Private Duty Nursing

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I am the Dad of a 20 year old Quadriplegic. He broke his neck when he was only 15. He is now a full time student at the University of Michigan. Paralyzed from the shoulders down and one a vent, but is very sharp, confident and determine to live his life. I have the hardest time finding quality and dependable nursing for him, I think its because of the pay. Since its not a auto case, the most the position pays is $23 per hour, so we "gift" another $100-$200 per week and we still can't maintain our nurses. suggestions???

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Are you just hiring on your own or have you worked with home care agencies.

If you work with agencies a lot of times they will put a few nurses on your case and they will always make sure there is someone there for your son even if a nurse has an emergency it is up to the agency to make sure the shift is filled and your son has his nurse when he needs her.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

I work PDN. I wonder if you'd get more response in the PDN area.

Personally, I don't stay on some cases for long if there are major issues or conflict. On the other side of that, I had a case for about 5 years. It depends on the case. I'm sure you can read through the complaints in the PDN forum to get an idea of what doesn't work. The pay isn't great, but I love what I do. So if the pay keeps my bills paid and I'm happy on a case, I'll stay.

I've left cases for a variety of reasons from the extreme to very practical reasons. I've left because the parents/patient were abusive/rude/sue happy/too demanding/too picky about silly things/roach infested home/hoarding or filthy home/ridiculous rules. I've left if a comparable case opened up closer to home or if better hours opened up. I've also left after being shot at (not meant for me, but doesn't matter).

Reasons I stay...clean home, nice family, involved family that educates themselves on good care, being allowed to use microwave/bathroom, respect. Having a comfortable chair to sit and chart or eat is nice. Also wifi is nice...not to abuse, but for down time or night shift. Wifi for wifi calling is nice if the home is located where there is no cell signal or home phone. Being allowed to read or whatever during down time is nice too.

I had one family that didn't allow phones/reading or anything else. We were to sit in a chair facing a white wall all day. The family would call us if they needed us to help them. No kitchen privilege and we had to bring our own tp. They kept the room at 80 degrees. Obviously, they had a high turnover.

Another family had 5 cameras in the pts room and watched us all day from another room in the home. Cameras were around the house. They didn't allow microwave use, soda, pork, and a few other things in their home.

The cases I have now are great. I'll be around for a while. Each family is super nice. Their homes are clean. A couple of them always want to make me lunch/dinner (however, I would feel guilty if I accepted). They offer wifi to nurses for down time. One offers TV and Netflix. They make sure we have what we need to get the job done. They don't flip out if a nurse swaps a shift with another nurse. One case is very similar to how you describe your situation. They just make things simple. The care is timed so most of our day is spent with the pt instead of stopping every few minutes to do a feed or give a medication.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

Oh, and as far as quality and dependable goes...I've seen the worst of the worst and the best if the best. Interviewing weeds through some of the bad ones. You can also have them do something like a trach change or circuit change during the interview and see how they do. I call out for colds/illness and I take vacation with advanced notice. I don't want to make my pt sick so I call out. If possible, I time vacations with the families I work with. You can find nurses that are reliable and good at what they do, but sometimes you have to weed through a few to find what works for you.

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Unfortunately in extended care home health, you may have to go through a lot of sub-par employees before you can find those that are good. That is the nature of the beast. Many agencies are not on top of the supervision required to deal with employees who gravitate to home health in order to get an easy paycheck. Frankly, you should not be paying extra to entice good nurses. The fact that this is not working would cause me, as a consumer, to look at whether or not I should continue to do so. Are you doing this with the knowledge and cooperation of the agency employer? If not, you could be sabotaging yourself with the rare nurse who is strict about maintaining appropriate professional boundaries.

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And BTW, in my very large metro area, agencies pay nurses as low as $14 or $15 an hour to do extended care, $23 an hour is a very decent wage in the overall scheme of things.

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Specializes in Peds(PICU, NICU float), PDN, ICU.
And BTW, in my very large metro area, agencies pay nurses as low as $14 or $15 an hour to do extended care, $23 an hour is a very decent wage in the overall scheme of things.

Keep in mind pay depends on the area. $23/hr may be the norm there. In my area, some agencies pay more than that and others pay slightly less than that. If it's private duty without an agency, the extra may be to assist with insurance/gas. If it's agency and even private insurance, the pay could be more than the wage above. It may not be a decent wage depending on the area.

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yes I do work with an agency. all our nurses must get hire through them first.

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So these are all great responses. first, which i said in my previous response (still learning the site lol) we do work with and agency and a very good one. Our home is clean and we train all the nurses ourselves on his care. we cook, fix cars if they breakdown, cover for them if they need an unexpected day off. My son is incredible and I am not just saying that. We started a nonprofit to help others with brain or spinal cord injuries. We just raised enough money to by a young lady who is in college as well as a quad a new manual chair so she can travel with her friends, it was 13k. We don't use drugs and we live on a lake and have a great view. the night nurses have complete access to the entire house. Now i did paint an incomplete picture. we have two night nurses one has been with us for 3 years and the other is going on her second year. ( it took forever to finally get them) we also have one day nurse who has been with us 3 years as well, she was a student in the college of nursing at UofM with my son but she did have her LPN. She is leaving in July to go to grad school at Georgetown. its sounds like things should be great, heck Me, his mom (my ex) his older brother and sister are all on the schedule each week while they attend school. the issue is that he is 100% vent dependent and cannot move anything below his shoulders. So we have to cover 169 hrs per week. to do this effectively we need 4 nurses to go along with the family schedule and we seem to always stay at 3 nurses or less. Once we find the right person they love us its just so hard to find them. when we lose a nurse it usually takes at least 6 months to find a replacement. I guess I'm just frustrated because I want the world for my son. Any one on this site live in Michigan? We have auto no-fault with no cap so if you are car accident victim, your nurses get paid top dollar I'm talking 30+ per hour. but if you are not an auto case, such as my son, then it goes down to as low as 18 and never higher than 23. I agree that this is good money but its hard to compete with 30 per hour for the same work.

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