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.
I have never taken a private pay case. However, I would NEVER take a case that had housekeeping/laundry etc on the 485 (would have to be private pay as insurance companies, medicaid and medicare in the USA will NOT pay for custodial care). To heck with that, I did not bust my a$$ in nursing school to clean someone's home.
If you are a new nurse and you reading this please take a few things into consideration:
- When your patient is sleeping, you are not just "sitting around doing nothing", you are monitoring your patient with the nursing skills that you learned in your years of experience and in school.
- Insurance companies, medicare and medicaid will NOT pay a nurse to do custodial tasks (laundry, housekeeping etc..) if you are doing them while on the clock then you may be considered to be playing a hand in insurance fraud.
- You are a nurse, you are a medical professional, you are there to take care of the patient, the laundry/dishes/vacuuming is not a medical task.
- Don't try to be super nurse. Doing the laundry and the dishes will not make the family like you, they will just begin to view you as a servant (and many families already do).
- Clean up after yourself, keep your patient clean as possible, keep the medical supplies organized and tidy and do a good job as a nurse.
- I am currently working night shift 11p-7a (sometimes 7p-7a) as a pediatric private duty nurse via agency. I currently float between 6 to 8 clients per month. I really don't have what I would call a "base" client.
- I am willing to do my patient's laundry (especially soiled/wet bedclothes). I will NOT do the the family's laundry or dishes, in most instances. However, in once case, I do have to cook breakfast for the client (scrambled eggs, toast), then puree the result, and feed it (orally) to the child. The nurses (myself included) are required to clean the mixer, and put the utensils and cooking pans into the dishwasher. Sometimes, we are required (by agency) to clean up after the family and put their dishes in the washer as well. It takes 5 minutes (nothing major). When the dishes are done, we put them away.
Day shift is required to do this particular client's laundry as well. Again, it's in his care plan for the nurses. Mom and dad are super nice and both work about 60+ hours a week.
So it comes down to whether you want to gig or not. In this case, it's an agency requirement plus a personal decision. So not a big deal. Any other client, I have the parent's do the laundry. I will carry the client's laundry to the basement (in the laundry basket) if asked. But that is the extent of my laundry capabilities with the exception of the one aforementioned family.
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- My biggest gripe in this industry (private duty), relates to job instability. You could be working a client for 2 or 3 years (40 hours a week), and then be out of job. as out of nowhere mom decides she wants a different nurse. No reason is ever given. It happens to every single one of us (male and females nurses alike), some with close to 30 years nursing experience.
- I do study at all my client's (since I work the night shift). I carry a laptop with extra batteries, and a binder with notes. I inform all of my clients that I will be studying at night. I tell them, if this is a problem, let me know now and I will make arrangements with the agency to get you another nurse. For $25 to $28/hour with no benefits, I am going to be hitting the books. That being said, if your kid has a BM at shift change, I have no problem staying late and cleaning up the mess. Emergencies happen, where the kid needs your attention the entire shift, and that's fine. But for the most part, kids sleep at night, and I study when I can. Most of my families are agreeable to this arrangement.
- Again, what I hate is getting a shift cancelled at the last minute. Worse yet, having the client decide they don't want my nursing services. Lots of parent's rotate nursing staff every 3 months, so it's nothing personal. Others, who knows. I've had 3 families decide they have not wanted my services over the course of three years. Just had my 3rd mother cancel my services this week. Her reason, "my husband is getting jealous." So go figure.
- Once I get through school, nursing can kiss my sweet rear-end. For those wanting to get into the industry, I say to stop and take a really, really good look. We all got into this industry to make a difference and help others. In reality, hospitals and agencies are there to make as much $$$ in as little time as possible. Patients will turn on you in a dime. My advice, find something else to do.
The schools today (especially BSN) are much to expensive, compared to the pay you'll make in the real-world.
