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I'm a nurse, not a babysitter!!!

Specializes in Pediatric Private Duty; Camp Nursing.

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

Specializes in peds-trach/vent.

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.:)

WHAT?! You were FIRED??? That's ludacris! As far as I'm concerned nurses aren't MATH TUTORS! how silly...

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

Specializes in LTC.

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.

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

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

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::yeah::yeah:

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

Specializes in Peds Homecare.

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

Specializes in ER, Med-surg.

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. :uhoh3:

evolvingrn, BSN, RN

Specializes in Hospice.

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.

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.

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.

BuckyBadgerRN, ASN, RN

Specializes in HH, Peds, Rehab, Clinical.

I'm currently doing home health via an agency for a 9 mo vent dependent child with a constant G-tube feed. I have to say that Mom is VERY good about drawing the line with the older 2 siblings. When she runs an errand the older girl has asked to "stay with the nurse lady" and Mom tells her absolutely not, "nurse lady" is here for your baby sister, not to watch you. I am going to nights starting next week so my interaction with the siblings will be minimal.

I have my own kids and as much as I love kids I dont think I could deal with other peoples. I def wouldnt want to deal with the parents. I applaud you all!

prmenrs, RN

Specializes in NICU, Infection Control.

Moms of kids w/spec needs have trust issues. They've been around the block a few times w/their child. If they don't know you, they don't "trust" you, but they do need you. If something goes wrong, even if she knows what to do, she needs back up. If you don't do things the way she was taught, she'll have a problem w/you.

"How do you like this done?" "I need your help w/[client's sibling]; it's not really safe for either one if I have to keep track of both." "What can I do to make this easier for you, Mom?" "Let's see if we can find something for sibling to do so s/he doesn't have to hit us to get attention.'

Parents are still grieving for the child they didn't get. They may have pulled their "big girl panties" up and learned to deal w/what they got; they love the child beyond belief, but every once in a while they get a case of "it's not fair!"

I guess I'm saying maybe your clinical skills aren't being utilized, but you can help the client and Mom in a big way--you just have to figure out what and how. Start by asking her to tell you the client's story.

jmho

I completely understand that some nurses, including in my home, were under utilized. If I couldn't really trust your skills enough for me leave to get a fountain drink from 7-11, there was a good chance that I wasn't going to let you do anything besides suction and set up feeds.

Conversely, I can't tell you how many stories I have heard from my nurses where they totally allow themselves to be used and abused by patients, parents, grandparents, etc. It pained me to listen to some of them. We had a nurse that had another case where she was routinely physically abused by an undisciplined school-aged child. And I mean abused. She came to my house with bruises, cuts and bite wounds. And the parents did not provide a seat for the nurses. They were to stand or sit on the floor. When she first got that case, I thought her husband had started abusing her. I was so worried that I sat her down and told her how much I was worried about her and if she needed any help, she could talk to me and I could help her find resources in our area.

I also find it appalling how some families completely cheat the system by telling Medicaid they have no insurance and getting 16 hours of care from that and then telling their own insurance that they have no supplemental insurance so they get 8 hours from there. We couldn't get 24 hours between Medicaid and our private insurance when our son was being suctioned every minute and couldn't ever be alone. Not being able to pee for 8 hours while waiting for the nurse to get there sucks.

That being said, I adored the vast majority of our nurses and was touched when they came to the hospital for hours to sit with us and bring us food, then to say goodbye and then for his funeral.

It's not the parents who decide whether or not their child gets a nurse vs a HHA. It's the State regs or insurance company that dictates that pediatric cases get a nurse when a similar adult case gets a HHA.

SDALPN

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

kids, thats not completely true. I had a case where the family was given CNA's. The CNA's slept on the job or didn't show up and weren't knowledgable on anything other than the act of the task they were performing. They also couldn't change the GT. The family complained and said they would rather go without anyone than have staff like that. They insisted on a nurse so that the GT could be changed and assessed as part of his care. The family managed to get the ins company (can't remember which one of if it was through the state) to provide a nurse. They had no trouble after that. So with the right situation a parent can push for and receive their choice in nurse vs CNA.

PediLove2147, BSN, RN

Specializes in Pediatric Cardiology.

I totally understand your frustration. I did PDN and a lot of the time it was playing games with very little nursing. I made the switch to acute care because I could not take it anymore. I loved the kids I worked with but after one passed away I felt it was time. I still am considered back-up so I do a shift like every other month. I get to see my kiddo but my sanity stays intact.

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