Specialties Private Duty
Published Mar 23, 2012
CloudySue
710 Posts
I sometimes don't understand how people get approved for skilled nursing care. A lot of parents seem to obtain services and think they got a free nanny. I had one client who needed someone to go to school with her just to keep herself from smacking herself in the head and to feed her and change her diapers. She easily could have done with a HHA. Plus there were 3 aides in the classroom who were there to handle those things anyway. There was only one med she took and the school nurse could have easily have given it to her. Another case, a 23 year old MR girl, the foster mother would do all the meds and start the tube feeds right there in front of me, turning down my offers to do the actual skilled nursing care, since that's why I was there. Nope, all I was there for is to play with her all day, just to entertain her with musical baby toys. Those were long days. Another client, a 12 year old MR girl, mom just needed someone to take her for a walk in her stroller and push her in her swing, but mom gives the meds. If the girl seized, mom would push me out of the way and care for her herself. I know some mothers are control freaks with care and meds, but I dislike feeling underutilized. I enjoy working w kids and don't mind doing these things, but I wish the nanny tasks were in addition to actual skilled nursing care. Straight babysitting is not what I worked so hard in school for.
frankie,RN
392 Posts
thats one thing about home care i didnt like.after meeting some of the families , ive often went back and told the agency that this person needs an HHA, not a nurse, and i wouldnt take the case. i once was told by a parent of a trached child i was taking to school that since there was no school that day, i should help him with his homework since he struggles with math. my response- i was going to go to school for teaching but i changed my mind and went to school to be a nurse instead. dont ever say that if you need a job. fired the next day.:)
nursebooboo
17 Posts
WHAT?! You were FIRED??? That's ludacris! As far as I'm concerned nurses aren't MATH TUTORS! how silly...
pinkfluffybunny
162 Posts
My pet prev is when they let the other children hang out in the room with me all day. I am not there to entertain your children. If it has reached the point where you hear me scolding your other kids then something should be done. I really know the mom is just happy she isn't the one being bugged. I wouldn't mind if it was just playing/interacting but making my pt cry by taking her toys and hitting her when I'm not looking doesn't fly with me.
NurseLoveJoy88, ASN, RN
3,959 Posts
I know what you mean. I did Pediatric home health. I loved the idea of home health nursing but I was more like a babysitter. I would spend 12 hours during the shift talking to the children and playing video games. Mom did most ADL care and meds. Needless to say I couldn't do it long. I would love to try it again but I rather do visits instead of shift work.
GitanoRN, BSN, MSN, RN
2,117 Posts
unquestionably, i couldn't do it, as a single parent it's hard enough to deal with my own 3 children, therefore, i take my hat off to all of you as i applaud all pediatrician nurses :yeah:
caliotter3
38,333 Posts
The ill-behaved sibling of my client has taken to throwing heavy items and hitting me outright. He likes to do it when I am bent over the bed taking care of the client. His favorite word is the "f" word, which he likes to yell at you when he wants emphasis. He has hurt me. Literally, hurt me, and I can't do anything because I need my job and I don't care to lose my cool and get accused of abuse. He is a toddler and knows I can't lay a hand on him. He runs to his mother and makes accusations that are blatantly not true. I have been present when one of the other nurses twisted his ears. I told the nursing supervisor. Of course, that little tidbit never phased the supervisor. I know there are worse things to put up with if I want a job. I don't look forward to the day when I can no longer put off leaving the case. Pickings are getting very, very slim out there.
realnursealso/LPN, LPN
783 Posts
Some cases are just like that, others are crazy busy. As far as telling the mom you aren't a teacher, wow, you have to watch what you say. Problems such as other children being in the room with you should be handled right away. The first time it happens you need to speak up and say, "I'm sorry, but I can only be responsible for my patient, I'll get in trouble if it appears I am taking care of your other children." Pediatric home health care shift nursing can be wonderful if you get the right family, but can be hell if you get a stinker mom. Once, a long time ago I had a case with a little boy of 5. His parents had never layed down ground rules of behavior. He was fully capable of understanding, no. I was sitting on the floor playing with his toys with him. The next thing I knew, a heavy tonka truck went whizzing by my ear. Mom sat right there, never said a word. This boy also was on a vent while sleeping, but you couldn't just put it on, you had to wait until he fell asleep and sneak it on,otherwise he would disassemble it before your eyes. He was deaf too, can you imagine sneaking hearing aides in a childs ears? Needless to say I did that case one day. Other kids/families tug at your heartstrings. Mom's and dad's hugging you and crying and telling you how wonderful you are at their child's funeral. They continue to treat you as part of the family, years later. I've had great families through the years, and others I am glad I never had to see again. Hugs and I hope you have better days.
WannaBNursey, ADN, ASN, RN
544 Posts
Wow OP, your job sounds exactly like what I did when I worked as a CNA in home health. Why would they waste your skills like that? I'm going to assume your services were covered by insurance. You going to a house to do less than CNA work is a waste of time for you and a waste of money for the insurance agency.
evolvingrn, BSN, RN
1,035 Posts
I could never let someone handle my sons seizures i think its the nature of being a special needs parent. I have encountered some really dumb nurses to when it pertains to him.....We decline all home services. Sorry you aren't getting utilized. i think its just the nature of parents in that situation.
BrandonLPN, LPN
3,358 Posts
I agree that what you describe is a waste of skills. On the other hand, as long as they paid me LPN wages, I don't think I'd personally have an issue with it. I guess it would depend on what other options were available.
Where I work the LPNs can be pulled to the floor to take a CNA assignment as staffing demands. Some LPNs hate this, and are almost tearful when they find out they have to "work the floor" that night. I never really got what the big deal was. Remember, feeding, bathing, changing etc. are all part of every nurse's scope of practice. It just happens to be the part that overlaps with an aide's scope.
Cuddleswithpuddles
667 Posts
Devil's advocate time.
Some parents intervene out of fear. It is comforting to them to know a skilled, knowledgeable person is around as a back-up but some will always feel that deep terror and an unshakable parental desire to act.
That being said, I do not believe that they should do it on the taxpayer's dime if they got skilled nursing through a government program. I *did* climb up the walls and bang my head on the desk in frustration over "babysitting" cases when I did private duty. I left, switched to more challenging assignments and now made the move into acute care. But the devil's advocate statement above took the edge of my frustration and allowed me to see these families with some kindness and understanding.
I do miss the video games, the craft projects, the homework help (I worked as a tutor before being a nurse), family outings and all the time in the world to do the job right. But I knew where I was headed, did not like it and made a change. Figured it's easier to change me than to change everyone else hehe.