How many days off are appropriate?

Specialties Private Duty

Published

Hi,

I'm wondering how other PDNs with regular full-time assignments schedule time off? I've pretty much followed the standards of regular office work -- 3-5 sick days/year, and 2-3 weeks worth of vacation or personal days, scheduled in advance and in after discussing w/the family.

I haven't had any problems with this, and only rarely need to negotiate a day off. But other nurses I've worked with think nothing of taking 2-3 shfits off each month, and often that's not even scheduled. This is very stressful for the family, and it puts more pressure on the other nurses in the home. The agency just says, well their per diem so we can't do anything.

I guess I don't think of this as per diem work. I commited to a schedule, and it's my job to do the work. No, I don't benefits, yes I wish I did. But I don't think it's fair to take that out on the family. I get other perks from this job, and I chose it.

Am I being too conservative? How do you all deal with time off?

I get zero benefits working PDN.

Having the flexibility to take any time off I need/want (with plenty of advance notice) is the reason that I do PDN.

Without that "benefit", PDN would not be worth it to me.

I am taking 2 1/2 weeks (unpaid, of course) off this summer, and I feel zero guilt for it. I am a good worker and show up for all of my scheduled shifts otherwise.

I would never argue that a nurse should not take a planned vacation, 2 weeks, 6 weeks (so long as they know we may have to replace them) - I get that that's part of the job.

What is much harder are the random days every month that can't reasonably be filled. Like I've said, it's rare, has only happened with 2 nurses.

I have a nurse right who has commited to 5 shifts/week with us, and 1 shift with another family. She takes almost a shift off each week between the two cases. She clearly does not need to work all these shifts or almost a year later she would not do this. So I feel like she is indeed overscheduling as RNathome alluded to. I'm told that some of the nurses where my husband used to work did the same thing -- signed up for OT, then called out of their regular shifts. Same pay, more flexibility, but gray to say the least when it comes to commitment and professionalism. THIS is what I feel screws us.

Or our nurse who told me last Friday that this Friday she won't be coming. A week's notice is better than no notice, but wow, when this means i have to reschedule an out-of-state full day of appts that took months to book b/c the other nurse ALSO took a day off... and reschedule not only the appts but the childcare for my other kids and my work... It's inconsiderate. Agency ruling: Per diem means SOL. Yet you better believe she's expecting to remain our Friday nurse, so I have no leverage at. all.

Also, I'd question whether you don't get any benefits... "glorified babysitter" is what I've seen you all refer to yourselves at times (and I get it for some cases, don't get me wrong.) For many nurses I've spoken with, this job is much easier job than hospital nurses, and I'm all for it. Not many jobs can you binge watch Orange Is the New Black, or work on your BSN. And I encourage all of that as well. But it's not like you're not getting anything out of this set up.

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

You don't know why the nurse takes off "random" shifts. Maybe the nurse or their family has cancer or some other illness and goes in for Dr appts. Nobody wants to tell their employer that info, and certainly not the families because they overreact. Maybe the nurse lost a child or is going through divorce and is talking to a therapist to get through it. Maybe the nurse has a special needs child that you don't know about. We don't always discuss every piece of our lives with the family, even the open nurses keep some things private. And the things I mentioned above are all things other nurses I work with have trusted me enough to discuss with me. Those reasons may be why they chose this job in the first place.

Some of your post almost sounds angry/jealous towards nurses for having flexibility that you may not have in your own life. We all choose our path in life in one way or another. You are given the same options as any other person in life. We (nurses) made choices that put us in the career we are in. Don't forget that just as there are benefits to flexible scheduling, there are consequences as well. You can be angry with how the agencies work. But your choices led to your situation. Your can remain upset and drain your energy or you can find a way to work with what you have and look at the positive. But getting upset with your nurses who are doing flexible scheduling isn't helping. I bet those nurses have no clue you are bothered. And its not their fault due to the nature of the job. They are just trying to make a living and hopefully a difference in a childs life.

I'll add that I'm working on my schedule for my next 6 weeks. I see open shifts, but unfortunately they don't work with my set hours. Some open shifts are til 11-12 @ night when I have to be in at 6-7a the next morning. Or I am working a late shift and the open shift is first thing in the morning. I'd love to pick up more shifts to cover call outs, but I'm not going in with just a few hours sleep. And I know the parent insisting on coverage would be upset if I went in yawning and sluggish all day. Its possible that's why a nurse isn't available to fill in for you. I'm not the only nurse facing those choices. Sometimes its just bad timing to cover another nurses day off.

I don't consider being called a "glorified babysitter" a perk for any professional.

