question for private duty nurses...any out there?

hi arwenstar, sorry i'm not a privateduty nurse yet so i can't really offer good advice however if it were me, i would suggest you ever so nicely explain to your pt.s family that you too have a life and don't want to get burn out therefore you want to spend some time off on occasion with your hubby. if you were to get burn out then there would be a new nurse to orient to the pt. i think it is your agency & the family's issue to deal with. just because the last nurse on the case spent every waking minute there doesn't mean you have to. there is nothing wrong with having a life. i was hoping you could tell us all you do in a day when at work. what are the pros & cons of private duty?????? how is to be in the house with family all day? do they interfere with your work????? do you have to do housework? what are your hours?? i'm looking to do private duty 2-3 days a week and i'm also going to ltc. 2 days a week(starting this job next week). i love change so i'm giving this scheadule a try. do you like peds pt. or adult/geriatric pt.s. good luck with your dilemma .hope to hear from ya soon.

Since you are working through an agency then just schedule your time off.

You can let the family know in advance, but do not feel guilty about taking your allotede time off. You did not adopt this family, you went to work for them. If they are unable to adjust to your needs for time off then maybe you guys will have to agree on a mutual parting of the ways.

I worked peds HH for a period of time a few years ago and saw similar with a couple of the families that I did shifts with. One family would conveniently leave the other children 7 and 9 home "alone" while I was present in the home. As far as mom was concerned we were free babysitting. Or mom might runn for a massage or a little shopping after work and just happen to be an hour late arriving home because she knew I couldn't leave till she got there.

Some people take advantage.

I took a full-time private duty nursing position last March. (I was totally BURNED OUT at the hospital. I posted about this back in March...) Anyhow... This post is long, sorry. Probably only those who have done private duty will relate or understand. But the main point is: Is getting time off, in general, a problem for private duty nurses?? And how do you best deal with it?

I actually love my private duty position!! It is low stress and the environment is ideal. I work in an upper class home in a fabulous neighborhood. My patient is an 8 year old disabled child. I could never go back to the hospital setting now! Even thinking back about the chaotic stress of the hospital environment makes me shudder!

I found this position because the nurse on the case was retiring. I have now taken over the case. The problem? Getting time off!! This is for several reasons. #1: The other nurse - this was her last case before retiring - and she apparently gave this case ALL OF HER TIME AND EFFORT because it was her last case. This case was HER LIFE!! She did lots of "off time" stuff out of the goodness of her heart for the family. And rarely took a day off. SO... an unfair precedent has been set!!!

#2: This child's care is VERY complex. A nurse couldn't just walk in and care for her without having at least several days of training. And, it seems hard to even find nurses who want to do private duty - I think becasue there are no benefits and you take a pay cut from the hospital setting. I "appeared out of the woodwork" looking specifically for a private duty position, and the agnecy was thrilled I came along just when the other nurse was getting close to retiring. So, finding someone per diem or part-time to be trained as a fill-in for me if I need time off -will be challenging to say the very least!

I am 35 and at the prime of my life. Although I am conscientous and want to do my best, MY JOB IS NOT MY LIFE. My husband (who is also a nurse) and I have very full lives outside of work. We don't have kids and take advantage of that by having full lives. (Hobbies, travel, volunteer work, church involvment, etc.) I need a reasonable amount of time off! My husband gets 5 weeks of PTO a year at his hospital. He takes all of it! (Never saves any of it.) I'd like at least 3 to 4 weeks off.

Actually, my employer (a health care staffing agency) is on my side. My boss basically said, "If you need time off, take it. These parents are not guaranteed or promised a nurse. It is ultimately the parents responsibility to care for the child." This is easy to say from the office, but harder for me to implement when I have to be in the home interacting with the family!!!! Ya know? I have gotten to know the family in a personal way that my boss has not! Sure I can just take the time off, but the parents will probably flip out. I'll feel bad. etc. etc.

Since starting last March, I have taken 3 days off. The most recent day I took off, the mother made some comment like "you aren't going to be taking any more time off for awhile are you?" She said it in a nice way, but the insinuation and the way it was said - is that I had already taken plenty of time off and shouldn't need any more for awhile. THREE days since March is all I have taken! That is like nothing!!! C'mon!!!

Maybe I am just making a bigger deal about this than needed.... But it keeps concerning me. I love this job, but I must be able to have more time off! Any thoughts or ideas out there from other private duty nurses?

Are you working the PD case through an agency or privately? Even though the agency takes their piece of the pie for every billable hour on a PD case, heres an example of its value to an individual. The agency would become responsible for accepting YOUR terms of when you wanted to be off and finding a suitable replacement.

remember-there are no victims-only volunteers.........i don't think you are making too big a deal out of the mother's remark to you-however you should have addressed it at that time....that remark was out of line and it has clearly continued to bother you-but don't let them lay that guilt on you...you are working through an agency so they are responsible for your scheduling and finding a replacement if you need a day off....you can handle this in a variety of ways-let the agency handle your scheduling with the family.tell the agency how many hours you are going to work and the days you are availabe-the next time you take a day off if one of the parents makes a remark to you about it you simply say "this position really suits me but it seems as though i am not meeting your expectations,maybe you would be happier with someone else?" believe me-they will change their tune fast---they just need to be reminded occassionally how lucky they are to have a dependable and trustworthy professional caring for their child.i've done private duty for that type of family and loved it-they could tell horror stories about some of the nurses and aides that came through the door and were so grateful when we met that they could not have treated me better...

Being a nurse and a caretaker of my Mom and brother and having help not by nurses but CNA's, I fully understand about someone not being able to come in and just take over without a learning curve. That is my dilemma also. I would suggest that you give the family/and agency a large time say a month notice to tell them you plan on taking off a certain week, you might also let them know how often you plan on taking off per year. Someone that helps me was kind enough to tell me 2 months in advance. It is then up to the agency to find a suitable replacement that can be trained either by you, or by the parents. I'm assuming since they don't have 24hr care and you're the only one that goes there, they ARE capable of also doing some training. I have 2 agency's I use since one had problems finding someone. These parents need to have someone that can help out if you're sick or ill anyway!

I work private duty and love it, but it has always been a real pain in the neck when it comes to asking for any time off, the staffing coordinator acts like I'm just asking too much. The pay is fair but the way I see it, they don't take out taxes, they don't offer any benefits or insurance, and I don't owe them my soul.

But yes, I know all too well what you mean when you say they don't want to give you any time off. You just have to stick to your guns.

Thanks everyone for your responses!! I appreciate it! This board is awesome. It is great to be able to get opinions from other nurses.

I am planning to make an appt. to meet with my nurse supervisor just to get this off my chest. And clarify the time off I need in a year. I already know the supervisor will be on my side, but it is the family I am worried about...

At first I was debating whether to wait another few months (until I am closer to my one year of employment mark), but I think I need to go ahead and address it now. I've decided that sooner is better than later...since this involves something basic that I require - a reasonable amount of time off! To wait longer, I think, will just prolong/re-enforce the families thinking that only a rare day off is acceptable..... and it is not acceptable!

ThanKs everyone! Arwen Evenstar (aka Laura!!) :)