WWYD: Caregiver not home at end of shift?

Specialties Private Duty

Published

You are on a 12 hour shift. Primary caregiver has an emergency at 2 PM. Your shift is over at 7 PM and PCG is not back, no nursing coverage is expected until 11 PM. Another competent adult is in the home but is not the primary caregiver, and you have never seen this adult provide care for your patient. What would you do? What have you done in the past, if this has happened to you before?

Specializes in Pediatrics, Emergency, Trauma.
Meh... I called mom when I got off of work to see how things worked out with the agency staff today and she told me that this didn't actually happen to her, she read about it on a discussion board or something and wanted some of us nurses to weigh-in. Apparently she contacted some other nurses to see what they would say as well. I wish she would've presented it as hearsay rather than first-hand experience. Parents.

Weird. :no:

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Specializes in Pediatrics.
I would defer to the agency. If the uncle isn't listed as a qualified caregiver that can sign the chart & assume care, my agency will have me stay with pay as unbillable hours. Agency would be contacting parent. If parent not home within a reasonable time, and parent declared uncle incapable of caring, parent would be given options such as verbal permission for uncle to assume care, self-pay for hours over billable at $xx/hr rate or informed that CPS may be called. By the outgoing nurse calling agency to advise of the situation, the documentation trail is started should mom later claim mismanagement of care or nurse abandoned patient.

Why is mom calling you? I would stay out of it and refer the mom to the clinical supervisor or branch director. Why risk it ending up well "I called nurse kiyasmom and she wouldn't have left so I am reporting you to the BoN for abandonment. And formally complaining about the agency. "

Why risk your professional relationship with the other nurse and your employer/agency?

If the outgoing nurse did not notify the agency that was her main error.

I totally deferred to the agency when she called, honestly because I was caught off guard and I didn't want it to go back to anyone that I said this, that, and the third. However, she is a parent that I do hear from periodically. I am not working PDN but she has called me several times to find out if I am willing to be fill-in on her case (as an independent, as I am not currently affiliated with any home health agency) but I always decline. I was one of the first nurses she had when she brought her child home over 5 years ago and she has always mailed me Christmas cards with updates, pictures, etc. even though I haven't been on the case in years. I guess that's part of the reason I feel lied to... WHY LIE? We have always had a pretty good professional relationship. Have no fear, I would NEVER throw another nurse under the bus, but I DID tell her to call the agency with her concerns. She said she already called on-call and would call first thing this morning to talk to the desk staff.

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Nurses are not babysitters. This topic makes me so annoyed. Parents know full well when your shift ends; getting home two hours late is not acceptable and it's disrespectful. There are very few excuses that make it okay. Personally, it would have been my last shift, unless she was in a car accident, or in the hospital.

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

Wow. I can't believe she acted like it happened to her when she got it from a forum. Then to try to bring you into it. One of the many reasons I'm glad I don't do PDN any more.

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I am sorry,but i expect to be paid.

I would be on the phone Asap with the agency;i d not work for free.

Now here is something i have to ask you all that is VERY similar:

I have several parents that did strange things,for example:

I did a 7pm to 7am shift.

Dad would sign the papers at 10pm,saying "I do not feel like getting up at 7am".

Now,it was small apt,and the 15 yr old daughter did not have a trach,but she did have Bipap and a gt.

I put in notes "left in Dad's care in stable condition".

Next one:

I had a mom who had her 16 yr old son sign the papers,because of the same reason...

she did not feel like getting up at 6am. Child was 9 with trach/vent and Ngt.

I thought that was illegal since he was a minor? I had to wake him up instead of mom.

He had school,and mom did not even have a job.

Agency never said a word.

Put in the notes" left in care of brother in stable condition".

Example #3. The MOST dangerous out of all.

A mom who refused to sign our timesheets.

This was the most strangest of cases.

She said"I should not have to sign those because then i would be responsible".

We never got a signature from her ever!

Turned them in blank,but we still got paid for it.

I still put in my notes"left in mother's care in stable condition".