I think trachmom and the op are talking of nurses who are scheduled 5 days a week and call out one day every week.

I understand both sides.

Then again,i am not per diem,and i am full time.

My agency also works hard to place me somewhere else when clients are in the hospital. I also extremely flexible with time thanks to Dunkin donuts coffee.

I see this as maybe an agency issue.

The agencies that suck at scheduling shall remain nameless.

I am angered and frustrated by any insinuation that any parent who has special needs/medically complex children have some how chosen their situation. Anyone saying such a thing most likely didn't mean it the way it came out at least I hope not. I am a PDN as well as the parent of a now adult special needs/medically complex child. I totally get what trachmom and rnathome are saying. It sounds to me like they are all for flexible scheduling they just think nurses should be professional enough to honor their commitments, barring emergencies of course. It seems pretty simple to me, if you can't keep a 5 day a week commitment don't schedule 5 days a week. If you're not happy with your current f.t. nurse request another one. Most areas now are overwhelmed with nurses looking for any f.t. work.

I think trachmom and the op are talking of nurses who are scheduled 5 days a week and call out one day every week.

I understand both sides.

Then again,i am not per diem,and i am full time.

My agency also works hard to place me somewhere else when clients are in the hospital. I also extremely flexible with time thanks to Dunkin donuts coffee.

I see this as maybe an agency issue.

The agencies that suck at scheduling shall remain nameless.

Yes. Exactly this.

When they call out the day of, the family has to speak up if something is to be done about it.

When they *schedule* a day off almost every week it is not much better. I would rather they just commit at the outset to one less day, so that I can have a chance to fill that day with a stable situation.

I am angered and frustrated by any insinuation that any parent who has special needs/medically complex children have some how chosen their situation. Anyone saying such a thing most likely didn't mean it the way it came out at least I hope not. I am a PDN as well as the parent of a now adult special needs/medically complex child. I totally get what trachmom and rnathome are saying. It sounds to me like they are all for flexible scheduling they just think nurses should be professional enough to honor their commitments, barring emergencies of course. It seems pretty simple to me, if you can't keep a 5 day a week commitment don't schedule 5 days a week. If you're not happy with your current f.t. nurse request another one. Most areas now are overwhelmed with nurses looking for any f.t. work.

Posts should not bring tears to my eyes, this one did. Yes, this is exactly what we're saying.

I've refrained from even acknowledging the repeated insinuation that families with medically complex kids have chosen this difficult path. Any more than an adult who drove a car one day and got hit and is now a quad chose that path. Of course there are consequences to any decision, no one is saying otherwise.

And jsut to be crystal clear: Nurses in the home do not somehow remove the difficulties of our lives. Nurse in the home are deemed MEDICALLY NECESSARY by doctors and insurance companies alike, so that these children can receive the care they need -- and no, it's not because nurses come in and do this care. It's so that parents can oversee this care, but have the respite we need to do it adequately.

When I say I want a nurse to honor his or her commitments, I do not feel entitled. I do not even feel happy. I HATE IT. I hate every single second that I *need* another adult to help me care for my child.

You don't know why the nurse takes off "random" shifts. Maybe the nurse or their family has cancer or some other illness and goes in for Dr appts. Nobody wants to tell their employer that info, and certainly not the families because they overreact. Maybe the nurse lost a child or is going through divorce and is talking to a therapist to get through it. Maybe the nurse has a special needs child that you don't know about. We don't always discuss every piece of our lives with the family, even the open nurses keep some things private. And the things I mentioned above are all things other nurses I work with have trusted me enough to discuss with me. Those reasons may be why they chose this job in the first place.

Some of your post almost sounds angry/jealous towards nurses for having flexibility that you may not have in your own life. We all choose our path in life in one way or another. You are given the same options as any other person in life. We (nurses) made choices that put us in the career we are in. Don't forget that just as there are benefits to flexible scheduling, there are consequences as well. You can be angry with how the agencies work. But your choices led to your situation. Your can remain upset and drain your energy or you can find a way to work with what you have and look at the positive. But getting upset with your nurses who are doing flexible scheduling isn't helping. I bet those nurses have no clue you are bothered. And its not their fault due to the nature of the job. They are just trying to make a living and hopefully a difference in a childs life.

I'll add that I'm working on my schedule for my next 6 weeks. I see open shifts, but unfortunately they don't work with my set hours. Some open shifts are til 11-12 @ night when I have to be in at 6-7a the next morning. Or I am working a late shift and the open shift is first thing in the morning. I'd love to pick up more shifts to cover call outs, but I'm not going in with just a few hours sleep. And I know the parent insisting on coverage would be upset if I went in yawning and sluggish all day. Its possible that's why a nurse isn't available to fill in for you. I'm not the only nurse facing those choices. Sometimes its just bad timing to cover another nurses day off.

