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ArwenEvenstar

ArwenEvenstar

med-surg, teaching, cardiac, priv. duty
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ArwenEvenstar specializes in med-surg, teaching, cardiac, priv. duty.

ArwenEvenstar's Latest Activity

  1. ArwenEvenstar

    Private duty forum???

    What has happened to the private duty forum? It used to be a sub-forum of home health, which I thought was a good placement for it. Then it was briefly its own separate forum. And now it is just gone. Where is it? Private duty is a very unique area of nursing with its own unique issues. PD nurses need a forum. Hope it re-appears.
  2. ArwenEvenstar

    I'm a nurse. Not a housekeeper!

    Yeah! Private duty (through agency) is low pay nursing around here too. I'm a RN. I took a 40% pay cut from the hospital when I made the switch. And, at the hospital I was at, you always got a yearly raise. In the 4 yrs of private duty, I never got a raise. So the pay difference only got worse with time!! I was willing to take the pay cut for less stress. But after several yrs, private duty got to me to - family drama, nurse's lacking professional boundaries causing all kinds of trouble, etc. I also agree with another response (nurse156) that pay is not the point here, nor is it about "sitting around" when you could be helping the family clean. It is about being a professional nurse. I found out that if you gave an inch, the families tended to take a mile! I would keep the PATIENT'S area clean, and do cleaning RELATED to the patient's equipment and such. But nothing for the family at all. It is too easy to get sucked in...and soon you are doing all kinds of things for the FAMILY, and the patient is being neglected. Or you have lost objectivity and do not even realize it. I saw things spiral out of control very quickly in private duty. Focus on the nursing care!
  3. ArwenEvenstar

    Maxin nsg per diem

    I may have discovered the reason this thread has not disappeared (yet at least!). The title of the thread is mis-spelled as "Maxin". So maybe it is evading some searches by the powers that be. Maybe that is the key - refer to Maxim as Maxin! Spread the word nurses! haha.
  4. ArwenEvenstar

    Maxin nsg per diem

    If I did not work for Maxim myself for 2 yrs, I would have a hard time believing this! But I did, so i do!! I was "harassed" by Maxim too. For example, they would call me MULTIPLE times about the SAME shift. But if i am not available, I am not available. Asking me 5 times is not going to change my answer!! I could give so many examples of highly unprofessional and discourteous behavior. By the way, negative post threads about Maxim are disappearing. One did today. And several old post threads about Maxim are "gone" too. One of the threads in particular had invaluable insights from many nurses from all over the USA with similar concerns and complaints about Maxim. There seems to be censorship going on!! What happened to free speech? There is a difference between libel or an attack, and simply sharing your honest experience. Many nurses have had not-so-good experiences with Maxim. Can this not be shared? Or can we only say wonderful and great things? I speak up BECAUSE I do not want other nurses to go through the nightmare and frustration that I did working for Maxim. Or so that they can at least go into it with their eyes wide open. I walked in blind. My experience with Maxim might not have been quite so bad if I had known some things ahead of time. For example, it is helpful to know how their offices are run - by young men in their early 20's with sales/marketing degrees. Or if I'd been told ahead of time to put all schedule requests in WRITING, because confusion and disorganization and schedule mix-ups were common place. If I'd understood the system to begin with, I could have dealt with some things differently to start with. Lets see if this post disappears now. I have noticed on several other employer review sites that similar things are happening - negative things on Maxim are disappearing, or posts are being made to defend Maxim and counteract the bad reviews. Makes me wonder if Maxim is behind this? ARE they putting pressure on various sites to keep negative things off???
  5. ArwenEvenstar

    fairly new grad in private-duty nursing, question about orientation

    My first agency...a "mom and pop" one...a new nurse on a case would always orient by working a shift or shifts with another nurse on the case. If it was an easier case, the orientation might just be half a shift. But a high tech case, you could get up to 3 or 4 days!! Also depended on your past experience. I know this agency lost money paying 2 nurses to be on a case. But they were very thorough, and pro-nurse, and wanted to be sure the clients got proper care. I know now how very unusual this was! At Maxim, orientation was just in-service materials at the office. They said that the parents oriented you in the home. Generally, parent orientation would work. (As above posts mention...good parents will want to properly train you. And would never leave you alone with their child until you felt confident, and until they were comfortable with your skills.) But there are exceptions! I remember one high tech case where the family had basically withdrawn, let the nurses take over, and they really did not know all the details of caring for their own child. Sad, but true. An in-experienced nurse would NOT get a proper orientation by this family. And Maxim of course did not care. With home care in general (but especially with an agency like Maxim) the nurse needs to be pro-active. Know what you know, and know what you don't know. May need to refuse a case, if you can not get an adequate orientation whether from the agency or the family.
  6. ArwenEvenstar

    Liar Liar pants on fire!!!!

