Pedi Home Health...difficult parents?

[kyowalpn]

I am an LPN who has 3 yrs experience med surg, and 3 yrs exp. home health. I have taken care of the same 2 children for a couple of years. The parents have all been wonderful, trusting, occasionally have asked me to do things differently, which I have always done, and they have always been polite and kind when asking. I just started with a new co. since one of my cases is entering a SNF. I have been put on a relatively easy case, 10 mos old with trach/g-tube, nothing I haven't done before. My second night on the case, mom enters the room as I am suctioning, tells me I am doing it wrong, wants it done this particular way.....I politely explain that I was taught differently (how to maintain sterility, how long to suction, etc), but I will certainly be happy to do it the way she wants (nothing she wanted was WRONG, just not how I was taught....or what is in the protocol for the company). She continues to tell me how wrong I am (not yelling, but not nicely), she thinks I need retraining....this time, I actually apologized for what I had done (although I did not do anything wrong) and again say I will do it her way. She became a little nicer, but still kept going on and on about how I basically did not know what I was doing. Question is....how do I deal with her? I can't do anything but say I will do it her way, which I certainly will as long as it is not wrong/outside of my scope. Anyone else with experiences like this who can help? I guess I've been spoiled with the families I have had before!

[caliotter3]

I would also be spoiled by the families that show respect to the nurse. Same thing happens to me on the case I am at now, and for the most part, most cases. Mind you this is the same person who does wound care to an open wound without washing their hands, or wearing gloves, who removes the wound packing, rearranges it with their unwashed, bare hands, etc., etc. And you can't get through to do proper teaching. They are not open to any way to do something but their own way. Is it any wonder that the wound is almost always infected? They grab the suction catheter from your hands, with their unwashed hands, and proceed to use improper technique to suction the trach and insists on "instructing" you on how to do trach suctioning. I have been suctioning trachs for almost 20 years. When the "instructor" and "complainer" is not in the room, I do it the way I was taught, the proper way. You can't win.

[nursel56]

Sounds like you got very lucky with those first two cases! I find most adult patients/families to be very protective of what I would call their rituals especially if they've been receiving nursing care at home for a long time. Because of this they rarely budge on their opinion and usually view a nurse who makes it an issue as an adversary.

So I bend on some things but not on others. Very few homecare patients that I see use sterile technique and a new suction catheter every time they suction their child I have discovered. One wants continuous suction going in and going out, not what I was taught but as you say, if something isn't overtly wrong, I do it their way.

I had a patient who tried to insist that I use Vaseline to lubricate the Foley catheter and I am sorry but no. I don't care if you think it's been just fine to do that for however long -- I will not do that. They relented on that one, probably because I chose to stand my ground. The phrase "choose your battles" comes in pretty handy in private duty/home health!

[caliotter3]

Knowing that I do not have the support of my supervisory staff at the agency goes a long way in causing me to decide that most of these battles are not worth fighting. I fall back on the old admonition the supervisors always like to throw at the field nurses, "Do it their way, and chart that you did it the way they told you to". If they are too far astray for my liking, I look for a new case, again, weighing how long I feel I can go without work. My agency does not bend over backwards to keep me working.

[joprasklpn]

family members are not your friends and will turn on you in a heartbeat, so my advice is move on to another case.

[juzme]

My client is a young adult and his mother is difficult at times, in fact, I almost left b/c of her. The case is also pretty boring. I think, I need a change!