Meet and greets? How to save my sanity?

Specialties Private Duty

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I last worked PDN about 5 years ago. I recently started back with it and I've noticed a new thing "meet and greets". Years ago it seemed custom to either just accept a case outright if it was low acuity or orient for a few hours with a nurse and if everything worked out great, if it didn't you politely declined returning. Now it seems I'm expected to shuffle between three counties for meet and greets. There's no standard of what they actually entail and can last 10 mins to hours and I feel burned out from meet and greets that are reimbursed at a visit rate of just $11. I also feel like more recently agencies are giving parents more and more control.

Last night, I drove 40 minutes to a case for a 3 year old with GT and seizure disorder. Mom proceeded to tell me that she totally forgot about me coming and that I'd have to wait for her to finish her emails for work because she works for the federal government. She mentioned this every chance she got as if she were trying to scare me. Anyway, she sat me down at a table and pretty much interrogated me and she had a notepad which she wrote down everything I said. She asked all kinds of bizarre questions like where I went to high school, how old I was, if I had siblings, if any of my friends or family smoke cigarettes, what kind of car I drove, ect. Then she wanted me to give her a complete list of places I've worked as a nurse with dates and phone numbers. Also, NCLEX questions she printed off the internet. She also stated that she makes the schedule and sends it to the agency and that she'll be in direct contact with her nurses via phone to make the schedule because not just any nurse van care for her kid. Nothing like the agency allowing their own rules to be broken. I was there for TWO and a half hours... $11.

The day before I drove out to a meet and greet for an adult patient with CP who PO feeds. No skilled nursing, none. Dad told me that he only allows nurses who are proficient in PO feeds on his case and that he wanted to watch me feed her breakfast. It took an hour and fifteen minutes to feed her. Yup, $11. A meet and greet for a case so low acuity a child could do the care. I could've worked this case blind. 

Also, later that day I went out to a meet and greet where mom literally toured me around her apartment and spent more time showing me her wig collection than the patient. The child was sleeping and I waited 45 mins for him to wake up before I gave up left. Also, in the almost hour I spent there no one ever mentioned the kids NG tube. I didn't find that out until I requested the 485 which they kept forgetting to send me.

Has anyone ever politely requested to just go out and work the case or are meet and greets just totally unavoidable now. Any tips on how to tell parents you're not staying past say 15 minutes for the meet and greet?

 

Specializes in Private Duty Pediatrics.
5 hours ago, lpn90425 said:

 

Last night, I drove 40 minutes to a case for a 3 year old with GT and seizure disorder. Mom proceeded to tell me that she totally forgot about me coming and that I'd have to wait for her to finish her emails for work because she works for the federal government. She mentioned this every chance she got as if she were trying to scare me. Anyway, she sat me down at a table and pretty much interrogated me and she had a notepad which she wrote down everything I said. She asked all kinds of bizarre questions like where I went to high school, how old I was, if I had siblings, if any of my friends or family smoke cigarettes, what kind of car I drove, ect. Then she wanted me to give her a complete list of places I've worked as a nurse with dates and phone numbers. Also, NCLEX questions she printed off the internet. She also stated that she makes the schedule and sends it to the agency and that she'll be in direct contact with her nurses via phone to make the schedule because not just any nurse van care for her kid. Nothing like the agency allowing their own rules to be broken. I was there for TWO and a half hours... $11.

The day before I drove out to a meet and greet for an adult patient with CP who PO feeds. No skilled nursing, none. Dad told me that he only allows nurses who are proficient in PO feeds on his case and that he wanted to watch me feed her breakfast. It took an hour and fifteen minutes to feed her. Yup, $11. A meet and greet for a case so low acuity a child could do the care. I could've worked this case blind. 

Also, later that day I went out to a meet and greet where mom literally toured me around her apartment and spent more time showing me her wig collection than the patient. The child was sleeping and I waited 45 mins for him to wake up before I gave up left. Also, in the almost hour I spent there no one ever mentioned the kids NG tube. I didn't find that out until I requested the 485 which they kept forgetting to send me.

Has anyone ever politely requested to just go out and work the case or are meet and greets just totally unavoidable now. Any tips on how to tell parents you're not staying past say 15 minutes for the meet and greet?

 

I wouldn't answer those questions. I would answer whether or not I smoke, but not the smoking habits of my friends & family. Some families don't accept a nurse who smokes, since they can smell the smoke on the nurse's clothes. 

