:angryfire I need to know if there is something wrong with me and if ALL HOME HEALTH private shift cases are usually like this.......because if so then I might not be cut out for this. I work a case that has 2 patients, they are twins and they have seizures, and g-tubes . One nurse for them both, am told by the agency that the state only pays just a tiny bit more for the second pt so not much pay increase for doing both of them. Single parent home and the parent has no home phone, told also that this is NOT Against the law, parent makes NO PHONE CALLS to any physicians or supplies, nurses do EVERYTHING, and I do mean EVERYTHING. Never saw the parent buy one item of clothing, shoes, for them. Nurses buy them all, not asked to, just feel sorry and they do it. Most nurses bring in food for them, because they feel sorry, kids have to go to school for therapies once a week and nurses take them, because this single parent has to work of course. These kids are behavior problems, hyper active not to mention thier medical condition. When family is home they will not even watch them so you can use the bathroom or even eat your dinner! I can't tell if I am just burnt out on doing just this case or if home health just is not for me. I have a hard time understanding how I am the "mom" all the time!! This is the only case I have ever done in home health and I am just wondering if they are usually ALL LIKE THIS? I welcome the comments! Thanks! OH and the agency just looks at us and tells us "its our job" to do all of it!!!
Specializes in med-surg, teaching, cardiac, priv. duty.
I'm a little late posting...
Dang...what a frustrating private duty case! I have done private duty (RN level cases) for 3 years now. I like it. But there are issues. I feel the frustration of the original poster (OP). I am going to be blunt in some of my statements. I blame the parent lack of responsibility on the NURSES that were on this case prior to the OP. The previous nurses ruined it for everyone else to follow!
Ever hear of a professional boundary?!? Nurses are suppose to have a professional boundary between themselves and the patient/family. It is the only way to maintain objectivity. It is imperative to be objective in order to give proper nursing care. You do not help a situation by ENABLING the family to be irresponsible. Yes, sometimes it is hard too be tough/firm, but it must be done! This situation the OP described has gone on for so long it is probably too late to correct it. I wonder if the OP has found a new job yet?? Hope so! Leaving sounds like the only option to me. The OP sounds like a great nurse who actually HAS a professional boundary (someone who is ideal for this job!!) - yet she is having to leave because of the bad situation created by previous nurses. Sad...very sad.
Nurses.... If you can not be firm and maintain a strong professional boundary - please do not do private duty cases! Private duty cases tend to be patients with long-term and severe disabilities. Families have a hard time coping and can respond in different ways. There are often complex psycho-social family dynamics. The nurse must maintain objectivity. If you do not carefully maintain a professional boundary, you will likely get sucked into the dysfunction AND NOT EVEN REALIZE IT! Your objectivity will be gone and you won't even know it. I've observed this first hand in my 3 years of doing private duty.
Although not as severe as the OP's case, my first private duty case ( peds case) had similar issues. I was replacing a nurse who had been on the case for like 5 years. It was her last case before retirement. This nurse had NO professional boundary and essentially socially integrated into the family. This nurse did EVERYTHING and I mean everything - besides direct nursing care, she ordered/monitored all supplies, ordered medications, drove around town (in her vehicle and on her OWN time!) to pick up meds at the pharmacy and other OTC medical supplies, did the child's homework with her, did housekeeping/cleaning/laundry for the family, etc. She also almost never took a day off in 5 years!!!! Well, the family got used to literally not having to do anything in regards to their daughter's care. I mean, the nurse did everything! And because she never took a day off, the family got used to always having a nurse. They never had to step up to the plate and actually take care of their daughter themselves. There was no TEAM EFFORT, the nurse did it all. I unknowingly walked into all this!!
Could go on and on... Private duty cases SHOULD be nice, low stress, easy nursing jobs. But nurses who lack a professional boundary RUIN it for the nurses to follow them by creating families who have grossly unrealistic expectations and do not want to help or take responsibility.
Well, I have essentially just ranted and raved.... Sorry. As you see I have strong feelings. If you can't be objective and maintain a firm professional boundary, please stay out of private duty!!!!! Don't ruin it for everyone else!
AMEN!! thank you!!! Everything you said was so true! And yes, I did leave and found a new job. It was sad that the nurses that were NOT PROFESSIONAL , ran me off, and I was a GREAT nurse and professional.
ArwenEvenstar
308 Posts
I'm a little late posting...
Dang...what a frustrating private duty case! I have done private duty (RN level cases) for 3 years now. I like it. But there are issues. I feel the frustration of the original poster (OP). I am going to be blunt in some of my statements. I blame the parent lack of responsibility on the NURSES that were on this case prior to the OP. The previous nurses ruined it for everyone else to follow!
Ever hear of a professional boundary?!? Nurses are suppose to have a professional boundary between themselves and the patient/family. It is the only way to maintain objectivity. It is imperative to be objective in order to give proper nursing care. You do not help a situation by ENABLING the family to be irresponsible. Yes, sometimes it is hard too be tough/firm, but it must be done! This situation the OP described has gone on for so long it is probably too late to correct it. I wonder if the OP has found a new job yet?? Hope so! Leaving sounds like the only option to me. The OP sounds like a great nurse who actually HAS a professional boundary (someone who is ideal for this job!!) - yet she is having to leave because of the bad situation created by previous nurses. Sad...very sad.
Nurses.... If you can not be firm and maintain a strong professional boundary - please do not do private duty cases! Private duty cases tend to be patients with long-term and severe disabilities. Families have a hard time coping and can respond in different ways. There are often complex psycho-social family dynamics. The nurse must maintain objectivity. If you do not carefully maintain a professional boundary, you will likely get sucked into the dysfunction AND NOT EVEN REALIZE IT! Your objectivity will be gone and you won't even know it. I've observed this first hand in my 3 years of doing private duty.
Although not as severe as the OP's case, my first private duty case ( peds case) had similar issues. I was replacing a nurse who had been on the case for like 5 years. It was her last case before retirement. This nurse had NO professional boundary and essentially socially integrated into the family. This nurse did EVERYTHING and I mean everything - besides direct nursing care, she ordered/monitored all supplies, ordered medications, drove around town (in her vehicle and on her OWN time!) to pick up meds at the pharmacy and other OTC medical supplies, did the child's homework with her, did housekeeping/cleaning/laundry for the family, etc. She also almost never took a day off in 5 years!!!! Well, the family got used to literally not having to do anything in regards to their daughter's care. I mean, the nurse did everything! And because she never took a day off, the family got used to always having a nurse. They never had to step up to the plate and actually take care of their daughter themselves. There was no TEAM EFFORT, the nurse did it all. I unknowingly walked into all this!!
Could go on and on... Private duty cases SHOULD be nice, low stress, easy nursing jobs. But nurses who lack a professional boundary RUIN it for the nurses to follow them by creating families who have grossly unrealistic expectations and do not want to help or take responsibility.
Well, I have essentially just ranted and raved.... Sorry. As you see I have strong feelings. If you can't be objective and maintain a firm professional boundary, please stay out of private duty!!!!! Don't ruin it for everyone else!