I'm a nurse. Not a housekeeper!

[EpiattIPNurse]

Ok, let me start by saying that I do not feel that I am above cleaning someone elses house. Since I have started with this last client I have already cleaned their bathrooms, washed the walls (because all the other nurses got gtube feed all over it), swept the floors.... so on and so on. Let me give you a little background on the situation. I care for a little boy. He has 3 adults living in the house with him and a teenager. Two of the adults do not work. The consumers mother and I had a conversation because she made the statement that a nurse she interviewed said that she is not an overpaid nanny/housekeeper. I explained to her that she may not have worded it the best but I think she was trying to tell her that she is a nurse and it is her job to do healthcare for her child and not clean because I have heard horror stories about families expecting their nurse to do laundry and dust and stuff. She looked at me like I was speaking chinese or something. Next thing I know I get an update on the all service plan from my case manager and laundry and light housework was added to the plan! ***!? Like I said, I am not above helping around the house when I am bored. I actually like to clean. The point is that I am a nurse not a housekeeper and their is no reason why I need to do these things. If I were caring for an adult that could not do these things on their own I would understand but a child with 3 adults living there. It is not my job to do these things. Does anyone else feel the way I do about this? I think it is outragious. :angryfire

Thanks for letting me vent.

[Ks mommy nurse]

I have since left that position and started with another client. Like I stated before, I do not mind helping around the house and I do. I have swept that floors, cleaned the kitchen, dusted and everything for this new client. Today the mother made this statement to me... "could you make sure you clean everything up before you leave. I had to pick up the towels you used for "Shelly's" bath yesterday. The other nurse knows that I do not have time to do these things. I just really need someone to help me out with these little things because I don't feel I should have to do it. It is part of your job."

Yesterday I gave my pt a bath and then right after I got her dressed her aunt wanted to take her to the park and we left. You can not leave the pt alone for even one second. I forgot by the time we returned to the home. I was really shocked that she would say something like this to me considering every morning her and her whole family mess the whole kitchen up and leave dishes all over including knifes and I clean it up without saying a word about it. I do not think that I am cut out for home health. I can't deal with these people always wanting more from me. I think I am a good person and try to go out of my way to lend a helping hand whenever needed. I am tired of everyone wanting more!

Wow, I know how this feels. I thought I had it bad, but its nothing compared to you. Sorry, You're having problems with these cases or clients families. This is why I moved myself around with different families til I'm happy. But, again after 2 years with this family, they too are getting to used to me being there. I've been asked to do stuff that I don't mine, but lately I've been a counselor, a cook, and a hairdresser. Recently the oldest daughter moved back home with her 3 year old daughter and I'm asked by the lil one if I can make her food. Her mom's at school, and gramma is stil asleep. So she's awake wandering the house when I get there. I feel soo bad for her. I've brushed her hair and colored with her too. Mind you, my pt is asleep or sitting in his w/c and nothing needs to be done. Bt, this is getting old and I've told them already I can't. They got bothered about it. So, I'm keeping my eyes open for my next family.

[smartnurse1982]

I would just like to know when did doing laundry become a part on nursing in the home? I just refuse to do laundry, but I think it has to do with the region u are in. In nj I never did laundry and nobody asked me to,but in the south its like its expected of you. I always worked for agencies with medicaid clients. If the family can't do the clients laundry,maybe they should reconsider ltc. Oh, and since I don't do laundry,the family is telling the office the 7 to 3pm nurse is doing more than the 3 to 11pm nurse. But as I recall, doesn't morning shifts always do more than 3 to 11pm even in hospitals and nursing homes?

[nursel56]

Doing laundry has never been part of nursing in the home in my area. Maybe a small amount for the actual patient--- for lazy family members? In fact, I would have a hard time biting my tongue when around people who would expect that, to be honest.

[tewdles, RN]

As health professionals in this setting we set ourselves up for unreasonable expectations by "trying to be nice" in the beginning. When we start out performing duties which are not related to our purpose there we create an "expectation" that we and others will continue those duties. Light housekeeping means keeping the immediate area picked up and safe for the patient. Laundry should never include the items of other family members...never. Washing dishes is only your function if you dirtied them in caring for the patient. If you bathe the patient, tidy the bathroom after the bath...that does not mean clean the toilet. It is not your job to enable the slothful behavior of some patients. There are co-dependent healthcare workers who will be happy working in those situations. If you are not one of them move on, not all consumers of private duty nursing are abusers.

[ArwenEvenstar]

As health professionals in this setting we set ourselves up for unreasonable expectations by "trying to be nice" in the beginning. When we start out performing duties which are not related to our purpose there we create an "expectation" that we and others will continue those duties. Light housekeeping means keeping the immediate area picked up and safe for the patient. Laundry should never include the items of other family members...never. Washing dishes is only your function if you dirtied them in caring for the patient. If you bathe the patient, tidy the bathroom after the bath...that does not mean clean the toilet. It is not your job to enable the slothful behavior of some patients. There are co-dependent healthcare workers who will be happy working in those situations. If you are not one of them move on, not all consumers of private duty nursing are abusers.

