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How to make a PDN job appealing?

Private Duty   (2,270 Views 84 Comments)
by nursenmom3 nursenmom3 (Member) Nurse

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158 Visitors; 85 Posts

1 minute ago, caliotter3 said:

In your first paragraph any of those scenarios could be the case. Unfortunately, sometimes the agency rep will fib to the client, nurse, or both, about circumstances. They think they are avoiding friction but they undermine the relationship when the client or nurses catch the untruth. Making up excuses is not necessary. Just state a fact. “We can’t cover Thur night at this time. We will continue to look.” Works for the clients or the nurses. One thing you can do on your own behalf: run your own employment ad (say on Craigslist or another empl website) and make your last statement say: “Nurse will work through patient’s agency”, or words to that effect. You can probably give nuanced info in your ad that might be a little different (acceptable) than what agencies put in their generic help wanted ads.

If I do that, advertise for someone and then refer them to my agency, does the agency have to give priority to my case?  Could I end up in a situation where the agency decides that someone else is a higher priority, and sends the nurse I found there?

To be clear, I'm not talking about a situation where the nurse I find decides they don't want our case.  I'm not interested in forcing someone.  

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I have never heard of the agency "stealing" your found nurse for another case.  That would be detrimental to their interests.  But that is not to say that the nurse themselves would not start working for you and say, ten months later, decide they wanted to move on.  It also isn't to say that the agency could start the nurse out on your case, and down the road, "convince" the nurse to leave your case for another agency need.  All kinds of the usual human interactions when wheeling and dealing can occur.  Unless you pick up on things you would probably never know if something like this were to occur.  When untruths are being bandied about, I think though, that it almost always makes itself known to the nurses and clients, and vice versa with the agency reps too.  People pick up on shenanigans, so to speak.

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Not sure where you are located, but here in California, recruitment is the most difficult part of the job. LVNs are required to have a year of experience before working for an agency and reimbursement rates were just increased for the first time in 19 years so wages were dismal in comparison to other job opportunities. 

Great advice from caliotter to advertise on an employment website such as Craigslist or some families choose Care.com (though this is much harder to find LVNs on). Agree from what you describe here that you have a lot of the “preferable” work assignment qualities. The challenge may simply be finding a nurse who is willing to travel to your location and/or work the hours you are working for

Certainly not every agency is reputable and some do “business” by robbing from Paul to pay Peter (moving a nurse to a higher priority case), ours does not, but I’ve heard otherwise from patients and nurses 

I am curious- are you employed by your agency and working any unstaffed hours? 

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Thank you.  Unfortunately for us, although it probably makes sense ethically, our state doesn’t allow nurses to serve as PDN’s for their own children or anyone living in their house.  I do have a few close nurse friends who have signed up with the agency so they can provide occasional care, but they have full time jobs, so they are not regulars.  

I agree that the issue is that there simply aren’t enough nurses willing to work for Medicaid wages.    I also think that while we parents experience it as a hardship not to have nursing, my kid is in no danger because we are in a position to do right by him.  I wonder if the agency takes that into account when they allocate limited staffing.  I know that I would probably do the same.

On the other hand, when I read about families who are abusive or don’t let people have TP or light or whatever, I wonder why those nurses aren’t flocking to our house.

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7 minutes ago, nursenmom3 said:

Thank you.  Unfortunately for us, although it probably makes sense ethically, our state doesn’t allow nurses to serve as PDN’s for their own children or anyone living in their house.  I do have a few close nurse friends who have signed up with the agency so they can provide occasional care, but they have full time jobs, so they are not regulars.  

I agree that the issue is that there simply aren’t enough nurses willing to work for Medicaid wages.    I also think that while we parents experience it as a hardship not to have nursing, my kid is in no danger because we are in a position to do right by him.  I wonder if the agency takes that into account when they allocate limited staffing.  I know that I would probably do the same.

On the other hand, when I read about families who are abusive or don’t let people have TP or light or whatever, I wonder why those nurses aren’t flocking to our house.

Well I hate to read that, having a trained nurse employed to provide skilled nursing services for a child who qualifies for them is the exact reason these programs are in place, a parent is certainly the best equipped individual to do this especially once they’ve obtained licensure. It is so wonderful to create a home environment where a parent who makes the choice to stay home and meet their child’s medical needs can support themselves financially doing so. I hope this will change in your State (and if I knew your State well enough would share how to advocate as such) 

On to your more immediate statements, I can say if you were without nursing in my agency, it would be because I just couldn’t get someone in the door whose hours matched your desired shifts (or anyone in the door at all). I know my “challenging” families (but abusive or unsafe work environments would not continue if they were reported to me either) - when I have a “desirable” home, family, and patient ... I just have to get someone in the door - so if you are successful in meeting a nurse from an advertisement - I would keep contact and if you felt they were removed to meet agency’s needs you might know where you stand. 

