"Wasteful Nurses"

[eeffoc_emmig]

Apparently, my new patient's mother thinks we're all "wasteful nurses". I already bring my own hand sanitizer and hand towels for my own use, now I have been informed that I must bring my own hand soap and toilet paper. She says we're all so wasteful and will no longer let us spend her hard earned money.

I'm starting to rethink staying on this case. I accepted the no TV/internet use rule and the bar stool to sit on in the kitchen alllll night long, but no there are more rules. I would never treat nurses like this if they were in my home caring for my child.

[ceebeejay]

Interesting!

Why would they choose to do that instead of giving it at the doctor's office?

It was their insurance company that set it up that way. I believe because then they only have to pay for the immunization, not the administration, because they only pay for "nursing care".

[ceebeejay]

I was talked to about drying my hands with paper towels. Apparently, they're considered luxury items, to be reused 2 or 3 times before being thrown away.

They should have a microbiology course for parents.

Most ridiculous request...

The dining room and living room were basically a "great room" but you could literally take one step and be in the living room. I moved a dining room chair next to the portacrib in the living room. I was asked not to do that. Seriously? I put everything back when I am done! Actually, I was TOLD to not do that. I was also asked to use the disposable suction caths over and over. If it's within 5 min, fine, but like for hours. NO!

[toomuchbaloney]

It is not cheap for family members to provide long term care for a loved one in their home. It costs a lot of money, in fact, and the emotional costs are not as easily measured or counted.

Try not to take most of the stuff too personally.

Create impeccable professional boundaries.

Communicate unreasonable or unacceptable behavior, communication, or expectations to your employer.

Do not sacrifice your health, your finances, or your job satisfaction for a manipulative, controlling, or poorly adjusted family.

[meanmaryjean, DNP, RN]

Interesting!

Why would they choose to do that instead of giving it at the doctor's office?

Because he's vent-dependent and there is a nurse in his home who is capable of doing it.

[meanmaryjean, DNP, RN]

They should have a microbiology course for parents.

Most ridiculous request...

The dining room and living room were basically a "great room" but you could literally take one step and be in the living room. I moved a dining room chair next to the portacrib in the living room. I was asked not to do that. Seriously? I put everything back when I am done! Actually, I was TOLD to not do that. I was also asked to use the disposable suction caths over and over. If it's within 5 min, fine, but like for hours. NO!

Medicaid only supplies one suction cath per day for our trached/ vented kids. They MUST be re-used.

[CloudySue]

Medicaid only supplies one suction cath per day for our trached/ vented kids. They MUST be re-used.

Penny-wise and pound-foolish. A respiratory infection and hospital admission d/t using unclean caths would end up costing a whole lot more than an extra case of catheters.

[meanmaryjean, DNP, RN]

Penny-wise and pound-foolish. A respiratory infection and hospital admission d/t using unclean caths would end up costing a whole lot more than an extra case of catheters.

Don't I know it!

[xoemmylouox, ASN, RN]

Interesting!

Why would they choose to do that instead of giving it at the doctor's office?

Also every time that child is taken to the MD office they are exposed to illness. During the Flu/RSV season we prefer to give them in the home vs the child going in for this injection. And yes some insurances only pay for 1-2 suction caths a day meaning the have to be reused over and over and over again. I hope someone told you that before you went through 15 in a day or that pt is going to run out way earlier than expected.

[ceebeejay]

Also every time that child is taken to the MD office they are exposed to illness. During the Flu/RSV season we prefer to give them in the home vs the child going in for this injection. And yes some insurances only pay for 1-2 suction caths a day meaning the have to be reused over and over and over again. I hope someone told you that before you went through 15 in a day or that pt is going to run out way earlier than expected.

This is just about the insurances preference. I have other patients who are required by the insurance to get their injections at the MD office.

The caths were disposable, single use only, PT received 500 a month. I was the nurse that had to check supplies and made the request for the increase to the MD because this pt required frequent suctioning.

[brillohead, ADN, RN]

I, too, am skeeved out by reusing suction catheters. Fortunately, while not enough to use a fresh one every time, we do have enough extras on hand that on particularly nasty days, I can pitch one early and pull out a fresh one.

Just as bad -- reusing inner and outer trach cannulas, you know, the plastic ones that say, "single use only, do not clean, do not reuse". Why on earth do they only cover TWO A MONTH??? Surely they don't expect us to leave them in place for two weeks straight, do they? Because THAT sure wouldn't end up with a kid in the hospital with all kinds of infections, would it?

Who comes up with these stupid ideas, anyway?

[ventmommy]

These threads always irritate me. If a family legitimately can not afford toilet paper, it should be the agency's responsibility to supply it for the nurses. The parent/agency relationship as employer is a tricky one to define. That being said, I don't think it should ever be the employee's responsibility to bring her (or his) own toilet paper to work.

Medicaid, at a minimum, will supply 90 suction catheters per month and an unlimited amount based on doctor's orders. My son was getting 600/month when he was placed with us and I had it bumped up to 750/month while still on Medicaid. Once on Tricare, I was able to get it up to to the 900/month that he needed. The doctor wrote a letter justifying the need and explained that a 7-day hospital stay could cost over $150K and that the suction catheters were just a few hundred dollars thereby making it in the interest of Medicaid to provide the necessary suction catheters.

No other medical employer would expect that a nurse should write her notes sitting on bar stools, the floor or child-sized chairs and it's disgraceful that home nursing agencies find it acceptable.

I didn't have paper towels for routine use. Each nurse got a clean hand towel at the start of her shift. If she needed additional towels, she was welcome to take them. I also didn't allow hand sanitizer and obsessive use of sanitizing wipes for hard surfaces. I know one other vent mom that also banned hand sanitizer.

I required gloves for all diaper changes. In the event of a suction emergency, you'd take the gloves off and have clean hands instead of fumbling to clean them and trying to get gloves on. My husband and I used gloves as well for diaper changes for that very reason. It's entirely possible, with good technique, to not touch the part of the suction catheter that enters the trach tube.

[KATRN78]

I, too, am skeeved out by reusing suction catheters. Fortunately, while not enough to use a fresh one every time, we do have enough extras on hand that on particularly nasty days, I can pitch one early and pull out a fresh one.

Just as bad -- reusing inner and outer trach cannulas, you know, the plastic ones that say, "single use only, do not clean, do not reuse". Why on earth do they only cover TWO A MONTH??? Surely they don't expect us to leave them in place for two weeks straight, do they? Because THAT sure wouldn't end up with a kid in the hospital with all kinds of infections, would it?

Who comes up with these stupid ideas, anyway?

because they are expecting the family to pick up the cost of the additionally needed supplies.

Technically the "kids" who get that government check each month, that should be going toward their needs.