I'm sorry. I really, really need to vent. I work for a pediatric private duty nursing agency, and I'm an RN. This is what I wish I could say to my new patient's mom: Why the heck would you ask your child's new night nurse to do her laundry?! When the hell did they put laundry questions on the NCLEX? Oh, yeah, they DIDN'T because NURSES AREN'T MAIDS! I'm not your kid's nanny, I'm a healthcare PROFESSIONAL - just like a physician. You wouldn't ask your pediatrician to do your kid's laundry, so you better not ask the nurse to do it, either! It's not 1950, anymore, Sparky!
Of course, I didn't say that. To be nice, I folded the kid's clothes tonight, but then I sent off an email to the clinical director at the agency complaining profusely about this insulting request. I mean, seriously! Where do people get the brass testicles to ask a nurse to do a maid's job?
Why do people automatically assume when they get private duty nursing covered by the state or their insurance that whoever is paying for it also thinks it's cool to provide you with housekeeping services? Isn't that insurance fraud? THe state doesn't want to pay for someone to do your kid's laundry. You can't ask me to do that! Not only is it DEGRADING to ask a healthcare professional to do laundry, it must be abuse of services. I hope to God above that no one at my agency told this woman that nurses do chores, because I will go all the way to the top of national corporate management if someone did. This better be an unfortunate misunderstanding on my patient's mom's part as to what nurses do and DO NOT do.
Has anyone else had to deal with this? I had one other patient's mom ask me if that was something we do, and she totally apologized for asking when I politely told her no. This new patient's mom guided me to the laundry room to make sure I understood how the machines work because she is assuming it's totally in my job description to do laundry. She didn't even ask, she just started out with "when you do her laundry..." Excuse me?! I clean the kid and his or her medical equipment. Nothing else! I'm not a home health aide (whose job it would possibly be). It's just not *my* job to do household chores!
OK, vent over. I feel a little better. Thanks for letting me vent.
Part of the job is monitoring. There is nothing wrong with multi tasking and reading while caring for the pt. I'd be worried that the nurse would have a hard time monitoring the pt if they were that busy doing busy work.
I've find the nurses that feel the need to stay busy are the ones that don't last. Those nurses do better in a busy environment. I just dealt with one the other week. The nurse rearranged the pts rm and made the nurses and family upset. Then the nurse had the nerve to ask the family if she could clean the siblings rm. How can she care for the pt and be cleaning in another rm? And that really gives the family the wrong idea about us and makes families try to get other nurses to do the same thing. The nurse had only worked a shift or 2 when she decided to rearrange. The rm didn't even make sense. The nasty, smelly trash can was beside the pts bed. And the emergency o2 was moved across the rm to place the trash can where the o2 was.
Doing a pts laundry is in our job description per medicare/medicaid like it or not. But I refuse to do cleaning for anyone else. I only do pt laundry when requested, but avoid it if possible. If my pt is able, I assist them in doing their own laundry and cleaning. I think its important to encourage pts to do what they can for themselves if the task is appropriate for their age and ability.
My patient has severe retching episodes, and I have a hard time getting to the bathroom much less running around doing chores. I pretty much have to be within an arm's reach of him at all times.
I can do that while watching tv or reading a book. I can't do that while running around trying to be busy for the sake of being busy.
My patient's mom the other day, asked me if I could help her out by cleaning her bathroom. She's nice and we have a good working relationship... I actually said yes and did it, because there is a LOT of downtime on this case and the patient is super stable. Also, the bathroom is next to the patient's room. It was kind of odd, but I like the fact she felt comfortable enough to ask. I guess.
My patient's mom the other day, asked me if I could help her out by cleaning her bathroom. She's nice and we have a good working relationship... I actually said yes and did it, because there is a LOT of downtime on this case and the patient is super stable. Also, the bathroom is next to the patient's room. It was kind of odd, but I like the fact she felt comfortable enough to ask. I guess.
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The only problem is that it sets up other nurses to be expected to do it. Then the family looks down on them because they are doing their job. Plus if insurance caught you, you could be charged with fraud. Or another nurse could report you.
