I do not feel like a nurse

[LovebugLPN]

I am an agency nurse who has been working with a boy at a public school. My company says my only job is to stay with this child only and keep him alive. I have had many problems with the teachers because they expect me to help out with crafts and teaching students. I am smart enough to do this. When I tell them I am only there to keep this child alive they roll their eyes. One teacher said "in the past my aides always helped in the classroom." I explained 1) I am not an aide and 2) If she wanted an aide hire more. I let my company know and they said they would call and talk to school. I knew this would make situation more annoying so told them not to. I am still running into this problem and now the aides really don't like me. The other problem is I have 1 day off during the week and the other nurse runs around doing all the stuff that they ask her to do. When I return I get "so-and-so does all this and why can't you" I don't want to get company involved because I do like my job and don't want to go back to weekends, holidays, evenings, and nights. I like M-F school hours. I don't feel like a nurse anymore. I do not feel like they respect me except when a child is sick or hurt then they come looking for me.

[bollweevil]

There must be a common sense middle ground.

But really it sounds like you miss what you call hands-on nursing. Maybe you should pick up a 2nd job?

[KLKRN, RN]

Have you considered doing an inservice or asking your agency to do an inservice for the the teachers/school regarding the difference between a nurse and a teacher's aide?

I do think you owe it to your agency to keep them informed of what's going on and let them intervene. You owe it to yourself too. Trying to be nice is only going to make you resentful, and that will spill out eventually and affect your work.

I work as an agency RN at different hospitals, and I do have the option of not scheduling myself where I don't want to be. I understand wanting to work somewhere but circumstances are beyond difficult.

Good luck.

[RN1989]

You are hired to take care of the physical problems this child has. Anything else is not within your scope of practice. Your liability is way high if you are doing anything except acting in a nursing capacity. Even helping with crafts, etc. could pose a problem as you might get so engrossed in helping the child with a project that you did not notice a subtle change in condition that later deteriorates. It sounds as though you are getting too personally involved with this client. Particularly if you don't feel that you can "leave" this client because you don't want to let the child down. Step back and get some objectivity before you get into some trouble that is hard to get out of.

[LovebugLPN]

I am well aware that I may be seen as overly involved with this child because I feel guilty if I left him but maybe that is one of my biggest problems. I know that nursing is a job but at some point it has become an extension of me. I used to be able to leave work behind but when I began working with this child it all became blurred. I am envious of teachers for example who are never told they care about their students too much. I work with a teacher who wanted to leave and stay home with her children but when I asked her why she did not she said it was because she was depended on by these students and cared about them almost as much as her children. That to me made her a good person in lots of peoples eyes. Why is it that as a nurse I am seen, by many, as less of a nurse or someone who needs fixed when I say I stay with this child because I don't want to let him down? How do I build up that wall like I had when I began nursing?

[felixfelix]

Perhaps ask the teacher when she visits a loved in the hospital if she passes the food trays, does vital signs and empties bedpans? I bet she would look appalled.

Toq

Touche!

[pagandeva2000, LPN]

This is a similar story that made me leave my pediatric home care client. I felt like a baby sitter. Now, I didn't mind that, per se, because I already have a full time position in a hospital clinic, but, when the family wanted me to escort them on shopping sprees, birthday parties, movie trips and such, I got tired of this. You are right, these things can be a liability issue. Escorting children to these events and no emergency equipment around, other children interferring with dressings, trachs, and whatever can compromise your position. Also, the demands of the instructors should not be tolerated.

I know that this was posted some time ago, but I felt compelled to answer. I would do actitivies with MY patient, but not others. Also, I would not provide nursing care for other children, because you have no medical records, or any access to possible contraindications of their care. This is not to say that I would not help if I saw another child choking to death, or such, but unless it is a dire emergency, my first priority is to the client I am being paid to care for, not to be the aide to other children.

[pagandeva2000, LPN]

Have you considered doing an inservice or asking your agency to do an inservice for the the teachers/school regarding the difference between a nurse and a teacher's aide?

I do think you owe it to your agency to keep them informed of what's going on and let them intervene. You owe it to yourself too. Trying to be nice is only going to make you resentful, and that will spill out eventually and affect your work.

I work as an agency RN at different hospitals, and I do have the option of not scheduling myself where I don't want to be. I understand wanting to work somewhere but circumstances are beyond difficult.

Good luck.

That is a good point-you SHOULD have your agency involved, because they should have policy and procedures that you should adhere to, since you are under their payroll, not the school's.

[LovebugLPN]

Thank you for responding. I did say something to the teacher today when she was standing next to me and told the child I am with "you don't need that" (referring to his drink he carries around). I explained that it was there to keep his secretions wet due to his trach and if she did not feel it was needed then there was no real reason for me to be there. I went on to explain that I was his nurse and that even though "the other kids did not have this" he was to have it. I don't think she liked it but I said it nicely and with respect, she did roll her eyes but oh well. My company likes to stay out of things and would rather I not get them involved. I pretty much just take care of things to the best of my knowledge and actually feel like my own boss most of the time. I am not sure I always like it but as Mom always told me "like it or lump it" whatever that means.

[Thornbird]

I think you should also speak to your agency about the other nurse. The agency is liable for her conduct and she should not be helping out as a general aide. I, too have been in your situation and been able to make the boundaries clear, but didn't have someone else undoing it when I wasn't there. I didn't have a problem helping my client with tasks and facilitating communication for her, but no involvement with other kids except as a visitor to the class. Good Luck, these are challenging but rewarding positions. Also, keep in my mind that if you do homecare with these kids you are expected to perform non-nursing tasks such as meal prep and laundry. You have to work all this out for yourself so that you maintain professionalism.