Quitting long term case

Specialties Private Duty

Published

I am a PD nurse and have worked with this family for over 5 years. I've followed them to 2 new agencies, and used to be the primary nurse on the case for4 years.

Recently (over a years ago) a new nurse came on, and she has caused a lot of problems. Ingratiating herself with the family through gifts, coming to patients bday party with her kids, following family's requests even when it goes against orders/485, causing parents to question why other nurses won't.

Of course, the parents now seem quite unhappy with me, as I won't do or condone these things. They've cancelled my shifts (so she can pick them up, since she "has a family and would prefer to spend more time with them" (I'm happily married l, but haven't been blessed with kids yet... Apparently this makes my time less valuable).

Also, I am fully aware that I working in THEIR home. They are free to set their own house rules, to interact with their nurses as they see fit, to direct their child's care as they deem appropriate. But I do not have to be a part of it any longer. They don't accept my recommendations, question the basic care I give, and want to do everything the way "she"( nurse so and so ) recommends. Even though they are not best practice, or anything close.

I've told the agency, they are aware. They may be following up and taking steps without telling the rest of the nurses in the home. I believe and hope this is the case.

Anyway, I'm done. I've been very fortunate to have an amazing supportive agency who want to keep me happy and working, but I haven't told the parents yet. I'm sure they feel like they are in the right 100%, and I'm not interested in a confrontation. By when I tell them I am leaving, they WILL demand to know why. I've contemplated making something up (my class schedule, another job, etc). But when I leave, I want to at least be honest. They are good people at heart, and I have learned so much caring for their child (my first peds patient ever). I feel that they will continue to lose good nurses behaving this way. I'm not the only one, 2 others on the case have had it with the parents since this new nurse came on a year ago.

I'm leaving, one way or another, and am tempted to leave it at that. Part of me really wants to tell them why I'm leaving, after all this time. And 5 years with one PD patient, is a long time. When they demand an explanation, what would you say? I'm trying to work out the best way to begin this conversation, so that I can remain professional and at he same time, let them know why i no longer feel comfortable in their home.

Thoughts? Please?

Specializes in Complex pedi to LTC/SA & now a manager.

Just walk away. It's not worth it. Work your last shift and be done.

Nothing good will come with trying to explain to the family. You only are obligated to discuss leaving the case with your employer. The family will figure it out. I'd make it clear with the agency why you are requesting to be removed from the case.

Any "explanation" is not necessary and would be unprofessional. You would be attempting to express YOUR dissatisfaction.

The family cannot demand any explanation. Work your last shift... be DONE with it.

Time for a change... enjoy and let us know how it's going.

Thank you, JBN and BTDT. After (too)much thought, I've come to the same conclusion. It's not about me, and my satisfaction or lack thereof. After being with this family for so long, I'm really understanding boundaries in a way I never anticipated. Thank you very much for your input. I will leave as a professional.

Truly, this case has taught me about the need for boindaries in nursing like nothing else could. As you both have posted before, families can turn on a dime. I guess I didn't think this would apply to me... Until it did. Lesson learned. At a relatively low cost, based on some stories here.

Thank you

Specializes in Complex pedi to LTC/SA & now a manager.

No one ever thinks it will happen to them especially if they are the primary nurse in favor.

Walk away. Be done. Be cordial. The why is now the agency policy. If you say something know the odds of it backfiring is very high and can ruin your reputation with the agency and other clients. Parents talk

Specializes in Private Duty Pediatrics.

Finish your last shift and leave. The agency can tell the client that you are moving to a new case and they will bring in another nurse to replace you.

Specializes in Complex pedi to LTC/SA & now a manager.

I'm doing this now. I'm pulling out this week. Funny thing is my office asked, as they always do, that I not discuss with the parent (more problems happen when nurses overshare when they pull from a case. For some reason feel things will change by voicing their concerns and objections to the parents. It never ends well. Ever). The office will contact the family after the last shift is done.

Specializes in LTC & Private Duty Pediatrics.

Hi there:

Nursing is a business, never forget that. You are there to earn a living. The agency is there to make money.

The problem is that we as nurses (and as human beings) actually care for our patients and consequently develop relationships and bonds. Five years is a long time to be on a private duty case. My advice, treat this as a business transaction. It's up to you whether to give the family notice or not. I would not give a specific reason. Just say that you found a case closer to home. Make something up Really, it's none of the family's business.

Once you leave, don't look back. Meaning, don't send Christmas Cards or attend parties. As far as the other nurse goes, who cares. Agency is there to make money. If the family is happy, the agency is happy. Your agency probably considers you a valuable employee. Meaning, you make money for them. In other words, you are a profit center. Let them find you a new case(s) and go from there.

Seriously, don't sweat it.

Hope this helps.

Specializes in Home Health, Mental/Behavioral Health.
Just walk away. It's not worth it. Work your last shift and be done.

Nothing good will come with trying to explain to the family. You only are obligated to discuss leaving the case with your employer. The family will figure it out. I'd make it clear with the agency why you are requesting to be removed from the case.

Thanks you for directing me to this thread. And thanks for your advice

If the family invites you to a birthday party for your current ped client is it unprofessional to attend?

I notice if you keep boundaries you will be labelled as "Not compassionate" and "unfriendly"

I refuse to give out my phone number,but that has made other nurses question my compassion.

The nurses even questioned my compassion because I wear scrubs all the time.

Specializes in Complex pedi to LTC/SA & now a manager.
If the family invites you to a birthday party for your current ped client is it unprofessional to attend?

if you are working during the party find, don't go on your time off, especially if another nurse is working.

Inotice if you keep boundaries you will be labelled as "Not compassionate" and "unfriendly"

I refuse to give out my phone number,but that has made other nurses question my compassion.

Current agency policy is all calls through office not direct to nurses. We get blasts routinely when people circumvent the system. By texting supervisors critical info was missed. I got burned once by a backend deal. No matter how much they ask I don't give out my number to parents or most coworkers. The one group was doing mass texts that included patient info...until someone added the wrong number to the group. That did NOT go over well with anyone. And again blast emails this time from corporate compliance. Field staff is not on call so zero reason for phone number exchange. We have a call center to track an route calls for compliance.

The nurses even questioned my compassion because I wear scrubs all the time.
I always wear scrubs unless Im called to cover a case and I go with whatever I have on and a scrub jacket. The office approved my non clinical attire as it was an emergent situation. Of course blast email again policy is scrubs or a company polo and khaki pants. Shoes on at all times. No flip flops or Crocs. Why? Parents complained. Bus drivers complained. Schools complained. Nurses got too comfortable and too familiar. I know a nurse who always wore yoga pants and a hoodie regardless of the shift or whether they were leaving the home. Transferred agencies. Tried it again except this agency parents know the policy. Only waiver is parent/client request. She was getting comfy and thought she was the bees knees until the parents called to complain about boundaries & her attire. No other nurse wore workout clothes. The clincher may have been the supervisor visit when the supervisor thought the nurse called out because the nurse was cleaning wearing yoga Capri, hoodie & open crocs. The boss thought she was the cleaning lady! We wash our clients dishes not the whole family's dishes and clean up as the child ran amok.

You just keep following policy as it will be to your benefit in the long run

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