I am a nurse, darn it!

Specialties Private Duty

Published

Text from patient at 8pm = bring bathing suit and change of clothes because I am bringing X to pool and I need you in the pool to help.

A) I have no lifeguard training or CPR training for lifeguards (which is a different animal).

B) I am an RN, not a physical therapist?!

I just said I will accompany, but I am not going in the pool. Am I wrong here? Isn't that a liability issue? I mean this client can't even attempt to swim. If they get water in their lungs they are toast.

Specializes in Peds(PICU, NICU float), PDN, ICU.
I always refused any shift that required me accompanying my patient on outings on one particular case because Dad was a horrible driver. If they announced we were going somewhere after I arrived, I called the agency and then went home.

I also would not agree to go to a pool with a patient of they were wanting me to go in the water.

Edited to add: I work nights so I wouldn't have to go to MD appts/school with patients. Just not my cup of tea.

I've avoided the bad drivers. I worked with one family where the parent admitted he was a bad driver while we were on the road. He wasn't kidding! I made sure I didn't ride with them again. Shortly after, he was driving and hit by a train and was killed. Super nice guy and I was sad it happened. But wasn't surprised, I hate to say.

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I once worked a weekend stayover for a private duty client where I was asked to be poolside while he exercised in the pool. I spent the entire time praying that he would not have an emergency while in the pool as he was a large man and no way could I have helped him. I was lucky. If pool activities requiring intervention or some action by the nurse would be an ongoing thing, I would see to it that an appropriate addition is made to the Plan of Care, otherwise, you are just 'going where the client goes'. As far as accompanying on outings, I have started to see the phrase, "nurse may accompany.........insure safety equipment: suction machine, ......" is being added to care plans. I've always considered it to be par for the course that I accompany my client to doctor's appointments. If the nurse does not want to deal with pool activities or other activities, then this should be discussed with all concerned and perhaps it will become necessary to change nurses for the case.

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Specializes in hospice.

Why are you getting a text directly from a patient? I'm guessing there is no agency involved? If there was, this would be crystal-clear and the agency would handle it.

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Specializes in Complex pedi to LTC/SA & now a manager.
Why are you getting a text directly from a patient? I'm guessing there is no agency involved? If there was, this would be crystal-clear and the agency would handle it.

Communications like this must come via my agency. Other nurses text the parent after a year I finally got my clients mom to realize she gets more response and definitive answers by going through the agency after a major incident last fall.

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Why are you getting a text directly from a patient? I'm guessing there is no agency involved? If there was, this would be crystal-clear and the agency would handle it.

I here you. The agency puts our cell phone numbers in the client book. In my opinion, this breeds more problems than it solves.

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A waiver for any trips away from the home? That's odd. With all the dr appts some kids have and the trips to the mall or park out just for a walk outside? That's just strange. We are there to allow the kids to have a semi normal life. Without us they would be in the hospital or a facility. Medicare/medicaid requires us to be wherever the kid is. And what about kids that go to school? Something is off about that. What's next? A waiver for them to swing or go down a slide at the neighborhood park?

Why do the agencies need waivers, because we live in a litigious society.

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I once worked a weekend stayover for a private duty client where I was asked to be poolside while he exercised in the pool. I spent the entire time praying that he would not have an emergency while in the pool as he was a large man and no way could I have helped him. I was lucky. If pool activities requiring intervention or some action by the nurse would be an ongoing thing, I would see to it that an appropriate addition is made to the Plan of Care, otherwise, you are just 'going where the client goes'. As far as accompanying on outings, I have started to see the phrase, "nurse may accompany.........insure safety equipment: suction machine, ......" is being added to care plans. I've always considered it to be par for the course that I accompany my client to doctor's appointments. If the nurse does not want to deal with pool activities or other activities, then this should be discussed with all concerned and perhaps it will become necessary to change nurses for the case.

Yes, this. This is how I see it.

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I here you. The agency puts our cell phone numbers in the client book. In my opinion, this breeds more problems than it solves.

This is in direct contravention of what (almost) all agencies direct regarding personal phone numbers. I have known of one nurse who was fired for giving out her personal number. Most employee handbooks state that nurses are not to give out their personal numbers. Even if the agency provided me with an agency-paid phone, I would turn that phone off when I am not on duty.

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Specializes in Complex pedi to LTC/SA & now a manager.
This is in direct contravention of what (almost) all agencies direct regarding personal phone numbers. I have known of one nurse who was fired for giving out her personal number. Most employee handbooks state that nurses are not to give out their personal numbers. Even if the agency provided me with an agency-paid phone, I would turn that phone off when I am not on duty.

Both agencies I work for have the same policy.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

I work for two different agencies on three different cases (two PDN and one HH), and I've given all of my patients/families my cell phone number. So far, it has been extremely helpful and not abused.

Communication through agencies, particularly nights/weekends when most of my work occurs, can be spotty. Having cell/text access comes in very handy for last-minute issues.

One time I arrived at a PDN home to find nobody was there. I tried calling both parents' cells and also left text messages, and I called the office's after-hours on-call person for direction. After half an hour, I got a text back from the parent that they were gone for the night and I wasn't needed for that shift. Never did find out what happened at the office that I never got the message that I'd been called off for that shift. I've asked the family to text me in the future if they're going to call me off for a shift, in addition to calling the agency. When I recently had to call in sick, I texted the parent in addition to calling the agency, just to make sure that the parent was notified.

Recently had something similar happen at another PDN case, nobody home when I arrived. A couple minutes later I got a text from the mom that their outing had run long and they were on their way home and would be there momentarily. If the parent and I had both been calling the on-call after-hours person at the same time, one of us would've gotten voice mail, and the entire process would have taken much, much longer while the on-call person looked up all the pertinent information, etc.

My HH case lives about five minutes from my house, and I've given them my cell number and told them to call if anything comes up between visits. So far nothing has happened, but I want them to have access to me if something does come up.

So far, none of my cases have abused the phone/text privilege. It's used solely as a last-minute communication method, and things such as me calling in sick or the family calling me off for a shift still get called in directly to the agency, but we also give each other a heads-up via text out of courtesy.

If in the future it became problematic, I would have no problem telling a family that the agency was restricting cell/text access and they could only call the office from that point forward. (And I'd block their number if they persisted.)

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Specializes in hospice.

You need to find a job with a different agency. Clients being allowed to call the nurse directly is a recipe for disaster. What if there is something urgent going on and you are on vacation, in the middle of the ocean, with no cell service available? If the client calls the agency they get help. If they call you, the call goes into the great void. Then the client assumes you are ignoring calls that you never got. This is not good for anyone involved.

I can't believe your agency allows this. Not only is it a violation of professional ethics; it is stupid, stupid stupid.

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You need to find a job with a different agency. Clients being allowed to call the nurse directly is a recipe for disaster. What if there is something urgent going on and you are on vacation, in the middle of the ocean, with no cell service available? If the client calls the agency they get help. If they call you, the call goes into the great void. Then the client assumes you are ignoring calls that you never got. This is not good for anyone involved.

I can't believe your agency allows this. Not only is it a violation of professional ethics; it is stupid, stupid stupid.

Based upon how many calls after midnight I received from the latest client after I had just left the home at 10 PM, I would have to agree with this. The agency told me flat out that the constant harassment from the client was my fault because I gave her my number. And boy did I laugh up a storm to myself after I left the office one day. They jumped me and jumped me because the entire office staff had spent the entire morning dealing with this person AND the father. My response to them: what do you think I deal with on a daily basis? You don't get but a fraction of it. I had to change my number. No more chance to abuse my private phone number.

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