I later found out the nursing supervisor signs our timesheets.

I did not stay there too long.

Last one,this is between 2 nurses:

This is what happened to me.

My shift time started at 11:00 pm. I immediately get shift report and sign the timesheet.

The previous nurse sat there and was still writing notes until 11:20 pm.

She put that as the time she left.

Meanwhile,i put the time i came in.

Agency paid me and not her.

She flipped out in me.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I totally deferred to the agency when she called, honestly because I was caught off guard and I didn't want it to go back to anyone that I said this, that, and the third. However, she is a parent that I do hear from periodically. I am not working PDN but she has called me several times to find out if I am willing to be fill-in on her case (as an independent, as I am not currently affiliated with any home health agency) but I always decline. I was one of the first nurses she had when she brought her child home over 5 years ago and she has always mailed me Christmas cards with updates, pictures, etc. even though I haven't been on the case in years. I guess that's part of the reason I feel lied to... WHY LIE? We have always had a pretty good professional relationship. Have no fear, I would NEVER throw another nurse under the bus, but I DID tell her to call the agency with her concerns. She said she already called on-call and would call first thing this morning to talk to the desk staff.
Why would she call the desk staff when she read this on a discussion board? If this mother is nakig statements and changing her story I would be vary cautious if I were you.
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Specializes in LTC, Memory loss, PDN.

this has happened to me several times

irst call is to the agency - always

for a true emergency i stay and tell the parent not to worry

the pt will be well cared for

i have also had cases where the parent was notorious for being late (up to an hour)

and then say, "don't tell the agency", "you can leave early next time"

me," I'm sorry, but that is considered fraud, besides, I have to call the agency since

this will be overtime"

in other words, i let the agency deal with it or pay me overtime

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My agencies follow the policy of leaving the patient with a responsible (sober) adult. We are not expected to provide training in a 10 minute end of shift handoff. If the mother is concerned, then she will either get the substitute adults trained during an appropriate time frame or she will not leave the patient under such circumstances. It is her responsibility to provide competent caregivers at the end of nursing shifts.

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Additionally, we are not allowed to leave the patient with anyone under the age of 18, unless there is a waiver in place. Also we can not get signatures from anyone under the age of 18. If there is a question about your handoff, the parent is asked to sign the time sheet before they leave the home.

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My agency: each patient has a form "who may assume care of ______ if you are not present?" Then the parents write a bunch of adults over 18. Then they sign it. Agency keeps a copy.

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this has happened to me several times

irst call is to the agency - always

for a true emergency i stay and tell the parent not to worry

the pt will be well cared for

i have also had cases where the parent was notorious for being late (up to an hour)

and then say, "don't tell the agency", "you can leave early next time"

me," I'm sorry, but that is considered fraud, besides, I have to call the agency since

this will be overtime"

in other words, i let the agency deal with it or pay me overtime

Same here - I have had a parent who have made plans for the day but did not plan on being back home by the time my shift ends so they ended up just letting me off for the rest of day. This one parent would always say to me "just put your regular shift end time down and I will sign" ...Ummm NO I don't think so. I always put the correct time I left her house. Always made me wonder if the other nurses on the case would do it.

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I have a parent who is sleeping when I arrive. I just write that caregiver unavailable for report, in another room monitoring child with baby monitor. One time parent wanted me to leave child with teen sibling at the end of my shift. I contacted agency about whether there was a list of approved caregivers, what the policy was. They said the list of approved caregivers are not the only ones that child can be left with. Supervisor told me it was up to my discretion whether the oncoming caregiver was competent. Child is quite stable. It was only for one-half hour time. Parent told me only comfortable for short time with the teen caregiver. I ended up logging off and just staying there and chatting with teen as a back if needed (was not - time was uneventful). I did it more for the teen than anyone - very charming, enjoyable person - wanted to help with feeling secure with the responsibility. If I had had a reason to rush off it might have been difficult, but that was the choice I made in that situation. It has only happened once in one year.

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