Nurses and families do communicate and many of the stories of agencies doing unethical things (moving nurses to another case against their wishes to a higher priority case for example) were reported by the nurse to the parent directly in confidence. 

I hope you find your “match” soon 

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Thank you!

You mention not being able to find someone who wants the hours.  Do you think that some hours would be easier to fill than others?  I have a lot of flexibility at work, so if different days, or different hours would make a difference, we could probably figure it out.  

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27 minutes ago, nursenmom3 said:

Thank you!

You mention not being able to find someone who wants the hours.  Do you think that some hours would be easier to fill than others?  I have a lot of flexibility at work, so if different days, or different hours would make a difference, we could probably figure it out.  

I would ask your agency the question on hours, for us, there are certainly ebbs and flows to nurse availability, with the most difficult to staff almost always being weekend and NOC hours (which it sounds like you’ve already struggled with).

If you are flexible, I would give your agency the opportunity to find any available shifts based on nurses hiring on. Just let the agency know you are trying to find reliable care but have some flexibility in how you use the shifts, so the next time a nurse comes in looking for full time work regardless of the hours they’re available - you’d like to meet them? Can you work opposite your husband for a time until you feel comfortable with a nurse being reliable and available? 

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1 minute ago, kaliRN said:

I would ask your agency the question on hours, for us, there are certainly ebbs and flows to nurse availability, with the most difficult to staff almost always being weekend and NOC hours (which it sounds like you’ve already struggled with).

If you are flexible, I would give your agency the opportunity to find any available shifts based on nurses hiring on. Just let the agency know you are trying to find reliable care but have some flexibility in how you use the shifts, so the next time a nurse comes in looking for full time work regardless of the hours they’re available - you’d like to meet them? Can you work opposite your husband for a time until you feel comfortable with a nurse being reliable and available? 

We do work opposite hours.  Right now, my husband works 5 nights, and I work 12 hour shifts on the two days after the nights he doesn't work, and sometimes a third day if a friend or family member who is trained on the vent etc . . .  can cover the night before.  I can't cover my son overnight, and safely work the next day, so I only work days when I can sleep the night before.   

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Orion81RN has 7 years experience.

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On 6/28/2019 at 12:15 PM, caliotter3 said:

Find that sweet spot in the middle between standing directly behind the nurse to micromanage their every move and never ever being seen after the first meeting.  Nurses are required to provide input to the parent about their child and to document that they have provided teaching regarding care. Please don’t provide impediments if a nurse is serious about this. Likewise inform the nurse. If you took the child to an appointment, let the nurse know what transpired so the nurse can update the care plan. That care plan (the paperwork) is part of the nurse’s job.

This! I can't tell you how many times I had a parent take their kid to a Dr appointment, get new orders, and not tell us. I'm not your babysitter. I'm your child's nurse. Don't you think it's important the agency and I know this info? That drove me nuts. 

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Orion81RN has 7 years experience.

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8 hours ago, nursenmom3 said:

 

On the other hand, when I read about families who are abusive or don’t let people have TP or light or whatever, I wonder why those nurses aren’t flocking to our house.

I've found that those types of families are very demanding with the agency. Unfortunately, if you have one very demanding family, and another family that doesn't push hard for nursing, the agency will staff the demanding family first. I myself have absolutely wanted other cases, yet they've lied saying they didn't have anything just to try to keep me where I am. 

 

How I found this out was both my mom (a nurse) and I were signed on to the same company, and they would notify her about some jobs and not notify me and vice versa. I can't tell you how many conversations that went along the lines of, "Oh, realllly. They told me they didn't have anything. Hmmm very interesting." 

 

Basically, they cater to the jerks. 

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1 hour ago, Orion81RN said:

This! I can't tell you how many times I had a parent take their kid to a Dr appointment, get new orders, and not tell us. I'm not your babysitter. I'm your child's nurse. Don't you think it's important the agency and I know this info? That drove me nuts. 

That would drive me nuts too.

i like to think I walk a perfect middle line, but the truth is that I veer to the helicopter side.  Anyone working with my kid might get annoyed with too much detail and communication, but they won’t suffer from the opposite!  

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Do nurses choose jobs based on who is in the house?  

I read the archives, and two things that stood out were someone who didn’t want to alone in the house with an adult male, and concerns about other kids.

My husband works nights so if we ever got daytime nursing there would be times when he was there, and we also use a Grandfather as a caregiver for my other kids.  One of my kid’s home teachers through the school system is also male.  

Our other kids are 9 and 12, and would also be in and out.  When my kid with the medical needs isn’t in the house, then we let the 12 year old stay alone sometimes, or the two of them together.  Is that even an option?  

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