My whole life just turned upside down and now I am considering a different field of nursing. Im an RN and have been a skilled nurse for teach vent kids for 7 years, basically since I got my RN license. I worked for a an agency with clear boundaries and very professional management team. Pay was extremely low though and therefore the turnover rate was high. I and many other nurses stayed regardless of pay because of the good working relationship we had with both the agency and the families. Boundaries and expectations were always made clear and that included never asking the nurse do any household chores including taking out the trash outside of the home even the clients' trash. We nurses were expected to change the trash of course put in a new bag but the trash was always placed in a designated place inside the house for the parents to take outside of the home in their trash bins. Most of the time the trash designation place was next to the front or back door so it was easy for the parents to take it outside into the bins. Laundry even the clients laundry was never accepted either for a nurse to do, nurses were expected to place them in the designated hamper or directly in the washer but not anything else. Even taking things out of the dryer was not allowed, the parents were expected to do that themselves. Washing the dishes even the clients dishes was not allowed either, nurses were expected to take the dishes from the client and simply place them in the sink or dishwasher, you can add water to let it soak but not clean. lest you break their dishes while your are washing them. Nurses were expected to strip the bed and make the bed but the parents were expected to provide the clean sheets for the nurse to be able to make the bed. Of courses some nurses don't really follow these rules but it was always highly discouraged by our agency and if the parent makes us do any of these extra things, the agency highly encouraged us nurses to report it to them so that they can talk to the parents. It was just clearly unacceptable and it was made clear to all parties involved that it is unacceptable. There's a sheet of paper even that the parents have to sign to make sure that it is known to them that it is not acceptable. With this, I never had a problem with parents asking me to do anything they never asked me to do these things, although some were more diligent in keeping their place clean and some were more diligent in making sure theres always clean sheets/clean clothes/clean bibs/clean wash cloths/clean towels/clean dishes for the nurse to be able to use for their child, the ones that weren't (because they themselves worked/studied) always apologized for not having them ready. It was an ideal relationship completely amiable to the dedicated nurses who really wanted to make a difference and help out these kids and families despite the low pay. There was a nurse who decided on her own to do these household things and the parents were grateful yes so grateful in fact that they now expected her to always do it. That when it was that particular nurses shift, it was expected to be done. Needless to say that nurse ended up quiting and looking for a different case. She gave the parents and the agency a different reason but she let us fellow team nurses know the real reason why she didn't want to work for that case anymore and it was because of the house chores now expected of her by the parents. My agency was great, the management in my agency was topnotch and they cared for not just the clients/families but also their employees. All parties always felt valued while maintaining professional boundaries and still being compassionate. I strive very much to be like them and to be like these supervisors and the nurses I worked wit. Unfortunately I got married and had to move to a different state but I was adamant about doing the same job and going about it with an agency because I had such positive experiences with my last employer, clint and families. And the agency I now work for and the families I work for are completely different and such a disappointment. Im now expected to do house chores as well any way that they can tie it to the patient's needs it's suddenly our job as well. And the families take advantage of this and its gotten to the point where they literally don't work and they don't take care of their homes because they have all these benefits from taxpayers money to do everything for them because of their trash vent child. The boundaries are so blurred the kids themselves ask the nurses to buy them things like toys and dads and video games. It's all tolerated with this agency that I work for which is very ironic because this agency is not just multinational but international as well and they look really good on paper with awards of the year even of best place to work. It's very ironic. Needless to say I went to management to discuss my concerns of these household chores (the non working non disabled parents are having me hand wash their childs clothing with hand washing soap free from the government, soap thats supposed to be used for nurses to wash their hands and prevent spread of infection. Geez she doesn't even have the courtesy of providing the nurse with detergent to do her chores. Meanwhile their own laundry is overflowing and theres now baskets and baskets un unlaundered clothes while they FaceTime their relatives planning weekend parties) (They also make the nurses go out of their house in this dangerous neighborhood to take the clients trash out into the bin meanwhile they can't even take their own trash and their own is overflowing with garbage while they munch on chips watching tv) (They make the nurses wash the kids dishes and cook the kids meals and wash the tube extension and syringes and neb kits and all other equipment 20 times a shift totally unnecessary but the nurses do it coz PER MOM this is how she likes things done meanwhile how own sink is overflowing with used/unclean dishes) (SHe's having the nurses clean the kids room which is fine it's part of maintaining cleanliness of the client's area