Was I wrong?

Specialties Home Health

Published

Specializes in HH, Psych, MR/DD, geriatric, agency.

I recently had an in-home orientation with a new assignment that raised red flags for me.

1] Family required/wanted more care than what I was being sent there for. A 3rd child that needed repositioning through the night while Mom slept. Mom wanted dishes/laundry done for the entire family at times, not just for the two children I would be caring for.

2] Mom's house rules require no television, no radios, no laptops, etc. Nurses are to be quiet and sit at the kitchen table until the children needed repositioning after HS care is completed.

I called the office this morning to clarify for myself what was expected of me and the (I feel) unrealistic expectations from Mom on the night nurses. I relayed to the office my concerns (legally and professionally) over repositioning a child that I am not there to serve (What if one of us were to be injured??). I also expressed my concerns over being able to stay awake without some kind of visual/auditory stimulation (I fall asleep if I read, so that was out). I asked if I could use a personal, portable DVD player at the kitchen table... "Not if Mom is against it" was the answer I got. Which I have no problem with house rules, but how are we supposed to stay awake??

So anyway, I was excited to get this case... easy, good pay, great kids, etc. But when the office called me back (after discussing my phone conversation amongst each other, I assume), I was essentially fired from that case... "We won't be sending you back".

Was I wrong to express my concerns? Was I over-reacting?

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No, you were not wrong. I would not have bothered expressing my concerns expecting to get consideration, I would have told them an outright "no". There was too much in your post that told me this is not the case for me. The fact that the agency is, as usual, siding with the family instead of backing up the nurse on certain issues, tells me you might be better off with a different agency.

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No you were not wrong. I would be happy they told you that they are not sending you back, otherwise I would have said don't send me back. When I was working as a home health aide, I had a situation where a mother called my agency and said I broke a Nintendo Wii, and not only did I not break one but in the 6months I provided care I had never even seen one in their home. I told my company this, and they called me two times to confirm I was sure I didn't break it. Needless to say my company reimbursed the money she said it costs and they never scheduled me for that client again. Good riddance.

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No you were not wrong. I would be happy they told you that they are not sending you back, otherwise I would have said don't send me back. When I was working as a home health aide, I had a situation where a mother called my agency and said I broke a Nintendo Wii, and not only did I not break one but in the 6months I provided care I had never even seen one in their home. I told my company this, and they called me two times to confirm I was sure I didn't break it. Needless to say my company reimbursed the money she said it costs and they never scheduled me for that client again. Good riddance.

There was never a Wii in that house, as you observed. The mother wanted one and figured out a clever way to get your agency to buy her one. Rotten people everywhere.

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Specializes in med-surg, teaching, cardiac, priv. duty.

OP - no, you were not wrong! Some of these families...:uhoh3: Even sadder that the agency did not back you. Nurses are not there to do dishes/laundry for entire family! Or care for other children! I can't quite understand these agencies?! When they don't back a good nurse, they lose a good nurse! When they only use unprofessional nurses who lack boundaries (who will do dishes,laundry and all manner of other things) it usually creates a nightmare situation with a family who is increasingly demanding. I've seen these situations blow up and the family leaves for another agency, to start over with new staff to manipulate! You'd think it would ultimately be in the agencies best interest to stick with professional nurses, but evidently not? Must be a lot of unprofessional, co-dependent nurses for hire out there to work these cases, so the agencies just prefer to ignore problems and send in unprofessional staff???

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
I recently had an in-home orientation with a new assignment that raised red flags for me.

1] Family required/wanted more care than what I was being sent there for. A 3rd child that needed repositioning through the night while Mom slept. Mom wanted dishes/laundry done for the entire family at times, not just for the two children I would be caring for.

Do I hear any nays? Nope- well it's unanimous then! No you were not wrong! Thank God so far I haven't been asked to do that and had to choose between living on the street or having a job where I was expected to also clean up after the able-bodied people in the house who did not need skilled nursing care. Jeez, some people. . . .:uhoh21:

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I am considering going into HH on PRN basis for extra $$. Is doing dishes/laundry for the patients usually expected? I'm not above doing laundry/dishes, but I didn't envision going to nursing school to end up doing dishes/laundry. I understand the OP point that the family was requesting extra services, but that implies that dishes/laundry was expected to be done for the actual patients. Really?