I do think a non-smoking family should have a nurse who doesn't smell like cigarette smoke. That means no smoking on the way to work, too. If you smell too much like smoke, and you are not willing to abstain, then they don't have to accept you. This is something the agency should check out before even sending you out.

It's illegal for an employer to ask my age, so the family doesn't get to do so, either. And asking what high school I went to is the same as asking my age.

The list of every place you've worked was on your resume - your employer had reason to want this - but you don't have to list it all out for a client.

She does not have the right to my phone number. There are too many red flags here.

If your normal pay is, say, $22/hr, then you should agree to a 30 minute meet & greet. That's $11. I would tell the agency that 30 minutes was my limit, and why, unless they are willing to pay me by the hour, and not by the visit. If they disagree . . . there's another red flag!

Specializes in Emergency Nursing, Pediatrics.

My company is good about explaining to the families what the meet and greet is for. We don't get paid for ours.

My advice would be to speak to your company, and get a clear picture of what they want done at the meet and greets. You should be allowed to view the 485/care plan before ever setting foot in the home, so you know at least a little bit about the child. It may be difficult for you (because it's been difficult for me in the past), but be firm with the parents and explain to them you only have 30 minutes to spare. Most parents like when us nurses have questions, so I would bring a short list of questions written down to ask (even if you're the type like me who doesn't really ask too many questions and rather likes to watch and learn). Hope this helps!

Yes, meet and greets are now par for the course. You should set your own parameters and limits with the agency and don’t allow the clients to deviate. The agency provides a copy of the 485 and usually a supvr/DPCS conversation beforehand, or you don’t agree to go. Remember, too, in most cases, if the situation were desirable, there would already be nurses assigned and hogging up the good shifts. Keep your expectations reasonable. You can tell your agency that you will go to a “meet and greet” for up to an hour that leads into a shift worked. Should the family find you unacceptable and vice versa, you/they can end the visit/shift and you get paid for time spent. My best agency expectations came when this method was routinely followed. Better worth your time and trouble because it usually ends up with a new case assignment. If not a good situation, you just let the agency know afterward that you don’t want to return. Think of an “emergency” excuse to use when it clearly appears impossible early on and you want to get out of there.

My agency will not allow anyone to go out to any case before a meet and greet. The parents have to "approve" you before you before you can work with them. Agencies are giving parents more and more control like the scheduling issues you brought up. Are families supposed to text and call nurses to make a schedule? No. Will agencies say anything? Absolutely not, less work for them and they can't risk losing the case.

All the meet and greets I've been out to are pointless and are nothing but a dog and pony show. I feel your pain.

You have had some bad experiences. Usually when I get a new case I just show up and start working. Occasionally, if it's a complicated case, or a newborn, I will get a couple hours orientation. Only once have I had an actual interview. Once I showed up for a meet n greet and nobody answered the door, and it looked like a rough neighborhood so I just left and did not reschedule. Once I showed up for a meet n greet, and nobody was home but parents had one of those camera things so they could see me on the porch and asked me to reschedule because they "forgot". I refused to reschedule. 

I make it known that I won't go out to anything unless they pay my hourly base wage while I'm at these meet and greets. NJ minimum wage is $12/hr and the big agencies in the state are all paying $10/hr for trainings and meet and greets!? Not sure how that's legal, but they're definitely not taking advantage of my time. If I'm getting fairly paid I have no problem staying as long as the family would like me to. 

10+ years ago meet and greets weren't a thing, you went and shadowed or just worked the case. If agencies want to make meet and greets a thing make them pay you for it! They need you more than you need them! Tell them you'll only go out if the full hourly wage or you just won't work the case and see how quickly they bend for you. Every meet and greet I go to I get paid for an hour of my time, no matter what. Just demand it. I work for a large nation wide company and they gave in pretty quickly to me when they realized that they needed me, but I would absolutely not be taken advantage of. We're educated and licensed professionals don't let anyone treat you otherwise. 

I also won't go out to any case before reading over the 485 and speaking with the clinical RN supervisor about the case, these used to be standard, but now it's often skipped over. The college aged men in the offices of these agencies are no different than used car salesman, they know nothing about healthcare or the cases, but will try to up sell every case to you regardless of your skill level or personality.

I wish all nurses in home care would start advocating for themselves and demanding fair pay all the time. Too many nurses are scared of upsetting the office staff when 99% of the time they will bend for you if you make them because they need you. 

 

 

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