Legal implications of providing care post D/C

Jolie, BSN · May 9, 2005

Hope someone can help answer this ?...I am an RN in the Neonatal ICU. THere are times when parents of our former patients ask us to help with the care of their baby in thier home in exchange for money. THis is "under the table" and not arranged through the hospital in which we work at all. Specifically, a parent of former preemie twins recently asked if anyone would be willing to come to their home and do the overnight care/feedings for the twins because they were so desperate for sleep. They said they would make it "worth our while" in terms of money. One of the twins is still on O2. It seems as thought the parents just need a babysitter or nanny, not necessarily a nurse, but since they are so comfortable with us after caring for their babies for 3+ months, they are asking for our help & money is not an issue with them. What are the legal implications of this? Would we be performing under our nursing license if we accepted this under-the-table job, even though it is more like a babysitting job...just to feed the kids overnight. What if something went wrong? After all, one of them is still requiring O2! What is the appropriate way to go about this? Thanks for any info...

While it is flattering to have the confidence of these parents, I think it would be ill-advised to "baby-sit" for them. You don't get to park your RN license at the door in situations like this. If something were to go wrong, such as an aspiration or an apneic episode, you would be putting your license on the line.

If these parents are truly in need of home-care help, they need to approach their pediatrician and health insurance company and get approval for nursing visits. Then, as an employee of the nursing agency, you could go into the home and take on a professional role with expectations, payment and malpractice insurance issues clearly delineated.

If they are exhausted (what parents of twins aren't?), but not in need of professional services, they need to ask Grandma and neighbors for help, and not impose on you.

froggy4 · May 13, 2005

Hi there, I understand what you are asking...I too have been asked to help parents at home..I am an perinatal nurse and weary parents have asked me for help being very comfortable with me after days of nursing them and their baby.....You CAN help them at thome...HOWEVER, your license WOULD be on the line...you would be providing care as a PRIVATE DUTY NURSE... you would need to take out Liability Insurance for yourself ( I have it through NSO, it is $89.00 a year, good price). I have been a private duty RN before, it was a wonderful experience....You would need a contract with the parents as to what duties they expected, what fee they would pay you, when you would be evaluated, what you expected, etc....legally you would lay out what they could expect from you...your insurance would be in place, if, heaven forbid, something went wrong. I suggest a contract because it keeps it legal, you could go on line for ideas on a contract, or, find a lawyer in the family, or, yellow pages. It is worth it to keep it legal. ( I am taking a legal nurse consulting class, not that I'm an expert, but, I know a bit.) It is rewarding to be able to help a family and enjoy caring for them and their babies, but you must protect yourself..... You also need to keep in contact with the Pediatrician as you would in the hospital and keep very good, professional notes......Good Luck!

Froggy 4 :)

LydiaNN · May 14, 2005

You could also approach the family and a home health agency and see if you can be an employee of that agency for this particular family. Nothing untoward about that at all. I know several families of children with developmental disabilities who hire their children's caregivers this way- they get to choose the person they're comfortable with and the caregiver enjoys the benefits of being an agency employee. Just a thought for if you're not comfortable contracting with the family yourself. I would add that I consider it inadvisable to do this "under the table" if what you're referring to by that term is not paying taxes on the extra income you earn. That can come back to haunt you.