyone can post jobs and such on for free.

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