    i take it you are independent and not through an agency since you say there is no supervisor. yes, this is tough - even if you have a supervisor. i once resigned a case (through an agency) because of a nurse that was not only telling lies but being grossly incompetent with pt care. the family, initially at least, only saw this as "nurse drama". when it all began, i initially had the backing of the supervisor at the agency. but then, wouldn't ya know, the agency was sold to a new company and most of the management left! i was left with no one who knew me (that i was the competent nurse on the case) and the details of the situation. the new supervisor was no help at all and seemed to perceive me as the problem! i quit because i feared getting fired. i felt so torn up - leaving the pt with this incompetent nurse and a clueless new supervisor!! but sometimes you have to do what is best for you. this other nurse really scared me...i feared getting falsely accused or my license being put in jeopardy. the story is a long one...i eventually ended up back on this case through another agency...because the family eventually realized how incompetent this other nurse was. so i don't really have any advice, only my story. private duty has unique problems, and each situation a bit different. maybe start a new thread, as some might not see this at the bottom of this thread.
  7. ArwenEvenstar

    Liar Liar pants on fire!!!!

    My last agency was not always forthright either. Kyasi, I too wondered at first why they would waste the company's time and money in the hiring process if they did not have the hours/locations/case types the nurse was interested in or available for! But after seeing the situation more at Maxim at least....Maxim was very sales oriented, and I think they just wanted as many nurses "on the role" to call as possible to fill cases. Any warm body would do. They saw nurses as chattel to make the company money. Also...They would literally HOUND me to work (calling me multiple times about the same shift at times!) - but if I was not available, I was not available. I came to the conclusion that too many of the nurses must have been VERY lacking in assertiveness and easy to manipulate....and would end up saying yes after being called for the 3rd time, even though the shift hours or location or type of pt was NOT really good for them.
  8. ArwenEvenstar

    Give prn meds because Mom said to give it?

    If the parent wanted me to give a med that I did not have an order for, or wanted me to give it in a way that was not ordered, I would simply say something like "I do not feel comfortable giving this because my orders don't match, but you are free to administer it yourself." Usually the med was something appropriate, but I just would not risk giving without an order. The parents I dealt with had no problem with this. They understood my caution. (But I know some parents would not be and would be annoyed at you!!) If they gave it, I would just document in notes that "Parent gave ______." I'd make sure to touch base with the office to get the order clarified, so I would be able to give it in the future. I would never give a med, even something benign and OTC like Tylenol or a basic cough syrup without an order. Other nurses would though! I remember several times calling and getting an official order for something that the parents and other nurses had just been giving for days with no order!! And no one documenting giving it, because there was no order. The stuff that went on never ceased to surprise me...
  9. ArwenEvenstar

    Did I make the right decision

    Sadly it is often the dependable, professional nurse that does a good job, that is booted or forced off the case....because the manipulative nurse (who also gives shoddy care) has wrapped the family around their finger. And, the family is blind to it. (But, of course, manipulative family can be part of it as well...) I was forced off a case once....even though I was the good guy! It is so very rare to get vindication in life. Usually you just have to live with the injustice. But I was vindicated...The manipulative nurse giving unsafe care...the situation finally blew up in her face big time! She was fired. And the agency and family begged me to return to the case. I did. The family treated me much nicer after this and was so appreciative that I returned. They even admitted their wrong doing and apologized for not listening to my concerns. I was in shock! haha! So rare this happens in any realm of life!
  10. ArwenEvenstar

    Dangerous home, what to do?

    I think some of the later posts are perhaps misunderstanding the earlier posts. I do not think being evasive about the problem in the home was exactly encouraged, but the unfortunate reality is that some agencies just do not care, and this was presented for the reality that it is. Someone new to PDN agency work, might naively assume the agency would be totally supportive. For example, someone posted "I actually resigned from a job BEFORE I started because I was assigned to an unsafe patient with psych issues and guns in the house (other nurses from the same agency had warned me about said patient) and complained about it, got berated and pooh-poohed for refusing the assignment and told they wouldn't schedule me for any different assignments until I did a few shifts with the unsafe patient, so I resigned. " Case in point! Be prepared that your agency may not support you at all, and you may have to resign. But, of course, speaking up honestly is the right thing to do!! Do the right thing! But be prepared that you may lose your job. When you are a PDN through agency, you must be very assertive. Often the only one who will care about you, is you.
  11. ArwenEvenstar

    Dangerous home, what to do?

    Agencies often just want to turn a blind eye to "problems" in a home...Money is often the bottom line, and they want to keep the case and keep nurses on the case. They don't like nurses complaining or bringing up issues, because that just makes their job harder. Just go to work and make the agency money! Keep the machine running! Some agencies are worse than others. One that starts with "M" is particularly money hungry. To be more positive...I did work for a mom and pop agency that DID truly care about the nurses, and patients too. Situations were carefully sized up. It was great to have a supervisor who you knew would back you up, and take your concerns seriously, whatever they might be. I was so sad when they retired and sold to a national chain...everything changed then.
  12. ArwenEvenstar

    what do you do in a shift?

