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I have a DCG who is here full day on M,W,F and afternoons on T, TH because she attends a specialized programs in the morning. When she comes on T, TH she has a private duty nurse with her because the other program requires it. It is my understanding that the family gets 8 hours every overnight and 24 flex hours per week, and they use some on the Tuesday and Thursdays... and sometimes on the weekends for a break. This lady is their primary nurse and works the day shifts and I believe the majority of the night shifts.
On M, W, F the nurse is not here and we do all of the interventions; the tube feeding, the CPAP at nap, her wound care, and changing her ostomy. Really, we do it all and it's OK because both myself and my assistant are RNs and she is not the only child we have with special needs. So obviously, we don't need the nurse to come in the afternoons on the other days but it would be too disruptive to their nursing schedule for the nurse *not* to come so we allow it. In the beginning, it was actually a bit of a blessing.
Lately, however, it's becoming more of a hinderance than a help. The nurse is rude, unprofessional, and kind of lazy. When she is here I don't feel like myself or my assistant need to do DCG's treatments because the nurse is being paid to do them. She has, on occasion, refused to change the colostomy and waited around until one of us did it. When brought up to said nurse in a professional manner, she got a bad attitude stating, "what do you do when I'm not here?!" and similar smart comments. She's a smoker and while DCG is napping she will go out back and smoke. That didn't bother me so much at first but now the smoking breaks are getting longer and longer and it's disruptive to the other children when she traipses back in during nap, slamming doors and coughing excessively. Additionally, and more concerning than anything, I've seen her do some care on the child with technique that was questionable at best, unsanitary and downright wrong at worse.
Last week one of our other children was having a visit from their Occupational Therapist and said nurse actually sat in on the session and kept interrupting her, trying to converse about non-work things because apparently they have a mutual friend on FB that posted something that may or may not have been contraversial. The OT was really put off by that and when she came yesterday she asked me to please ensure that doesn't happen again.
I had to let her know that the nurse is not my employee and I have no real authority over her. I felt like a real arse. This nurse has been with the family for many years, and I know they won't get rid of her so now we're faced with terming the family because we simply can't handle this nurse in our facility any longer. She'll be here this afternoon and I'm dreading it. WWYD?
I have a DCG who is here full day on M,W,F and afternoons on T, TH because she attends a specialized programs in the morning. When she comes on T, TH she has a private duty nurse with her because the other program requires it. It is my understanding that the family gets 8 hours every overnight and 24 flex hours per week, and they use some on the Tuesday and Thursdays... and sometimes on the weekends for a break. This lady is their primary nurse and works the day shifts and I believe the majority of the night shifts.
On M, W, F the nurse is not here and we do all of the interventions; the tube feeding, the CPAP at nap, her wound care, and changing her ostomy. Really, we do it all and it's OK because both myself and my assistant are RNs and she is not the only child we have with special needs. So obviously, we don't need the nurse to come in the afternoons on the other days but it would be too disruptive to their nursing schedule for the nurse *not* to come so we allow it. In the beginning, it was actually a bit of a blessing.
Lately, however, it's becoming more of a hinderance than a help. The nurse is rude, unprofessional, and kind of lazy. When she is here I don't feel like myself or my assistant need to do DCG's treatments because the nurse is being paid to do them. She has, on occasion, refused to change the colostomy and waited around until one of us did it. When brought up to said nurse in a professional manner, she got a bad attitude stating, "what do you do when I'm not here?!" and similar smart comments. She's a smoker and while DCG is napping she will go out back and smoke. That didn't bother me so much at first but now the smoking breaks are getting longer and longer and it's disruptive to the other children when she traipses back in during nap, slamming doors and coughing excessively. Additionally, and more concerning than anything, I've seen her do some care on the child with technique that was questionable at best, unsanitary and downright wrong at worse.
Last week one of our other children was having a visit from their Occupational Therapist and said nurse actually sat in on the session and kept interrupting her, trying to converse about non-work things because apparently they have a mutual friend on FB that posted something that may or may not have been contraversial. The OT was really put off by that and when she came yesterday she asked me to please ensure that doesn't happen again.
I had to let her know that the nurse is not my employee and I have no real authority over her. I felt like a real arse. This nurse has been with the family for many years, and I know they won't get rid of her so now we're faced with terming the family because we simply can't handle this nurse in our facility any longer. She'll be here this afternoon and I'm dreading it. WWYD?
All of this!! Worse case scenario, they keep their nurse but have her work different hours outside of when the child is in your care. If they want to keep the child in your care, I would present that as the only option, otherwise term. I hope things work out for you!
She is employed through an agency but would it be overstepping my bounds to report her directly to the agency when their contract is with the family? I'll have to look into that. As far as having her not come, we addressed that in the past because we didn't know how the arrangement would work initially but we were informed that because the bus picks them up in the morning and drops them here the nurse doesn't have access to her car until the parents pick her up and take them back to their house where her car is parked. She is required to ride the program bus with the DCG. It's so complicated, and I really don't see a way out besides losing a little girl and family that I overall adore.
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