and making sure no nurses and patients trip and fall and break their hips or anything. But the siblings who play with the client run tornadoes through the room and leaves the room for the nurse to clean. Something by the way was another thing my old awesome agency made sure the parents understood was that it was also the families responsibility to keep the area of the child clean and pathways clear and the nurse could even refuse to go on a shift if these conditions were not met. It was always a joint effort which is very reasonable considering you are getting free cares from medicaid.) Well, my new agency made it clear to me that these are all my job and that they would provide me with gloves and a gown for free to do the laundry/handwash the laundry. That I should just throw the trash on my way out as I go to my car to go home. Basically all of my complaints they had a solution to get me to continue to do it because they are all related to the client. I was even called by my boss a not special nurse. and they even doubted my past experience doing the same job. I wanted to prove to them that I am a good nurse I had a patient who once wrote to the state just to say how amazing me and this one other nurse is and thats without doing household chores and without buying the kid/family anything, just simply going above and beyond as a nurse. Ive had parents tell me that I'm such a good nurse and what makes me a good nurse is because I put all my heart into it I don't just do the job required of me and thats all without taking out the trash and house chores and without buying them anything. Just simply being a nurse. So this agency expects it from me and I have now applied for different agencies and just hoping that one of them will be suitable for me. Ive been crying every day and reaching out to my past families and bosses and team to let them know how much I value them I how much theyve made an impact in my life and my choice of being a nurse and to let them know that there is now a huge hole in my chest that it seems no other agency/family can fill because they were just the greatest. I still strive to be like them but if every agency in this new state is like my current one, then I will switch to a different field of nursing, at a place where atlas I can maintain professional boundaries and still be compassionate and make an impact on peoples lives without having to do things I'm not comfortable doing. I don't want to be in a different field of nursing but if this is what home care skilled nursing has come to where I actually have to overstep boundaries and my boundaries overstepped and where being a good nurse equals doing house chores and laundry and taking the trash out and buying them food and toys then Im clearly never gonna impact anyones lives in this state Im never gonna make a positive difference here so might as well cry now, get myself back together and find meaning and purpose in a different field of nursing and help make a different in the lives of other clientele/patients/families because the families that get medicare to provide for their child's special needs care just really want free housekeeping free things free food free toys free nurse free nanny.
In response to cc7's lengthy post, one could take the stance that eight hours of work equals eight hours of pay. However, the problem with nurses doing the job of the maid, is that for every minute they spend doing maid's work, that is one minute not spent caring for their patient. Wrong on more than one level.
I think I was fascinated by CC7's post. I really tried to read it all. But I simply can't read long posts that don't have paragraphs.
Can someone smarter than me explain why that is?
Lol, I'm scrolling on my phone and I had a hard time with her post because I kept losing my place if I glanced up for a second. Paragraphs are used to get across an idea and for organization. It also helps with giving you a visual start and stop point while reading something long.
Seems the insurance paying for an RN is not intended to pay for unskilled labor. Unless the parents are overwhelmed with tasks or working and cannot maintain basic needs like laundry or patient's dishes, you are not be the housekeeper. If they are self pay, and you agree to that, you may decide it's appropriate. An agency who is paid by insurance for skilled nursing tells you to do unskilled care, they may be violating insurance regulations. But if a family is self-pay, the agreement may be through the nurse?
I agree ?! This is unfortunately a huge misconception in home-health. The family expects the nurses to clean their house among other things. I have been a nurse in homehealth for many years. I do not mind doing anything for the child, including laundry. That is actually part of our care plan with the company I am with currently.
However, I will not do the clients families laundry or clean their house. It is amazing what some expect! I am in a current situation that I am looking for an opportunity to address this very thing. It has mostly been implied and I just ignore it. The other nurses have apparently gone above and beyond with organizing and cleaning, so now it's expected. I am not there to do anything but care for the client and follow the care plan. My next case I will make sure this is addressed before I start. It should be addressed upon the initial enrollment visit with the nurse supervisor but apparently it's not. And it puts us in awkward situations.
I have been doing PDN for 20 years and we have plenty of cases needing nursing in my location. I wouldn't do housework. I will strip my patient's bed and remake it, take her hamper to the laundry room. Restock supplies, meds etc. If more is wanted I'd have to move on to another case.
NagathaChristie
24 Posts
I have never taken a private pay case. However, I would NEVER take a case that had housekeeping/laundry etc on the 485 (would have to be private pay as insurance companies, medicaid and medicare in the USA will NOT pay for custodial care). To heck with that, I did not bust my a$$ in nursing school to clean someone's home.