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How important is the nurse's comfort?

Posted

Specializes in Peds. Has 17 years experience.

Is a nurse being unreasonable if she asks the caregiver if she can lower the A/C?

The room gets too cold,and even wearing a scarf and two sweaters does not enough. Caregiver says client needs the a/c up high.

amoLucia

Specializes in LTC.

I'm guessing that the nurse is only a pop-in visit??? If it's a short time-limited visit, I don't see a problem to just grin & bear it.

Questions - who is the caregiver? A permanent live-in spouse, child, parent? Or is the caregiver a paid personal care provider, like a CNA, HHA or nurse that is spending some extended periods of time within the home to provide nec care, but then leaves?

Is the pt overweight and/or with respiratory issues? How about the caregiver? Same? They usually like colder!

Has the pt been able to voice any choice???

I know they teach us that "it IS the pt's home". So that would usually trump any provider preferences. After all, it is the comfort of the pt that is the paramount priority; a provider's is secondary.

Back to the beginning, unless the nurse is there for any length of time, the decision may have to be to decide whether to stay or go at the assignment. And it needs to be said, all bets are off if the nurse is there for any extended length of time. So then, yes, her comfort needs to be considered and negotiated.

Now without going too much into psychology, could there be passive-aggressive games going on? Or someone just trying to maintain some semblance of personal control in a restrictive environment. And then there's the grief & grieving stages of denial, ANGER, bargaining, etc. Just some other things to be considered.

I inform my extended care clients at the first meeting that I am heat intolerant. If I determine that the home will be too hot for me, then I do not continue with the case. Otherwise, I will take my personal fan and use that during my shift. I have found that I am unable to dictate to the family how they will heat or not heat, cool or not cool their home. My heat intolerance is my problem, not theirs. The family usually makes that fact clear to me if they think there is a problem with me understanding who sets the rules around their home.

amoLucia

Specializes in LTC.

Bottom line, I guess it's the 'king of the castle who sets the rules'.

Runsoncoffee99

Specializes in Peds. Has 17 years experience.

It is an 8 hour case.

I know the patient's needs come first,but then the family cannot complain and curse out the schedulers because no nurse wants to work on the case.

Edited by Runsoncoffee99

amoLucia

Specializes in LTC.

Sorry .... but that's THEIR loss! As long as the agency has been honest and up-front re the difficulties for staffing then it's their decision to negotiate & compromise.

There IS a point where consideration for staff has to be addressed!

On AN here, I've read the OUTRAGEOUS demands that families have imposed on staff at times, and there would be NO WAY in Hades would I continue to staff under some of those conditions. If the family is unbending, then the decision would be mine - to continue or not. Do I need the time (and money) that greatly?? Making some accommodations on my part is understandable and reasonably expected. But there will be a limit.

So back to OP's question - staff comfort is very important, but ultimately, the final decision making 'camel's straw' will be a the level of the pt/family. So for staff, it's 'time to like it or leave it!'

quiltynurse56, LPN, LVN

Specializes in LTC and Pediatrics. Has 3 years experience.

On one of my assignments, the patient's room was always cold to me and I wore long sleeves as well as a sweatshirt. Mom told me the patient needed it cool. They did have a space heater which I would position away from the patient and put it on a very low setting directed towards my feet. I would also turn it on intermittently so as not to heat the whole room up. Maybe this is something you can try doing.

amoLucia

Specializes in LTC.

quiltynurse56 - family would likely complain that the little heater was using up too much electricity. Or could blow a fuse. Or pose a threat if O2 in use.

Can't please all the people all the time ...

amoLucia

Specializes in LTC.

Am re-reading this. Maybe one of those individual throw-size (50" by 60" or so) electric blankets? Had to dig mine out of storage since the weather is starting to change. And I don't do well when cold!

But then like my above comment, family could find something negative about it!

Runsoncoffee99

Specializes in Peds. Has 17 years experience.

There is a case now where there is a pitbull. My agency knows from the list I do not work with certain dog breeds,Well really only one-pitbulls. But they sent me here anyway. I did not know. I thought it was a golden retriever(which are sweet and docile). I worked here for two months now.

Tonight someone forgot to lock the gate and he comes charging at me. I was so scared and I ran through the house.The parent was like he just jumps on everyone to say hi. Yeah,NO!

And this case was only 20 minutes form my house darn it!

There are a couple of pit bulls that live in my apt. complex.  I've encountered them when their owners are walking them around outside.  Believe me, they can scare the bejeezus out of anyone no matter how friendly their owners report them to be.  I try to steer clear.

amoLucia

Specializes in LTC.

cali - I'd be carrying some of that pepper-spray on my handy-dandy key ring!