    Caliotter3, your reply made me laugh (in a good way!). Isn't it amusing that when one hears about total disorganization and confusion in an agency, the assumption is that it must be Maxim! Maxim has quite a reputation! So frustrating to deal with them! Yeah, run fast away from Maxim if you want to keep your marbles or not develop anger management issues.
  13. ArwenEvenstar

    Maxin nsg per diem

    Do a thread search, you will find plenty of posts about Maxim already...mostly negative. My experience with Maxim was a nightmare... unorganized, unprofessional, constant schedule mix-ups, etc! Avoid them is my advice!
  14. ArwenEvenstar

    heartbroken

    I feel your pain Blissmiss! Sometimes I think of private duty as nursing's best kept secret and other times as nursing's best kept nightmare!!! So many complex psycho-social issues with these families. If you give an inch with these families, they will take a mile. They will take all you will give, and more! A firm professional boundary is so imperative. You stated that the families "seem to not understand that it is primarily a business/professional relationship and you work and are paid through the employer and have to follow their rules and guidelines." I agree totally!! Unfortunately, however, I also found that nurses were often as much of the problem as the families! In 4 plus yrs of private duty, I encountered so many nurses who totally lacked a professional boundary, essentially socially integrated into the family, became their close friend, lost all objectivity, caved into all whims....and this caused so many very serious problems! You sound like a great nurse with good professional boundaries! If more nurses could maintain a firm professional boundary, I think many of the problems we encounter with private duty would be eliminated because the family would see a consistent front and would see that they could not push the nurses around!! Unfortunately, my experience was that professional nurses who keep a boundary are far and few between. I came to the conclusion that something about private duty seems to attract unprofessional, co-dependent nurses, with no boundaries! Sigh. Sorry I am so cynical. You also state that "it would be helpful if the agencies would brief you on these things in the beginning." I totally agree, and have posted on this before. I think all agencies should have some type of mandatory in-service on the psycho-social issues you typically see with these families, and emphasize the critical importance of the nurse maintaining firm professional boundaries. But no...they send you in "blind".
  15. ArwenEvenstar

    Taking Time off

    Ohhboyyy! Welcome to private duty or shift work!! Most unfortunately, your experience was typical and common during my 4 plus years of doing shift work in the home through agency! I worked through 2 agencies. First one seemed to have a serious lack of qualified nursing staff. If I needed off there was literally no one to replace me. And I worked this case full-time for 1 and 1/2 years! Well, sorry, but I can not work full-time and never have time off. I have a life and like to take vacations and such. The family would literally have a conniption and make me feel so guilty for taking time off. I would give a HUGE advance notice too. I stood my ground and took time off...but it was stressful. You MUST stand your ground - this family would have had me working 7 days a week, 365 days a year! Second agency seemed to have a better pool of qualified staff but was grossly unorganized. You would tell them weeks ahead that you were taking a certain day(s) off and they would just forget and they never notified the family. Communication was atrocious! Basically, if you are a responsible and caring nurse and wanted your patient to have a replacement nurse when you were off, you would have to: tell the family yourself that you would be off, and notify the agency you would be off, and then you would have to call the agency over and over and over again to keep reminding them of your day(s) off!! SERIOUSLY! This is ******, and I am not afraid to say it! What a nightmare. I started putting all my requests for time off IN WRITING so I had proof I had properly notified them. I no longer work for Maxim! YOU ARE CORRECT IN YOUR POST... All you should have to do is notify the agency once, and NOT tell the family. It is the agencies responsibility to do the schedule and notify the family. The agency is suppose to be the liaison so that things stay professional. Unfortunately, this is not how it plays out in real life. Sigh.
  16. ArwenEvenstar

    Is there a national private duty agency that you would reccomend?

    Best agency I ever worked for doing private duty was a smaller, locally run "mom and pop" agency. "Better" pay (as good as you can expect for private duty), a personal concern and interest for the nurses and the patients, little perks you usually don't get with agency work, etc. They retired and sold to a national chain and things then changed. Sigh. I would NOT recommend Maxim for multiple reasons! Like above poster, I have heard good about Bayada. PSA is a possibility for a national chain. They used to have a bad repetition, but it seems they have improved in recent years. A friend of mine locally works through PSA and has had a great experience. I think the "problem" with national chains is that individual offices can vary greatly depending on their management. One location may be excellent and another may be terrible. Maxim seems to have consistent complaints all over the USA, but even with Maxim there seems to be an office here and there doing a decent job. BUT still...avoid Maxim is my advice. Too many consistent and similar complaints nationwide. Whatever agencies you consider, just ask careful questions and make sure you feel comfortable.
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