private duty peds frustrations

olol765 · May 4, 2007

Keep up the personal boundry...even if it means you don't get homeade baked cookies!! :)

TheCommuter, BSN, RN · May 4, 2007

So what are my frustrations? One thing that has just really gotten to me is that the family shows NO gratitude or thanks at all! The first Christmas I had this job, they gave me NOTHING. Not even a card! This past Christmas they gave me a pair of slipper socks! At least something, but how pathetic! Or you might think that they might on occassion show appreciation in another way - for example, the mom loves to bake and there are often baked goods around. You'd think they might offer me a piece. NEVER!!! And this family is wealthy...not like they can not afford it. I don't know...I guess I am just feeling really unappreciated and taken advantage of.
I've tried to think of any possible way to drop hints that they should show appreciation! But I don't think there is any way to do that! (?)

While I am not too fond of patients and families who are full of ingratitude, I realize that they do not owe me anything. I am being paid, by my employer, to provide nursing care to these people. While it would be nice to receive gifts and goodies from patients as a show of thanks and gratitude, I can do just fine without them.

If I render services, my employer owes me payment. Otherwise, no patient or family member should feel obligated to give me anything, because they are already paying for my services in some way, directly or indirectly.

heron, ASN, RN · May 4, 2007

I know this sounds really harsh, but I'm going to say it anyhow ... are you working for free? I used to work in a setting in which the patient population was primarily street people, ex-convicts and active addicts ... talk about lack of appreciation ... you keep someone breathing all night ... at 5am he extubates himself, calls you some really nasty names and demands his (blank) drugs back! Fairly early in my career I had to get clear on what, exactly, I expected from my work by way of rewards ... and what, exactly, my patients and families owed me ... is it really their job to take care of my sense of self, fulfillment, etc? For myself, I concluded that delivering good care regardless of whether I liked the patient/family, or they liked me, was the difference between the amateurs and the professionals. I earn a reasonable paycheck for the work that I do ... neither the pt nor the families owe me anything else besides common civility.

Of course, saying thank you once in a while is common civility ... but it sounds as though the emotional dynamics of the family are such that you probably won't hear it very often. You weren't very specific about your reasons for believing that the family views you in a negative light ... are they making complaints? Or is it that they are not giving you any positive feedback? Is there any way you can ask them whether they are happy with your care?

Finally ... please don't let my first comment serve to invalidate your feelings. It is sooooo hard to do your best and have it go unacknowledged and unappreciated. I guess I see that as being the down-side of professional boundaries ... some families are just that dysfunctional and there is little that we can do to heal that. Sometimes all you can do is move on ... after 2 years it seems that you've paid your dues here. Good luck and hang in there!

ginger58, ASN, RN · May 4, 2007

Arwen, I tend to go more with your feelings, and I understand the other points brought up. You're in a family home and it would be nice if they'd offer you a cookie or whatever now and then. You're taking care of their loved one, you are getting paid, but you would like a little treat now and then and a "Thanks for your help today". At the hospital I get paid but I also get thanked by the patient or their family and sometimes offered a cookie or piece of candy. I don't think you're asking for anything out of the ordinary--just consideration for the good job you're doing.

Some needy people can suck you dry so it's best to keep the boundaries. Since you're not caving in they may strictly see you as a servant dedicated to their child. I've played a musical instrument for weddings, parties, etc., and some I was treated as a guest and others as a servant. The former is the most pleasant.

ArwenEvenstar · May 4, 2007

WOW! Thank you everyone for the varied responses! I appreciate all of them! Heron - I particularly appreciated your honest, to the point, but balanced response! My personality type is one where I tend to let "little things" get to me, over time this builds up, and I end up in a tizzy eventually. Sometimes I need a friendly slap in the face to give me proper perspective back! So to those who were blunt...thanks I needed that! : )

It is not so much wanting a Christmas gift or cookie. haha! : ) I totally agree the family owes me absolutely nothing. But just an occasional heartfelt thanks or encouraging word would be nice. In my 16 years of nursing (working in a number of different settings and situations), this is the only nursing job I have ever had where I've experienced such a total lack of respect, appreciation or gratitude. I'd expect it if I was working with addicts, convicts or such. But this is an educated, affluent family. Sad really. That they can have so much and be so self-centered and lack common courtesy....

I think that I have either got to:

ACCEPT that this family has "issues", will likely not change, and learn to live with it.

-OR-

look for a new job.

Thanks again for the great replies!

butterfly26pn · May 6, 2007

I think I understand your frustration. I am a person who needs a simple thank you every so often also. Thankfully though I am doing a peds private duty with a great family who thanks me often. Its not that I dont already do a good job but it helps me get through every day and want to do an even better job knowing that they do appreciate what I do there.

