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Parent/camera nearby...can u read?

There's downtime with GB kids where I would have liked to check my phone, read a book etc. They could be napping, feeding, standing in stander etc. I normally try to talk and sing to my pts all day even though they are all cognitively impaired, nonverbal and non responsive. But sometimes i do need a break and just let them feed or whatever. but one of the moms is always sitting a few feet away and i feel bad about reading/doing something not work related since she can see and hear everything ( theres no door to the room, its open to where she sits all day in the dining room). If theres no pcg there, I worry they are watching me on camera. Am I being paranoid...? Do you all talk and sing to the pt all day or also take time off for yourself when there's nothing to do?

I discuss this matter with the family at the start of the case so there is a clear understanding of expectations. Always work as if you are on camera. Some client families actually do hide their cameras and tell no one. I interact at a reasonable level, never do I "perform" for the entire shift with the exception of careful observation of the patient. And although most of the families tell me it is OK to read a book, etc. during down time, I always feel self conscious if they are observing me. That goes even for charting, a legitimate activity. It is usually best to break up periods of time for all activities to insure you are caught up with hands on care before spending a great deal of time charting or otherwise. In other words, don't let the patient lie in a wet diaper for half an hour while you write the great American novel on your nurses note. HTH

Right, of course not!! I too always feel self conscious if they are observing me. And yes even when charting. You are so right, it literally is "performing". Singing mary had a little lamb,the itsy bitsy spider and old mcdonalds has a farm all day long i feel like a preschool teacher. But worse, cause at least they get responses from the kids.

Are your PCGs home a lot too? I seem to always get patients where mom is always there (weekdays), in some cases many family members there, all the time.

Lately, family home around the clock, but in the past, somebody was usually at work during the day or sleeping at night, or a combination. I do not like it when they are underfoot, especially when they act like the gestapo with eyes in the back of their heads. If the parents are going to be standing next to you critiquing your every move, then the bottom line is that they don't really need nursing care. Having a nurse in the house is supposed to free them up to do something else, not provide an outlet for their neurotic tendencies.

Exactly carliotter3!!! I had a mom from hell who did exactly that, watched me continuously on camera then stormed into the room critiquing my every move. She was a micromanaging dictator control freak.

Exactly carliotter3!!! I had a mom from hell who did exactly that, watched me continuously on camera then stormed into the room critiquing my every move. She was a micromanaging dictator control freak.

And agency personnel wonder why nurses ask to leave cases.

Exactly. She went through a lot of nurses. I was warned but thought I could handle her, I was wrong. She was once furious with me I gave the kid tylenol when he was thrashing in pain. She said you should have come to me and asked me first! I said I didn't know I needed her permission to give tylenol....and of course now I know to ask permission to give tylenol next time...

I still stayed after that but another outburst a few weeks later was the last straw for me !

The case I have now the mom is home all day long, but for the most part USUALLY leaves me alone. She doesn't micromanage me. After all the care is done, they do not care if I read a book.

Alex Egan specializes in Home Health (PDN), Camp Nursing.

Over the years I have had a few productive conversations with parents and staff about cameras. A few points.

1. Visible camera are not only honest but are trouble deterrents. They are impartial when reporting serious events, but also let everyone know they are under supervision. This allows bad actors to leave I their own, before issues occur

2. They capture everything, much like overhearing a conversation that wasn't meant for you, the camera may capture things you don't like but wouldn't have been aware of. (You're going to catch people picking their nose and scratching their butt). Discression and tact the are required.

3. Hidden cameras are a gotcha game they are only useful once and are dishonest at the base of the issue. They don't protect they catch after an issue has already happened.

4. Cameras should store footage. Direct to monitor cameras are not useful for real evidence collection or settling disputes.

I like camera cases when they are upfront and store footage. Cameras have solved more issues for me than they have created.

Alex Egan specializes in Home Health (PDN), Camp Nursing.