:nono:At first I was just reading because the title interested me, but the more I read, I had to reply. I have been doing high/low tech pediatric homecare mostly since 1985, with a few years here and there on other nurse jobs. I have tons of experience dealing with kids/parents/caregivers. My number one rule is: I am your child's nurse, I am not your housekeeper, maid, or dishwasher.Learned this well about 12 years ago. New case, 2 kids, no daddy. Youngest was my patient. Brother went to daycare. Mother trying to better herself by going to LPN school. Sink overflowing with dirty dishes, little one napping. Kind hearted me washed all the dishes. Mom very appreciative, I really thought she had just been overwhelmed with starting school. Fast forward, she quit washing the dishes at all, thought it was my job. When I no longer did her dishes she started acting strangely to me. Eventually I told the agency I wanted a different case. Never again have I washed anyones dishes. I don't do anyones laundry either, and would flatly refuse the request. By the way, picky families love me and want me to care for their children. Big rule number 2: I am only here for your child, I don't care for your child's siblings, even for 5 minutes. If the house were to catch on fire in those 5 minutes, the only child I am responsible for is my patient. As hard as it is to refuse when they say "I just need to run to the corner store to get milk." I tell them right away that my agency could and would fire me if they knew I was watching other children. Big rule number 3:I do not leave early, this is a slippery slope, and some families would use this as leverage for other requests. It's friday, you can leave early, no one will know. I will know and if I drop my paperwork off at the office 30 minutes early, I can be charged with medicaid fraud. I arrive and leave at the correct time. The father of my patient actually asked me last week, Miss .........., he always calls me that, have you ever broken a rule in your life? I answered of course...lol. I love their little girl, and they know it, but they know I am honest and they know what to expect. All of my families say I am a straight shooter, and am an honest person. BUT, they know I am their child's nurse, not their housekeeper. No where on my pts. careplan does it say anything about doing the families laundry, cleaning the bathroom, or cleaning their living area. Homecare is just that, homecare. It's not an extention of the hospital, and no patient, no matter how ill, ever prevented me from going to the bathroom. A crisis situation is a totally different story, but no child who is being managed at home, should prevent you from relieving yourself. Oh, and by the way, I graduated from nursing school in December of 1979. I never heard of "Jean Watson", until I read her name on this board. I am retiring next July, all these years I have survived without ole Jean, and I don't need her now either.
I had a new one today that just about made me loose my cool!! The pt. fire alarm battery was low and started to "chirp" every 30 seconds. The pt. (adult/ SMA type 1 / vent dependent) lives upstairs in duplex and parents live in unit below. She phoned her Dad to tell him to come up and change the battery and he told her to tell your nurse to do it. Right. Leave pt., get ladder and mess with families fire alarm. I said I did not feel comfortable with that. Took the Dad 3 hours to come up and change battery. And it totally fell apart when he opened it. I am not your private Handy Man!!!!
Specializes in Geriatrics, Pediatrics, Vents, Trachs.
My agency told me it was up to the Nurse of we wanted to do light housekeeping duties. I would wash whatever dishes I used for my client & do another client's laundry, ONLY because I had down time. Another client, Im always on my feet doing something for her, the entire 10hr shift. I seriously don't have enough time to do my notes and would often leave late! One day, the mom asked me if I could put away 5 boxes of supplies that came. I told her I didnt think I would have time to seeing how I still had so much to do. She got upset and said, well so & so always does it. When other nurses do that, it puts more of a burden on the fellow nurses, which sucks! So, now, I just stick with totally taking care of the client!
I respect the parents/family, and I respect their home and rules. BUT, there is a line here and for me it's deviating from the POC. When parents ask me to do things or not do things that compromises their child I'm not down for that. I don't mind doing SOME extra things IF I CAN, but laundry/cleaning isn't my priority (other than the patients equipment obviously). I try very hard to nicely let families know that I am an RN, a college educated healthcare professional...not the maid, secretary, nanny etc...and my first priority is always my patient. I do try to support the family by educating, making suggestions or giving my professional opinion when it's needed. I don't mind helping out if I can, but it is a slippery slope and I've been in homes where parents wouldn't do my patients laundry specifically because they knew eventually one of us nurses would given in so the patient had clothes to wear. There are good families and very very bad ones out there, and unfortunately in home health/private duty there seems to be more "bad" families or "bad situations" than good ones (in my experience).