I know exactly why she is taking the days off and they are overwhelmingly for completely optional activities. She commited to 5 days a week, she very often works 4. Why this is so hard for you to compute I do not know, except that you all clearly have axes to grind about being called in to cover for others -- I do not, have never, and never will expect a nurse to cover for another nurse. Clear?

Wow, just so much empathy oozing from you. I think I have more empathy for my boss's work situation than you do for us families.

Also, please save the condescending advice as to how to make this work. My husband and routinely -- and i mean at least once a week for the last 4 years -- regroup to figure out how we are going to make this work. We are hopeful, faith-filled people who do not wish to have another's life or lifestyle, we wish to make this puzzle work.

And this: "I bet those nurses have no clue you are bothered. And its not their fault due to the nature of the job. They are just trying to make a living and hopefully a difference in a childs life." -- Holy ****. First, yes this nurse knows how I feel. Second, so families with special needs should just suck it up b/c dang you chose this. But... poor nurses who overcommit at the outset, it's just not their fault they are takign all these optional days off! Poor nurses, they're in a flexible field with almost zero oversight of professional demeanor (beyond legal CYA to the agency and nurse don't get into trouble) -- how dare I hold them to normal standards of professionalism. You're so right, I shoudl go think about this. I'll do that while I'm workign on my positive attitude.

Specializes in Complex pedi to LTC/SA & now a manager.

If the nurse is only working 4 out of 5 days most of the month you need to discuss this with the agency. This would not be tolerated in either agency I work for, you commit a month in advance except for advance notification before schedules are started--min a month in advance or actual emergencies such as contagious illness you are committed to the schedule. Failure to do so you are off the schedule. Period. Sometimes it takes a few weeks to orient a replacement.

You do usually have the option to change agencies or use a 2nd agency. I know that's more work but especially if you need 12-16h/day 7 days a week or 10-12hr overnights 7 days a week...many families in my area have 2 agencies to ensure full coverage.

If the nurse is only working 4 out of 5 days most of the month you need to discuss this with the agency. This would not be tolerated in either agency I work for, you commit a month in advance except for advance notification before schedules are started--min a month in advance or actual emergencies such as contagious illness you are committed to the schedule. Failure to do so you are off the schedule. Period. Sometimes it takes a few weeks to orient a replacement.

You do usually have the option to change agencies or use a 2nd agency. I know that's more work but especially if you need 12-16h/day 7 days a week or 10-12hr overnights 7 days a week...many families in my area have 2 agencies to ensure full coverage.

She's not calling out (anymore) 2-3x per month. Now, when making up the schedule, she is taking 2-3 days off, even though her commitment at the outset of the arrangement, as in last October not month to month, is that she works Mon-Thurs and Saturdays.

The agency is fine with this. They fail to recognize that, just as many nurses like to have a stable full- or part-time schedule of certain days every week, month over month, so do families... So that when a nurse benefits from these stable hours, so should a family. Right now, only my nurse benefits from this stability; she has her pick of 6 eight-hour shifts each week to get the 35-40hrs she seems to need financially.

I really don't know why this is so hard to understand as a problem... My solution, as I've mentioned, is finding a different regular Saturday nurse, something she was very surprised by. I offered her later hours during the week, and/or random Sundays... she likes early days and she likes all Sundays off. No problem. But flexibility goes both ways... want the extra hours but don't want to truly commit? Then you gotta work some shifts that matter less to me, than I can afford to have you come and go when you please.

I know exactly why she is taking the days off and they are overwhelmingly for completely optional activities. She commited to 5 days a week, she very often works 4. Why this is so hard for you to compute I do not know, except that you all clearly have axes to grind about being called in to cover for others -- I do not, have never, and never will expect a nurse to cover for another nurse. Clear?

Wow, just so much empathy oozing from you. I think I have more empathy for my boss's work situation than you do for us families.

Also, please save the condescending advice as to how to make this work. My husband and routinely -- and i mean at least once a week for the last 4 years -- regroup to figure out how we are going to make this work. We are hopeful, faith-filled people who do not wish to have another's life or lifestyle, we wish to make this puzzle work.

