3.24.95

I wish I could say something good or encouraging, but the following comes with a lot of experience and tenacious effort and desire to work things out. If you're lazy, complacent and comfortable with parents that refuse to accept that their child is sick/needs medical attention, you'll do great. And pray that the recruiters/schedulers aren't manipulative bullies, cuz I swear, it's becoming a job requirement. And the more kind, flexible, experienced and intelligent you are, the more you'll pay. I've been written up for things that didn't happen. One so bizarre, I asked the office director "what inappropriate thing did I do...that she (the on-call supervisor) apologize for...?" The director said she asked the same thing. I was written up based on 2nd and 3rd hand comments/accusations, from co-workers, that I had expressed concern about. With no input from me. The next time I saw Mom, she said "I want you to know, I didn't call the office." I was written up for confirming the status/dates of some unlabeled trachs, with PCG. I rearranged a few things to make them more accessible and easier to inventory, and asked Mom if she was OK with it. She said "looks great." The night nurse put everything back the way it was, and apparently mom called and c/o me rearranging things, to the point that no one could find them. I was devastated when I overheard -- she didn't realize she hadn't hung up -- our new Nursing Supervisor mocking and ridiculing me, to her superior. I had never met either one of them. I wish I could say I was exaggerating, but I've worked at the 3 biggest, in my area, and above is just a fraction of the insanity that is Private Duty Nursing.

I assumed the reference to "Home Health" was actually "Private Duty," as that's how Aveanna/PSA/Maxim, Bayada (mostly) refer to themselves. I did HH years ago & loved it! PDN, not so much

Truth!!

Based on a lot of experience, observation and fact -- IMO -- HH is neck-n-neck with the majority of "nursing homes," as the most "hostile work environment(s)" in the medical field. If doing the right thing, making a difference in people's lives and helping those less able is truly what you're looking for, you will not find it in any agency that I'm aware of. In fact the more compassionate, helpful and intelligent you are, the more likely you will be taken advantage of and manipulated. I wish I could offer something more encouraging or positive : / but my honest recommendation is Don't. Do. It.

I'd rather live under a bridge, than work for Maxim. Literally.

Your assumptions lead me to believe I would fall within your "generalization." Except you would be wrong. Only after 2 years of hellish emotional abuse, at the hands of my ex-husband, did I realize the compassion I'd always possessed, but was under-utilizing. I can't take much credit, as doing the exact opposite of my abuser became a habit. And yes, I speak up for others, whether it be a patient, fellow nurse or the janitor. I've always been a good & caring nurse, now I experience genuine joy in helping the disadvantaged, those unable to help themselves and less able than others.

I have run out of adjectives in which to describe how insanely unjust and unfair the at-will system is. In the same meeting -- with a very abrupt request, abt 10 minutes in, for me to go sit in the waiting room, "so me (DON) and Administrator can talk" -- I went from a great asset that they really needed, to "we don't think this is the right setting for you." You could have knocked me over with the proverbial feather! DON and Rehab UM knew I was the right person for the job, but were intimidated/jealous of my knowledge, experience and even self-honesty...creating things to nit-pick, sabotaging my every move/decision, taking credit for my ideas/work, and so much more. I confronted them -- together -- on a couple different occasions about contradictions and conflicting information. The DON always spoke first, then they'd work off each other, moving goal posts, creating nonsensical rules and citing nonexistent policies, in order to support one another/not look like an incompetent idiot...the irony. It was a truly bizarre experience. But research indicates 2-out-10 persons in supervisory/managerial roles are bonafide psychopaths, and I've had the misfortune of encountering so many, that I think it's more like 3 or 4 out of 10 : / For what it's worth, I was granted unemployment. Not easy to do, when you're terminated.

Agreed, thanks for the reminder!

Thanks for your input ladies. I gotta run, prep for 9 days in a row, not all 8’s & 12’s, but payday is gonna be sweet!

Thanks! I’m going to check it out.

If I hadn’t witnessed the Dr calling back, suggesting an abx — less than 30 minutes after her initial call, indicating culture was negative — I would have a hard time believing it! I’m 99% certain primary nurse played a role in that as well. It’s frustrating, and sometimes very upsetting, but I’ve just learned to do what I can, within reason, and roll with it.

Agreed, but unfortunately Drs have the power to override manufacturer’s directions, although infrequent, and only after the PCG has worn them down, and insists on sticking with whatever technique their primary of 5 years “has always done it.”

Exactly! Unfortunately his chubby chin will not allow this, leaving his trach wide open to RA, with a whiff of O2. Hand-to-heart, every time I walk in the door his SaO2s are in mid-90s. After I position collar as it should be, I’m able to turn his O2 down, by a liter or 2, and maintain 99-100.

I’m open to new ideas, and will definitely check our Aaron’s page, but as a policy-nazi, and germaphobe, I’m sticking to my agencies policy, until it changes, or I have a Drs order to do differently.

I guess technically “sterile procedure” isn’t appropriate terminology, but used more to encourage maintaining as sterile of a field as possible, not touching the cannula, etc. Based on a lot of research, my take is that trach care/changing is somewhere between aseptic<clean. Semantics aside, I guess you had to be there to see how careless and nonchalant this nurse was. Despite Drs orders/POC, and our agencies policies — both based on manufacturer’s recommendations — she had no clue what she was doing. She inserted a Bivona with no obturator, positions clients trach collar upside down, and wonders why his SaO2s are so wonky, and why his secretions are so thick, flowing non-stop. As a direct result of this, his pulmonologist recently put him on Augmentin, which caused diarrhea, resulting in a drastic increase in sz activity. That’s nuts! Mom is somewhat involved, however not very hands-on at all. She’s nice and laid back, but clearly doesn’t like the thought of “rocking the boat.” She did back me when I was nearly accused of fudging my documentation of SaO2s of 99-100. Anyway, I’ve just decided to follow protocol/policy, that way my butt is covered, regardless of how “unpopular” it makes me.