Reflections of a Private Duty Nurse

Some nursing jobs don't entail the typical nursing work that most people are familiar with. I want to give a voice to private duty nurses as well as nurses in any specialized field who may feel underrepresented or unsure of their place as a professional nurse.

Reflections of a Private Duty Nurse

I have worked as a private duty home health nurse for almost three years in this is the only area of nursing I have been employed in. In my current position, I work with the same pediatric client on a daily basis in their home, assisting with ADLs, providing skilled nursing care, and just being their companion. My client refers to me as her "arms and legs who she can talk to" as she is physically disabled with a genetic disorder. But as a new and young nurse, I often wonder what I am missing out on in not having the conventional hospital position. Am I actually making a difference? Am I really a true nurse?

When caring for my client, a normal day begins with disconnecting the various medical equipment she has monitoring, feeding, and assisting her with breathing. I lift her to the bathroom, clean, dress her, and then transfer her to her wheelchair. I make her meals and giver her, her daily treatments and medications. If she is in good health, this constitutes my skilled nursing care for the most part besides continual monitoring for needs and performing interventions as they are needed. The rest of my day consists of me just being her companion; helping her with homework, talking to her about her friends, watching her favorite TV shows, going to the mall, etc. It's an admittedly easy nursing job, though I have worked more demanding home health cases prior to this. I can't complain and gripe as many nurses do about high stress, long hours, working holidays, or too many patients. My schedule is flexible, rarely am I faced with life or death scenarios, I don't often work holidays, and I have one patient to care for each day. Because of these discrepancies, I sometimes don't see myself as a legitimate nurse, I don't think any complaints I may have about my work seem valid, and I feel self-conscious about my role in the nursing profession.

I enjoy the nature of my job, the one-on-one care that enables me to provide consistent and thorough care with sureness and connection I make with my clients and their families. On my bad days, I feel like a glorified babysitter whose sills are dwindling away and whose education is being wasted. On my good days, I realize that my services are necessary because if I wasn't caring for my patient then who would? Another nurse probably, but possibly no one and then the family would be stretched thin to have to balance and accommodate the special needs of their child as well as function as a family and provide for their own needs. Their case requires a nurse because of the skilled care involved, so a home health companion, aide, or even babysitter would not suffice. It's a nursing job and if every nurse developed an attitude that they are better than this type of work, the patient and the family would suffer. My client's family heaps appreciation and gratefulness on me constantly and I often feel so undeserving, but any share of the burden that I take on is significant to them.

Therefore, I am serving a purpose. Though my day-to-day routine may seem insignificant compared to that of a nurse in the ED, for instance, but I can assert that I am truly making a difference. I must remind myself often that my initial purpose for practicing nursing, as it is most nurse's, is to serve the weak and susceptible with genuine compassion for their health and well-being. I am certainly doing this type of work and I must maintain this value throughout my practice and realize the bigger picture and what I am, as a whole, contributing to.

There are so many areas of nursing and a lot of different types of nurses needed for the right job. I've determined that my current role and the role I've envisioned for my future is going to be different than that of the majority of nurses who work in a hospital setting. Because if not me then who? I have to own my role with confidence and certainty that this can be my purpose for as long as it suits. I do aspire to continue to advance in my practice, however. I hope to find a position that challenges me daily but that I can maintain proficiency in. Possibly in another specialized field of nursing that I can excel in. Ultimately, I am rewarded in my work by serving others in whatever form that may be. This is the most important aspect of my job and as long as I can claim to do such, I will be a satisfied nurse.

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pearsoaj

About pearsoaj, BSN, RN

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I can very much relate. I have worked PDN much of my LVN career. Just like you I wondered if I was a real nurse or just an over paid babysitter. I would have complex cases & really easy ones. But even the complex ones weren't that stressful. I also sometimes wondered if I was going to lose my skills because I didn't use them much on the job. I'm hoping when I become an RN I can get a hospital job so I can at least have that experience.

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Nursing is unique in that we all can refer to ourselves as nurses, yet what we do on a daily basis varies greatly.

