Adventures in Home Nursing

Last week, after being bargained with er, bullied into er, politely asked by one of our home nursing companies, Karin and I agreed to allow a new nurse to be trained in our home.  The new nurse would not be assigned to our case after training but would be observing and be tested by our assigned Wednesday, thursday, and friday nurse, who is a great nurse and is very good with Liam.  This little training benefits our assigned nurse who will receive extra training pay (which I know he deserves and am glad that we could help him to get it), it benefits the new nurse being trained because she gets some experience with a good teacher and a fairly complicated (but relatively easy as these things go) patient, and it benefits the company in that they are able to give effective on the job training and be sure that they hired someone capable before letting her care for a patient alone.  The problem is that none of it benefits a single one of the Olsons.

We live in a cozy house.  It’s comfortable and we love it, but it’s made even smaller by all of the large pieces of equipment and a spare bedroom that looks like the storage closet of a hospital.  The fact of the matter is that there isn’t much room for another person moving around in here.  The revolving door of therapists and oxygen deliveries and service coordinators have people coming and going throughout the day but even on an easy no appointment day like today someone standing around observing just gets in the way.   I know they have to train her somewhere but it can be frustrating to allow another stranger into our home for a shift or two, and then never to be seen again.  Karin and I have already decided that she’ll be added to the growing list at the agency of nurses who aren’t allowed to work at the Olson’s house.

No one in the Olson house slept last night.  It wasn’t that Liam kept us awake, in fact, Karin and I were able to go to bed at a reasonable time leaving Liam in the very wonderful care of our night nurse.  I for one tossed and turned all night.  My body clock has set itself to a 4am bedtime because of the nights without a night nurse and even after pilfering my own son’s over-the-counter melatonin sleep aid (recommended by his pediatrician by the way, not that it’s anyone’s business) I lay wide awake in the dark.  Afraid of keeping Karin awake I could tell by the jostling on her side of the bed that she was in the same boat.  Our stubbornness beat out reason and instead of talking or reading we tossed and turned some more and I don’t think I got even a wink until about 5:30am.  Karin checked on Liam around 4 when she fed the cats and learned that he hadn’t slept yet either.  Awesome.

7am phone calls are seldom a good thing and are usually accompanied by bad our at least annoying news.  So-and-so called in sick to work you better get here early,or your nurse called in sick you better make other plans for those couple of hours you were going to put in at the office, you know the type I mean.  The phone ringing at 7am this morning would have still pissed me off had it been the good people at powerball awarding me the ‘I know you don’t play but here’s a few million anyway’ prize.  Karin, God bless her, got the call.  “I’m the new nurse that’s starting at your house today and I can’t find your house.”    No other introduction, no ‘sorry if I woke you’, and loud enough so that even I could hear it on the other side of the bed.

“mmm, okay, …where are you?”  Karin managed to get out on even less sleep than I had.   I was already annoyed and it’s probably a very good thing that I didn’t answer the phone.

“I’m on your street.”

“well, we’re on [REDACTED] and we are the first house after you cross [REDACTED].  Right across the street from the [REDACTED] parking lot.” Karin said “It’s a white house with black shutters.”

“Nope, I’m at the end of your street and its a green house numbered 115.”  The nurse said with some attitude.

“Well I guess you need to turn around because we are in the middle of the street not the end.  We are the first house after you cross [REDACTED] street.  It’s a white house across the street from a parking lot.  Are you sure you’re on [REDACTED] street?”  Karin has so much more patience than I do.

“Yes, I am on [REDACTED], annoyed audible sigh, there’s no white house here.  another audible annoyed, attitude filled sigh.. is the nurse I’m training with there?  Can I just talk to her?”

“yeah, He’s here.  You better just deal with him.”  Karin said while getting out of bed.  Had I not been partly convinced that this craziness was just a dream I would have taken the phone from Karin and told the nurse to call the agency and figure out somewhere new to train.  Some home care professionals seem to forget that when they go to work that they are entering someone’s home.  Someone’s privacy.  My wife does not need to defend herself and argue about what color her house is that early in the morning or any time for that matter.  Coming to the realization that yes, this was how my day was going to start, I put on some clothes and headed downstairs to talk to our nurse and see how this would all play out.

I told our nurse to please give the new nurse his cell phone number and they could hash it out themselves while my wife got some more rest which he did.  But not until after we found out that the new nurse wasn’t even in the right city!  Look people, I may be very quick to judge nurses at this point after some bad experiences but wouldn’t you be critical of the people coming in to your house to take care of your baby?  How am I now supposed to trust someone with small details like medicine doses and ventilator settings if that person fails to pay attention to the small detail of what city they are supposed to be driving to?

Karin and I talked with our nurse and explained that while the new nurse can still observe for the day and go through her company orientation materials, she was not to care for Liam.  That’s his job and he completely understood.  He has been with us a long time and we trust him enough that we went back to bed to try to sleep and have no idea what time Nurse Wrong-City-Attitude arrived.  Karin and I were polite and professional (should I really have to be ‘professional’ in my own home?) when we met her in person but aside from a quick introduction we barely spoke.  A large portion of the afternoon Karin and Liam spent together in the living room while the two nurses worked on instruction in Liam’s bedroom.  How does that help the family which is what our home nursing is there to do?

I would be remiss if I finished this rant without mentioning that the three nurses that are assigned to Liam’s case right now all have different styles but are each in their own way perfect for this home.  They are all wonderful with Liam and are a perfect match for our attitudes, routines and personalities.  We are happy with the nurses we have.  But it has taken us over a year and at least a dozen firings to get us here.  Sometimes very capable and knowledgable nurses just don’t match up personality-wise like the nurse who treated Liam more like a patient than a little boy in his own home, sometimes nurses who seem to have just the right personality just don’t have the knowledge or the confidence to do this job, and sometimes they just don’t know what they’re doing and unfortunately we’ve seen our fair share of those.

In truth, the easiest way to tell if a nurse will work out here is also the most important.  Just look at how Liam reacts to them.  Liam can sniff out a bad nurse quicker than most hospital supervisors and he let’s you know it right away.  I’m not joking.  Liam has yet to realize that Mom and Dad can tell if he’s really sleeping by how low his heart rate gets on his monitor.  But that doesn’t stop him from closing his eyes and faking that he’s asleep when spending time with anyone he doesn’t like.  He’ll even open his eyes and pick up his head immediately after they’ve left the room.  It’s hilarious.   He’s the boss around here and if you can’t impress him quick you needn’t even apply.

Of all the things that make being Liam’s Dad different from being the father of a child without special medical needs the revolving door of medical professionals who come and go is the worst of them.  Luckily for us, our current roster are fantastic and though there is a barrier of professionalism that must be kept the three of them have all made their own way into being a part of this strange little household.  They assist where they’re needed and they back off when appropriate.  They understand that WE are the parents and they are only here to help us all try to enjoy a somewhat “normal” life.  Ironically, their presence alone makes that impossible though, and they all know that.  They get it.  Nurse Wrong-City_happy-Pants doesn’t.  Perhaps she will someday, but I won’t know.  She missed her shot at the best nursing assignment you could ever find.

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