I have a question for the original poster or whoever else wants to answer. I am a new nurse and started this peds job a couple of months ago. Like I said I work with a great family and child every day. I dont want to work hospital or nursing home where I will be overwhelmed and behind all day on my work. I enjoy a job to be a little more laid back. The problem is that I recently started to get bored. Ive only been on the job for 2 months and dont know if it will get better. Have I gotton myself into a job thats not for me or should I give it time, I dont want to go hospital , I hated it there during my clinicals in school. Im starting to wonder if I should have even went to nursing school. If I dont like hospital, nursing home, and now am getting bored with peds , what else is left? This has been the best job I have ever had. I simply am getting bored. Any suggestion?

ginger58, ASN, RN · May 6, 2007

Butterfly, there's nothing wrong with you! I would be bored before two months! YOu're right, hospital work is grueling, especially with what is expected of nurses today. What about a more independent unit like NICU, ICU, PACU where you have a limited number of patients at one time? I wish you the best.

allantiques4me · May 6, 2007

Maybe this family cannot afford to buy you Christmas gifts they might be struggling to pay for a half a million dollar house! :lol2: :lol2: :lol2:

ArwenEvenstar · May 6, 2007

I think I understand your frustration. I am a person who needs a simple thank you every so often also. Thankfully though I am doing a peds private duty with a great family who thanks me often. Its not that I dont already do a good job but it helps me get through every day and want to do an even better job knowing that they do appreciate what I do there.
I have a question for the original poster or whoever else wants to answer. I am a new nurse and started this peds job a couple of months ago. Like I said I work with a great family and child every day. I dont want to work hospital or nursing home where I will be overwhelmed and behind all day on my work. I enjoy a job to be a little more laid back. The problem is that I recently started to get bored. Ive only been on the job for 2 months and dont know if it will get better. Have I gotton myself into a job thats not for me or should I give it time, I dont want to go hospital , I hated it there during my clinicals in school. Im starting to wonder if I should have even went to nursing school. If I dont like hospital, nursing home, and now am getting bored with peds , what else is left? This has been the best job I have ever had. I simply am getting bored. Any suggestion?

Hi Butterfly! I'm the original poster. Ya know, I think I am going through the exact same thing as you. To go backwards a little... There are more complex sides and issues in my private duty case than I indicated in my original post. The family has a long history of dysfunctional coping. Adding to this is that former nurses on the case did not have proper professional boundaries, and this enabled the family to go even deeper into their dysfunctional coping patterns. There is a lot to it.

But ANYWAYS, I have had this job over two years now. Although there are some very good thing about this case, I'm thinking that after being in it day in and day out for over two years now - that, well, my tolerance level for certain things has gotten thin. I'm thinking that the monotony of the exact same thing every day has just gotten to me - and I am reacting by over-reacting to little things. (I'm trying to analyze myself! haha)

Anyways, I am seriously thinking I need a new job. Like you - I can NOT go back to a hospital or any other type of chaotic/hectic nursing setting. After almost 14 years of that I am totally burned out!! I just don't know what nursing job that I want! I'm picky in various other ways too (One example: I'm a natural night owl. Can NOT hack day shift) - so that rules out a bunch of nursing jobs right there! Etc. The thought of leaving nursing after 16 years has even occurred to me.

I have thought of one other option - maybe this might be a thought for you too Butterfly? My agency has several private duty cases that are for RN's. I'm thinking that instead of being on only one case, maybe I could be a prn/per diem fill in on several cases. It would still be the more relaxed private duty atmosphere, but at least I'd be on several cases so it would not be so monotonous! And if I'm just working the cases here and there, I won't be getting so tangled up by any dysfunctionality in the families. I think I am going to contact my agency and see if this is an option. My agency also does flu clinics and that would be another easier thing I could do during flu clinic time.

I hope my rambles may have helped...

Cattitude · May 6, 2007

Here's my .02 cents. The family had a nurse that broke professional boundaries before you. And now you won't. I completely back you up on that. I don't believe the nurse should be doing things for the family, you are there to take care of the child. I hate when other staff does that because it makes it much harder on the ones that DO maintain professionalism.

However, the family has now decided to maintain their boundaries as well. See you can't have it both ways if you know what I mean. Now I too think it would be very gracious of them to offer you a cookie or a small token during the holiday but it's not going to happen.

Don't sweat it. I have many patients that I have had for years. Some always give me little gifts at the holidays, others never even give me a card. It's fine by me, doesn't bother me a bit. I still wish them all well and Happy Holidays and give out hugs.

With most of them, I know I am appreciated and thats all that matters. I know that I do my job and they get good care (oh make that EXCELLENT as per PG!).

If it starts to bug you too much, time for another case:)