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

The client knows to call 911 if there's an emergency or the doctor's office if they can't get in touch with me by phone. They know that I'm working PDN cases also and am not always available. They don't expect me to be at their beck and call 24/7/365, nor do they think I'm a substitute for 911.

But if they have a question that I can answer for them over the phone, or if they're having trouble hooking up the oxygen concentrator and it's something I can pop over and handle for them in a matter of minutes, I'd like to be able to offer that service to them. The delay involved in them calling the agency, the agency looking up the case, then the agency looking up my information or forwarding the call to an on-call nurse, etc. -- I could have been there and back home again by the time the agency even got around to calling me.

Agency communication isn't always as efficient or as accurate as it should be.....

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Specializes in hospice.

But if they have a question that I can answer for them over the phone, or if they're having trouble hooking up the oxygen concentrator and it's something I can pop over and handle for them in a matter of minutes, I'd like to be able to offer that service to them.

If you are popping over to their house to do that kind of thing for them without getting paid, you are setting up expectations that no agency will be able to sustain. You're the client's best friend, but they may think everyone at the agency is an ***. That's a really bad dynamic for a business.

If someone is going to be on call 24 x 7 they should be paid for it. If a client is going to have 24 x 7 service s/he should pay for it. You are making every nurse who does not give their time away free look bad.

For some of us it's a matter of dignity as a professional. I am paid to do a job. I am not your friend. I may like you. I may even love you (at least a little.) I am not your friend. I am your nurse.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
If you are popping over to their house to do that kind of thing for them without getting paid, you are setting up expectations that no agency will be able to sustain. You're the client's best friend, but they may think everyone at the agency is an ***. That's a really bad dynamic for a business.

If someone is going to be on call 24 x 7 they should be paid for it. If a client is going to have 24 x 7 service s/he should pay for it. You are making every nurse who does not give their time away free look bad.

For some of us it's a matter of dignity as a professional. I am paid to do a job. I am not your friend. I may like you. I may even love you (at least a little.) I am not your friend. I am your nurse.

Who ever said I'm not getting paid for it (if it ever even happens)?????

This is a client that I do home health visits for, not PDN work. So if I ever got called over there to work on a problem, it would be charted and submitted for billing just like any other visit I do for the client.

Really, people, stop assuming so much.... I'm not the client's friend, and I'm not working for free. We don't have long chats on the phone every night, and we don't go for moonlit walks on the beach. I'm a Registered Nurse doing home health visits. How on earth does that make me less dignified than anyone else? :rolleyes:

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Somebody in the past thought it was essential to divide the home health forum into separate areas for intermittent visit home health and extended care home health. So, reasonable to expect certain references posted to refer to the general type of work being discussed, unless otherwise explained. When doing intermittent visits, I wasn't given the opportunity to make unscheduled visits based on calls from the client.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Somebody in the past thought it was essential to divide the home health forum into separate areas for intermittent visit home health and extended care home health. So, reasonable to expect certain references posted to refer to the general type of work being discussed, unless otherwise explained. When doing intermittent visits, I wasn't given the opportunity to make unscheduled visits based on calls from the client.

Sorry, but it was very clearly explained that this was a HH situation :

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.

.....

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.

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Personal boundaries are a must. The client needs to call the home office. If your expected to be reached via cell the office can either page you or issue you a work cell. Non-negotiable.

You need to tell your patient to call the office when he needs to talk to you so that they can page you. I know it's hard because I used to do home health and you get so close to your patients. But you have to maintain your boundaries. What if your patient were to call YOU when they are needing to call 911. It has happened before and it makes you liable. They need to understand and respect you as a professional. Plus if they call the home office to page you, usually the secretary can let them know that you are not a lifeguard ;)

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I have never been required by my employer to give my number to a client, whether doing extended care or intermittent visits. I keep my extended care posts in the extended care "forum" and my intermittent visit posts in the visit "forum" as much as possible. It only makes sense that when one is reading the forum that is titled private duty, another name for extended care, that they expect that information to be about extended care or private duty. And as a matter of practicality, whether one is going for a visit that lasts 15 minutes, or 15 hours, has no bearing on whether or not their employer instructed them to give their private number to the client. The client who whines and plays games with the nurses is quite adept at getting what they want by playing games with words. That is how they get the information to begin with.

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And for the record, on more than one occasion, the client(s) who has wheedled my phone number out of me, has used that fact as a tool to make me pay the price in more ways than one. It took a lot for me to learn my lesson with this, but I finally learned it.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

Just curious -- I recently had minor foot surgery. I'm OK to work, with socks and shoes on and a dressing over my incision. But getting into a pool would be a no-no. What happens then?

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Specializes in Complex pedi to LTC/SA & now a manager.
Just curious -- I recently had minor foot surgery. I'm OK to work, with socks and shoes on and a dressing over my incision. But getting into a pool would be a no-no. What happens then?

They send another nurse or kid doesn't go in pool. Life continues.

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Specializes in Pediatrics.

My agency's official position is to not give out phone numbers, but they know it happens. I've given it out to two clients because I 1) knew them for an extended period, 2) explained boundaries, and 3) had very little choice. Neither of them had home phones, and my agency's office hours don't coincide with shift change (I have to use their answering service and hope the person on-call gets back to me soon). I don't get paid when I show up and no one called to tell me my shift has been cancelled, and I've been burned too many times in the past to try and use the office to relay communications between me and the parent.

I definitely would have appreciated a text about bringing a swimsuit, if only to have the opportunity to tell the parent "NOPE" well in advance. There's not a snowball's chance in hell I would get in any pool with my client, therapy or not.

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Specializes in Geriatrics, Home Health.

My school case included occasional trips to a pool. There was a lifeguard, but my client had a trach, so I refused to take him into the water.

Another client went to a pool for PT once a week. The pool was at a gym that does a lot of rehab, and had a lifeguard. Two people needed to be in the pool with the client. We got her in and out (with a ceiling lift) and did exercises for 45 minutes. Later she did pool PT at a woman's house. She was in the pool with the client, and needed the nurse to help with transfers. PT in the pool was part of the care plan, and all nurses were CPR certified. I had no problem getting in the pool with that client.

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