Private duty just doesn't pay well, and to expect the nurse who worked hard for that degree and licensure to be the maid just isn't right. Private duty isn't the cake walk many think it is (sometimes it is, a lot of times it's not). Medicaid reimburses very little, and the nurse gets paid very little. It's astonishing how low in some states nurse pay is. I know when I moved to the state I'm in now I wanted to cry when I saw the exceptionally low pay for RN's in any healthcare setting here (it's an insult...disgusting). I think expecting a maid and a nurse is insulting, however if it's a great family who actually appreciates what I do treats me with respect as the professional I am, I'd gladly go above and beyond for them when I can. It's just discerning who you are dealing with, what you are willing to do and how and when to put your foot down as diplomatically as possible, and when that doesn't work then have the agency put anther nurse in your place and take on another case to replace them. That is how I do it anyways. Where I am, we are not expected to do laundry or clean anything except patient equipment and the patient.
:nono:At first I was just reading because the title interested me but the more I read, I had to reply. I have been doing high/low tech pediatric homecare mostly since 1985, with a few years here and there on other nurse jobs. I have tons of experience dealing with kids/parents/caregivers. My number one rule is: I am your child's nurse, I am not your housekeeper, maid, or dishwasher.Learned this well about 12 years ago. New case, 2 kids, no daddy. Youngest was my patient. Brother went to daycare. Mother trying to better herself by going to LPN school. Sink overflowing with dirty dishes, little one napping. Kind hearted me washed all the dishes. Mom very appreciative, I really thought she had just been overwhelmed with starting school. Fast forward, she quit washing the dishes at all, thought it was my job. When I no longer did her dishes she started acting strangely to me. Eventually I told the agency I wanted a different case. Never again have I washed anyones dishes. I don't do anyones laundry either, and would flatly refuse the request. By the way, picky families love me and want me to care for their children. Big rule number 2: I am only here for your child, I don't care for your child's siblings, even for 5 minutes. If the house were to catch on fire in those 5 minutes, the only child I am responsible for is my patient. As hard as it is to refuse when they say "I just need to run to the corner store to get milk." I tell them right away that my agency could and would fire me if they knew I was watching other children. Big rule number 3:I do not leave early, this is a slippery slope, and some families would use this as leverage for other requests. It's friday, you can leave early, no one will know. I will know and if I drop my paperwork off at the office 30 minutes early, I can be charged with medicaid fraud. I arrive and leave at the correct time. The father of my patient actually asked me last week, Miss .........., he always calls me that, have you ever broken a rule in your life? I answered of course...lol. I love their little girl, and they know it, but they know I am honest and they know what to expect. All of my families say I am a straight shooter, and am an honest person. BUT, they know I am their child's nurse, not their housekeeper. No where on my pts. careplan does it say anything about doing the families laundry, cleaning the bathroom, or cleaning their living area. Homecare is just that, homecare. It's not an extention of the hospital, and no patient, no matter how ill, ever prevented me from going to the bathroom. A crisis situation is a totally different story, but no child who is being managed at home, should prevent you from relieving yourself. Oh, and by the way, I graduated from nursing school in December of 1979. I never heard of "Jean Watson", until I read her name on this board. I am retiring next July, all these years I have survived without ole Jean, and I don't need her now either.[/quote']
So, from a super experienced nurse to a semi-experienced nurse. When you are sent out to orient to a case do you flat out tell parents these "rules" you have? Majority of home care agencies explain it to families but many choose to ignore them. I need my paycheck. I have a lot of responsibility to provide for MY family. Many times I have to knuckle under and do those "things" you spoke of just to keep my pt.
So, from a super experienced nurse to a semi-experienced nurse. When you are sent out to orient to a case do you flat out tell parents these "rules" you have? Majority of home care agencies explain it to families but many choose to ignore them. I need my paycheck. I have a lot of responsibility to provide for MY family. Many times I have to knuckle under and do those "things" you spoke of just to keep my pt.
You will have to choose your battles and pick the lines you won't cross. I have refused cases before that the mom goes on and on like the maid was there instead of the new nurse. Just be honest and polite when the issues come up.
OrganizedChaos, LVN
1 Article; 6,883 Posts
I couldn't either! I worked days & nights and I can only handle so much cleaning & you can only chart so much.