I agree totally! Thanks for your post! One of the biggest problems I encountered in my years doing private duty was demanding families with unrealistic expectations CAUSED/CREATED by the nurses who totally lacked a professional boundary!! It rather gave me a low opinion of our profession (nursing) to see so many nurses who seemed to lack basic professionalism. Co-dependent behavior galore! I wonder if the nature of private duty cases is that they ATTRACT nurses who have major co-dependency and martyr issues???? Even scarier was that these nurses did not "get" why their behavior was a problem!

[nursel56]

I agree totally! Thanks for your post! One of the biggest problems I encountered in my years doing private duty was demanding families with unrealistic expectations CAUSED/CREATED by the nurses who totally lacked a professional boundary!! It rather gave me a low opinion of our profession (nursing) to see so many nurses who seemed to lack basic professionalism. Co-dependent behavior galore! I wonder if the nature of private duty cases is that they ATTRACT nurses who have major co-dependency and martyr issues???? Even scarier was that these nurses did not "get" why their behavior was a problem!

I'm not sure if the nature of private duty attracts them initially-- but I've encountered stuff that makes my jaw drop. The worst-- nurses who would climb into bed w/ a young male paraplegic pt. "because he really needs the human contact" nurses who try to engage the other nurses in a fraud scheme,and just plain nutballs that can't fit in to a team environment. More common than that is nurses who borrow money from patients, embroil themselves in family dynamics, etc. and quite common unprofessional behavior such as a male nurse changing into a bathrobe at work, running around barefoot, and a forty-something nurse wearing a brightly colored Hannah Montana nightshirt to work. :omy:

[caliotter3]

Just this morning my new client and I were discussing the poor behavior of home health nurses and how they bear a poor reflection upon themselves, their employer, and the profession.

[smartnurse1982]

I still think even doing the clients laundry is taking it to far. That's what the family is for. They did it before the client got sick so why stop now? Do you guys put that u did clients laundry in the nurses notes?

[caliotter3]

I was doing laundry for a previous client. I did two shifts a week. Every other shift was a caregiver off the street. None of them were HHAs or CNAs. I wrote in my nursing note, "Laundry done by licensed nurse." I let the client know that laundry did not fall under the category of skilled nursing care. Her response was, "Or they're so busy and they get tired." That is why they left their thong underwear and clothing for their toddlers in the basket for me to wash along with the clothing of the client. I do not work there anymore.

[nursel56]

I still think even doing the clients laundry is taking it to far. That's what the family is for. They did it before the client got sick so why stop now? Do you guys put that u did clients laundry in the nurses notes?

Totally agree. I was thinking to myself-- what is the most I would be willing to do? For example, on the weekend if bedding gets soiled, I will rinse it and put it to soak so that it will be easier for the regular caregiver when she comes in. One time someone forgot to fold a dry basket, so I did it because I have total respect for this person, she doesn't try to foist stuff off on me, and she doesn't ever complain about anything. I don't do anyone's dishes but the patient's as a rule, but I have done the grandpa's one or two if they happened to be in the sink. Every family and every situation is different. If I felt I was being taken advantage of I'd be out of there in a hot second.

I don't chart tasks like that in the nurse's notes, unless it was part of an overall case of unsafe or neglectful home environment. We have flow sheets to check off most routine things, but not much space for a narrative. Some nurses do this, I find funny-- they write really small, and go up the side of the page every conceivable detail, fluffed pillow-tolerated well wiped chin x3 :chuckle

[caliotter3]

I charted the laundry task both to show that I was doing it, but more importantly to document it because to do her laundry, I had to physically leave the apartment and go to the laundry room, out of earshot of the vent alarms. I disagreed with this practice more than I disagreed that licensed nurses should not be doing laundry when predominantly unlicensed persons work the case. I also didn't appreciate having to leave the apartment at night, a personal safety issue. On at least two occasions I returned to find her vent alarming away.

[nursel56]

I charted the laundry task both to show that I was doing it, but more importantly to document it because to do her laundry, I had to physically leave the apartment and go to the laundry room, out of earshot of the vent alarms. I disagreed with this practice more than I disagreed that licensed nurses should not be doing laundry when predominantly unlicensed persons work the case. I also didn't appreciate having to leave the apartment at night, a personal safety issue. On at least two occasions I returned to find her vent alarming away.

You bring up a very good point. There are unique documentation issues we have. There is no end to the funny business family members will engage in, or attempt to engage us in. I'm sure you've come across things. We may not have friendly witnesses to the care we provide. I've been lucky as far as personal safety so far, but some of my co-workers have described some verrry "iffy" neighborhoods. It's too bad, too. The elderly and the children have no fault in that, but they suffer when nurses refuse to come to their areas.