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You are only required to keep the immediate area around the patient tidy. If they have their own bathroom you would tidy it, and you can do the patient's laundry. But only for the patient. No dishes, unless for a patient meal that you just prepared and assisted with. No babysitting or other household chores that are not directly for the patient. You are not the family maid, although many families may try to treat you as such.

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I have had about six cases so far. Of those six cases, I have never been asked to do laundry. I have been asked to prepare food though.

Of those six cases, I had three situations that were unacceptable. Not all those ended in disaster though. One thing I did was to a) recognize that things were not right ie. listen to my inner caution lights :redlight: and b) DOCUMENT IT! I sent my agency's business manager an "incident report." If you look back at the post I wrote a while back, this involved a 3 year old in the home trying to implicate me when things went missing. I wrote up the incident telling my agency that I would never do these things. I have a crystal clear record, so that helps.

See, by writing it up, I put the ball back in their court. I think sometimes that there can be those :redlight: going off in our heads that we want to ignore in the name of not judging anyone and being tolerant. The old adage that if we think positively, this will go away, doesn't work. I don't ignore those insidious accusations because I know little things can become big things quick, fast, in a hurry. So for example, if the mom said, "Wow, our Wii was broken. You didn't happen to go near it, did you?" I would write it up because indirectly, she is accusing me of breaking her Wii before she makes that accusation. I would say exactly what you said which is that to the best of your knowledge, there is no Wii because you've never seen it. I would quote exactly what she said to me as well. That protects both the agency and you from liability because you wrote it first as an incident report. In my particular case, what threw up red flags for me was when the parents started looking for the house key at 12:00AM. :)

I did have one mom that was very pregnant. The child I was caring for was an absolute out of control brat and so was her younger sister. I mean, I have never seen anything like this in my life. The patient bit me and I ended up in the ER for that, which my agency paid for. I was in that home one day and it was the longest 8 hours of my life. There was no toilet paper. I couldn't afford to take a break lest this child harm herself. I stayed because the agency told me that leaving would mean instant termination and I needed that job. There were other things at that home such as making sure that both children did not harm themselves. When both girls were playing with the electrical wires whilst the mom is sitting on the couch screaming for them to come to her, someone (me) had to take action lest they both end up in the ER. I was constantly keeping both of them in line. The next day, I wrote up an incident report complete with a picture of my swollen hand. I never went back and I never would want to go back.

As to being up all night without any means of staying awake except for reading, I would ask her what her objections were and why. Noise? Lack of response to her child? I have an iPad with earbuds. I keep one earbud in my ear and the other one free and I have never not responded to a child at night and I would tell her so. I am wondering if having a portfolio of references from other parents is not a good idea in such cases. At any rate, I would assure her that her child was my top priority.

With that one family, I would have written an incident report on taking care of the other child. Legally, that is what needs to be addressed. You are wise to have a :redlight: about that. If anything goes wrong, it is going to be you that's in trouble. I make it a real point to steer clear of the other children in the home. These days the way things are, people can be brought down by the testimony of a 3 year old and I am personally, not willing to take that chance. So I would definitely document it.

As to what I do at night, I would have appealed to the mom. These agencies have a policy that the parents make the rules. It is their home and so what they want is what goes. 100%, my agency has responded to parent wishes like that. It makes sense. How would you feel if a stranger were in your home all night? I can't imagine. Plus, I think these parents, at first, are accommodating and then they are angry at the whole thing and start taking it out on us. I don't think anyone ever anticipates a long drawn out chronic illness. At some point, the turn around in staffing must end up being horrific. Only the very desperate will stay in such a ridiculous situation. I wonder, in fact, if the mom's inappropriate demands are not a defense mechanism to end nursing care as though this would alleviate her problems. Someone needs to tell that mom what it is she is getting at the end of the day. Desperation can come in many different colors, if you know what I mean.

Sorry for the length but I think what I'm saying is worth hearing because it has made a difference for me. :twocents:

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Great advice above!! I wash dishes I use to make meals for the patient. I've never been asked to do laundry, but I would put something in to soak if there was a stain on it, and clean/tidy the immediate work area wiping counters, etc. and never babysit siblings. The agency has paperwork outlining what the nurse is there to do and not do. I guess I've been luckier than I realized as most stick to that pretty well.

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