Private duty annoyances

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Specializes in med-surg, teaching, cardiac, priv. duty.

I've been doing private duty RN level cases for close to 4 years now. I really do like it as I was a very burned out hospital nurse. But there are annoyances! One being family dynamics and issues. One case I was on for a long time, the family essentially withdrew and let the nurses take over. Nice, in a way. But there was no team approach with her care and the parents really should have been more involved....Sometimes the nurse would need a hand and the parents did not want to help or helped begrudgingly. Sad.

But now I have the opposite issue. I have been on my present case for over a year, and the mother is really starting to get to me! I've tolerated it just fine all this time, but now I have suddenly had it. This mother is involved in ALL aspects of her daughter's care. She takes the lead with all care, and the nurse is essentially just a helper. Nice, in a way. Great team approach. BUT this mother is anal! She is so precise and particular about how everything must be done. Everything must be done her EXACT way. Sometimes she criticizes every little thing you do. "Pull the chucks this way, not that way." "The water is too hot." (or it is too cold!) "You pushed the medication too fast." (or you pushed it too slow!) "You got the wrong washcloth, I wanted the other one." The other night she picked a dirty washcloth out of the dirty clothes hamper (that I put in there) saying it was "too dirty" to go in the hamper and only "mildly dirty" things could go in the hamper. I KID YOU NOT! At one point recently, I got real close to saying something like this "I am going into the other room to watch TV, because I am obviously not competent to care for your daughter."

Well, I am just venting! That is all! Thanks for listening. I have several ideas to resolve this....may just be time for me to move on to another case.

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I've been doing private duty RN level cases for close to 4 years now. I really do like it as I was a very burned out hospital nurse. But there are annoyances! One being family dynamics and issues. One case I was on for a long time, the family essentially withdrew and let the nurses take over. Nice, in a way. But there was no team approach with her care and the parents really should have been more involved....Sometimes the nurse would need a hand and the parents did not want to help or helped begrudgingly. Sad.

But now I have the opposite issue. I have been on my present case for over a year, and the mother is really starting to get to me! I've tolerated it just fine all this time, but now I have suddenly had it. This mother is involved in ALL aspects of her daughter's care. She takes the lead with all care, and the nurse is essentially just a helper. Nice, in a way. Great team approach. BUT this mother is anal! She is so precise and particular about how everything must be done. Everything must be done her EXACT way. Sometimes she criticizes every little thing you do. "Pull the chucks this way, not that way." "The water is too hot." (or it is too cold!) "You pushed the medication too fast." (or you pushed it too slow!) "You got the wrong washcloth, I wanted the other one." The other night she picked a dirty washcloth out of the dirty clothes hamper (that I put in there) saying it was "too dirty" to go in the hamper and only "mildly dirty" things could go in the hamper. I KID YOU NOT! At one point recently, I got real close to saying something like this "I am going into the other room to watch TV, because I am obviously not competent to care for your daughter."

Well, I am just venting! That is all! Thanks for listening. I have several ideas to resolve this....may just be time for me to move on to another case.

Personally, I would tell her to back off, in a nice way of course. If she refuses, find another case....:)

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At one point recently, I got real close to saying something like this "I am going into the other room to watch TV, because I am obviously not competent to care for your daughter."

....may just be time for me to move on to another case.

When you reach the point of thinking of saying that to the parent, it is nearing the time you should find a new case. If you make the mistake of hanging on, chances are very high that something will get blown out of proportion some day and the family member will demand that you leave the case. Better to go to another another case on your own request.

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Specializes in med-surg, teaching, cardiac, priv. duty.

Thanks for replies! I think the mom "is how she is" and will not change. I am looking for a new case. The cases my agency has open right now are either not in a good location (too far from my house) or the shift times don't work. So, I'm just going to wait it out for now and hope a new case that will "work" for me comes up sooner than later.

It is helpful that my agency understands the situation. They actually have a hard time keeping nurses on this case long term because of the family...

I sometimes hear people say that RN level PD cases are rare and hard to find....Does anyone else find this?? Just curious. Because I have not. My agency usually has at least a few case openings at any given time. And I even see other agencies advertising PD RN cases in my local newspaper classifieds sometimes. If I wasn't picky about the shift I work, I could have a new case NOW. But I need to wait for the right shift and situation.