Yep. It falls into the catigory of picking my nose and scratching my butt. You may not want to see it, but it's happening. I entertain my clients plenty. The trick is to avoid the cases where the parents believe that by rolling at ball around the tray enough times or using hand over hand to play twinkle twinkle little star on the keyboard 20 times a day is gonna cure their kid. Or worse yet the dreaded "you get paid x amount so you better make sure Jr is happy" meanwhile Jr hasn't responded meaningfully in his entire life and they just sit him infront of the tv when you're not there. It's more about the case then the cameras

Can't you just have a nice conversation with the parents? Our nurses had access to our wi-fi and there was a cable television in the bedroom. They could read/study, knit, watch TV/movies (nothing R-rated) as long as everything was done and kiddo was happy.

In your case, if the child is in the stander, he/she might need some distractions through singing or reading books. But a sleeping, content child should give you plenty of time to chart, read your own book, whatever.

Ventmommy, the thing with "as long as everythings done and the kid is happy" is that there are 2 perspectives on that. In my view , after competing all my feedings/ meds/ shower/ diaper changes etc etc for that hour, and after singing and engaging with the child all day, if the child is happy playing with toys on the floor mat, or ( if lower functioning) hanging out in the wc clean and fed listening to nursery rhymes on his iPad, then I would like to take a peek at my phone, or read a magazine, or eat in peace without having to sing the itsy bitsy spider or Mary had a little lamb. PCG however wants me there on the mat engaging with the child during that time... Why? Every child needs his play time, by himself. I'm sure shes not with him there every minute when I'm not there. Why do I have to constantly entertain for 9 hours on top of all the nursing care? I feel like I do above and beyond. On top of providing compassionate skilled nursing care, Im a preschool teacher with him, a nanny, an entertainer, everything. I need a break too. And im not comfortable going to the parents to ask permission to text on my phone ....or read a little, just cannot picture having that conversation. that is why I'm asking you all.

Edited by tami2017
Typos

Exactly Alex!!!! That's exactly how I feel. If Jr hasn't responded his whole life than surely I can stop singing for 30 minutes to text my daughter or read a magazine. But some parents expectations are rediculous. They want u engaging with their child hands on all the time. And of course they dont do it themselves. Even when there's no nursing care to be provided for the next hour, you can't go silent, take a break or do your own thing. Big brother is always watching whether by camera or hovering in person and they make you feel like a slacker on the job if youre sitting on your chair and the child is unentertained at the moment, even if he has his tv on or ipad playing songs, its not enough for them. I sing and talk to these (non responsive) kids 9 hrs a day, every day, and need a break or two from old mcdonald had a farm and 5 little ducks went out one day over the hill and far away.

Edited by tami2017
Typo

The point is that you should have had the conversation at the start of the case. Not necessary to ask permission every time, each and every day. If, or when, the parents renege on their initial requirements, and it gets to be too much, time to get another case. Don't allow unreasonable people to make your work life miserable, shift in and shift out.

You are right Calliotter. Unfortunately its too late now. I haven't thought of talking about this at the start of any of my cases. Maybe the agency could have mentioned that...One mom is an easygoing parent, lets you work and is busy with her stuff. the others are the ones with unrealistic expectations. They are also the ones that are always home. Lesson learned for next case.

Sometimes it is not so easy to find another case when times are hard. My area has not had a lot of work for a very long time. Nurses who have good cases keep them and nurses who have bad cases keep those too because they need the paycheck. But you really have to decide for yourself how much bs you are willing to tolerate and for how long.

Yes, you are right. Its true in this area too. Can take months to get a case that fits your days, times, distance. Finding a good fit is golden. I too would hold on to that, you're in a comfortable routine with the kid, everybody's happy with each other. So due to that i developed a high tolerance for BS theres just no other choice. And due to that I work for 3 different agencies. While working I try to exceed expectations but much prefer if those arent rediculous.

Why isn't your agency giving you the household info before you even go to the meet and greet? I had a comprehensive booklet with all of our expectations, requirements, rules, and responsibilities all laid out. It also explained our household composition so that you didn't waste my time if you hated dogs or were deathly allergic to cats. I also included things I was picky about (you needed to bring CLEAN slippers/crocs for use in the house),there was no pork of any kind allowed, and you needed to bring your own flatware if you were eating meat. It also listed the perks (cable TV with all movie channels, occasional fun outings, use of wifi, unlimited cat cuddles).

It's not too late to talk to the parents. If the parents are that unapproachable, then talk to your ADON or DON to get this worked out.

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