And this: "I bet those nurses have no clue you are bothered. And its not their fault due to the nature of the job. They are just trying to make a living and hopefully a difference in a childs life." -- Holy ****. First, yes this nurse knows how I feel. Second, so families with special needs should just suck it up b/c dang you chose this. But... poor nurses who overcommit at the outset, it's just not their fault they are takign all these optional days off! Poor nurses, they're in a flexible field with almost zero oversight of professional demeanor (beyond legal CYA to the agency and nurse don't get into trouble) -- how dare I hold them to normal standards of professionalism. You're so right, I shoudl go think about this. I'll do that while I'm workign on my positive attitude.

Now this is the mom that reminds me of myself and how I would react. My youngest son, the one with special/complex needs, is soon to be 27. He now lives in a group home he is high functioning but has a very complex medical case. He has lived there since he was 22 because I could no longer handle him on my own. It turned out to be the best move we ever made for him. He just got back from an awesome vacation that we could never have taken him on ourselves. When he was growing up we did not have access to help of any kind. No family, no nurses or aids and believe me it was VERY much needed and would have been VERY much appreciated. I have a very strong work ethic and can not abide those who do not. My main clients at this time have 3 of us nurses. I do nights. They are a wonderful family and treat us wonderfully. They do not drink coffee but have provided us nurses with a fancy kuerig machine and a variety of kuerig cups. They do not smoke and do not allow it in their home but 2 of the nurses are smokers and the family has provided a pleasant outside smoking area for them or non smokers to enjoy breaks. I don't think I have ever left a shift without a thank you from either mom or dad and sometimes both. If I pick up for one of the nurses who tends to over schedule herself, which I only do when I want to, they are nearly in tears with gratitude. We have free access to wifi, tv, microwave, beverages and even snacks if we want. They have white noise and fans in their rooms so we are not asked to keep the noise down though I do. I will just say it we are SPOILED ROTTEN. This is not the norm though at least wifi or tv as well as microwave should be. I am very grateful for this family and this job. The only complaint I have ever heard is the agencies complete lack of communication and organization. I can't tell you how many times they have failed to call and tell me I have been canceled even though both of my current clients call at least 12 hrs a head. We are not suppose to give the clients a cell # but you can bet your bippy we do otherwise we would do a lot of unnecessary driving. The books in the home with careplan, mars, tars, blank nurses notes and company policies are suppose to be maintained by the agency but another nurse and myself maintain them because the agency does not. I am kind of wondering if some of the problem with the call off nurses may not be lack of agency communicating with the family. Maybe they do know in advance that these days off are going to occur and fail to inform the family which is their responsibility. We do get bad families who treat us poorly and lack any kind of respect or consideration for us nurses and after a while it does cause bitterness or at least caution on our part but it should never lead us to assume all families are like that. We do need to keep our private lives as private as possible and try to maintain a certain level of professional distance but there is absolutely NO reason we can't still be kind, friendly and empathetic. There is never an excuse for repeatedly failing to keep your commitments. I feel it would be perfectly appropriate to give 1 warning along the lines of : We really need a nurse we can depend on to be here on scheduled days so if this continues to be a problem for you we are going to need to request a nurse with a more reliable schedule. Or you could just tell that to the agency which ever works best with the working relationship you have with said nurse of agency. Good luck I know it is never easy.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
She's not calling out (anymore) 2-3x per month. Now, when making up the schedule, she is taking 2-3 days off, even though her commitment at the outset of the arrangement, as in last October not month to month, is that she works Mon-Thurs and Saturdays.

The agency is fine with this. They fail to recognize that, just as many nurses like to have a stable full- or part-time schedule of certain days every week, month over month, so do families... So that when a nurse benefits from these stable hours, so should a family. Right now, only my nurse benefits from this stability; she has her pick of 6 eight-hour shifts each week to get the 35-40hrs she seems to need financially.

I really don't know why this is so hard to understand as a problem... My solution, as I've mentioned, is finding a different regular Saturday nurse, something she was very surprised by. I offered her later hours during the week, and/or random Sundays... she likes early days and she likes all Sundays off. No problem. But flexibility goes both ways... want the extra hours but don't want to truly commit? Then you gotta work some shifts that matter less to me, than I can afford to have you come and go when you please.

I agree with you. The nurse should follow her obligations. I worked per-diem complex home vent child and I promised x amount of days I worked x days. I think if she is not working her promised Saturdays then you should fill those Saturdays and she can fill in from there.

I also think it is ludicrous that parents are mentioned about choosing to bring this child into the world and somehow it's all their fault.

Consistency, accountability, and reliability are important in private duty/home health. I would call the agency and let them know of your current needs and issues.

Follow Beachy's advice. She is a good nurse and does private duty. My private duty was very limited to one child I had transported multiple times by helicopter. She lived close to me and I did it to fill in when needed.

BIG HUGS!

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