I prefer direct patient care whether it be a hospice job, a home care or having the same patient each day. Yes you are a nurse. You are providing care to a patient that needs and deserves your nursing expertise and sounds like she gains great social skills as you go through your day together. I admire what you do for the very reason that you doubt yourself. Too many times I see nurses questioning themselves and their roles simply because they are not on the floor at a hospital. As nursing takes a leap to employers demanding more training than ever before, (BSN's, MSN's) etc., what happens to the population of patients that require the care of a nurse yet do not need advanced degrees? As baby boomers (me) age, who will care for those who are able to stay in their own homes?

My heart is with these patients, they need us and we make a huge impact on their lives. I'm an older, old-fashioned nurse who went back for my RN only to have my father need me as he was on hospice dying from colon cancer. I quit school (had to) and have been a happy LVN since. I tell you this because I believe that experience with him, and my mom a few years earlier, taught me that where my heart lay in nursing is exactly what I should be doing. I'm IV certified and have gone neck to neck with some nurses with more training & higher degrees. But in the end, it comes down for me to the patient who may be lonely, away from society, and to see us walking through their door can make their day. It's not about losing my skills or worrying about what other nurses are doing in their chosen profession. I also love the closeness we get to have with our patients families. Hospital nursing and some other fields just can't give us the time for that.

Stick with what makes you satisfied at the end of the day. Life's too short to do anything else.

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But as a new and young nurse, I often wonder what I am missing out on in not having the conventional hospital position. No & Yes......nursing is a relative thing as far as what you enjoy doing as it relates to missing out or not. For example, if you have a desire to try ER or ICU go for it. PDN will still be there for you when your knees and back wear out. ;) Am I actually making a difference? Did you really just ask that question? Of course, you are making a difference. In many ways more than an ER or ICU nurse. Am I really a true nurse? Yes......but if you don't feel authentic then you are not taking your PDN seriously enough. My suggestion is to look down at your name bag and stop worrying about how others view you. There will always be those with elitists attitudes who think they are better than you no matter what field you are in. Is ER & ICU harder? Yes, mentally and physically. But to question your authenticity as an RN or if your work matters should never be in question.

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Specializes in Case manager, UR.

I think we make a mistake when we think that nursing is only about really ill patients with complicated conditions and high technical needs. Your patient sounds plenty complex..and you're providing not only companionship, but the security of having an experienced nurse at bedside in case something DOES go wrong. Nursing goes beyond just the routines of a medical or ICU unit....it means being there for your patients and families, having empathy, advocating for them. I am currently no longer involved in bedside nursing but I don't feel that I'm any less of a nurse just because I don't. Your patient sounds really fortunate to have such a consistent and caring person in her life.

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I have been a private duty pediatrics nurse for over 14 years now. I have had so many wonderful lil patients, all with a different story of their own. I have taken care of mostly hospice patient's due to the fact that most nurses did not want to work with them. I did not set out to be a pediatrics nurse but that is where God put me.

I am currently with my first non-hospice patient and he is a wild 3 year old. Sometimes with him, I do feel like I am a babysitter but I tell myself, that is okay. I love my job. He will be having his last open heart surgery this spring and will not require nursing shortly after, if all goes as planned.

My biggest concern now is that I have lost my skills by not using them. I was considered an excellent skilled nurse at one point in my career but now I wonder. I am asking myself if it time to move on to an non-nursing job and if so, What will that be? I just don't have a clue.

My advise to you would be to stay where you feel you are making a difference in your pt's life. Enjoy what you have if you can. If you can't and you are not sure if it is really what you want, find something or someplace while you are still young. Be willing and open minded to explore all the options out there. I am sure you are a wonderful person and God will put you where you are needed most. Hang in there.

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Did pdn as a new grad. I work in a busy ER now and I hate it. It's way too stressful and the patient load is insane. I never get to spend time and talk to my patients. I miss pdn. I liked the family I worked with and I miss them and the stress level was much less. I'm physically and mentally exhausted as a nurse in the hospital. I hate my job. I want to go back. I plan on leaving.

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