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Specializes in Med/Surge, Private Duty Peds.

sorry you are having such a difficult time with mom. right now i am very blesses to have the case i have. i am with this pt till at least may and probably later then that depending on how the insurance goes.

i completely understand the feelings, guess some people have no clue in how to treat professionals like us.

vent all you want, makes you feel better in the end to get it out and over with.

hope a new case comes your way soon!

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Sorry that you are dealing with these issues.... I am sure that you just want to pull your hair out. From doing peds private duty for 11 years I have found that the parents are super involved or not much at all... They just want a nurse for all of the hours that they can get. The ones that are super involved seem to be "anal", as you mentioned. I have tried to figure that one out. I think it is a defense mechanism because they have lost so much control. But it sounds like she goes over the top. I once worked for a family that went to the other extreme. They never changed out the linens or towel and washclothes.. They wanted you to use them over and over... So gross. Whenever I was there for my 12 hour shift I promptly changed everthing out. They never complained (ABOUT THAT). My agency doesn't have "just" RN cases. The pay is so low that they staff mostly all LPN's. I have tried many other areas but I always go back to peds home care. When I was a LPN I couldn't wait to get my RN so I could do something else.... Well guess what.... I'm still doing it and loving it.

I work with a nurse in the OR that does private duty for adults and she makes A LOT more than me. Anyway, good luck to you... I hope that you find another case soon. I personally won't work a case if the parents are there the entire time watching you. I feel like what do they need me for??? TAke care and good luck again..

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Specializes in med-surg, teaching, cardiac, priv. duty.
... from doing peds private duty for 11 years i have found that the parents are super involved or not much at all... they just want a nurse for all of the hours that they can get....it is "nice" to hear that my experience seems typical...families respond in one extreme or the other. the ones that are super involved seem to be "anal", as you mentioned. i have tried to figure that one out. i think it is a defense mechanism because they have lost so much control. you are probably right. this is probably the key "stressor" of pd in my opinion...learning to deal with/accept complex family dynamics and coping mechanisms........my agency doesn't have "just" rn cases. the pay is so low that they staff mostly all lpn's. i guess the only reasons i said "rn level case" is that here most cases are medicaid and i was told that on medicaid cases rn's and lpn's can not be mixed on the same case. either it is a rn case or a lpn case. this may be something specific to my state? i was told that our state has some unusual medicaid rules. and both of the agencies i have worked for were seeming to prefer rn's over lpn's. i think it is a pure money thing. it was indicated to me that medicaid reimburses the agency more for rn's, so the agency can make more money on rn cases. and of course, they don't accordingly pay rn's way more...only slightly more than lpns. grrrrr... i have tried many other areas but i always go back to peds home care. when i was a lpn i couldn't wait to get my rn so i could do something else.... well guess what.... i'm still doing it and loving it.

i feel like i have found a nitch for myself too! just gotta learn to tolerate some of the "family coping" extremes, and move on to a new case when my tolerance is exceeded! haha! ...... i hope that you find another case soon. me too! i personally won't work a case if the parents are there the entire time watching you. i feel like what do they need me for??? exactly!!!......

my reply is in blue...thanks!

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my reply is in blue...thanks!

hello: i'm in maryland i never heard of the rn/lpn difference.. so as you said i guess all states are different. hmmmm, makes me wonder if my agency gets more with me on the case instead of a lpn. they employee mainly lpn's though. it is a fabulous small agency started by 2 nicu nurses and now just one reamains and she is pretty wealthy. good for her!!! i have worked with maxim too. they are alright. had some of the same problems with them as you have. high turnover for inner office staff and they grill you big time if you are sick.. they even told me "i" had to find another nurse for the shift... lol!!!! oh well... good luck to you and keep us posted!!! have a great holiday season...:saint::redbeathe:saint:

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I know what you mean! The pt. I take care of, his mother is always there and sometimes I feel like I am just a babysitter and I don't put the right clothes on him and don't do things her way. Most of the time she is great, but I am a new grad and don't get to take advantage of my skills, except for administering meds and suctioning trachs.

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