October
2008
Home Nursing, or The Land of Never Ending Personal Drama1
When we were home in January, we weren’t yet approved for more than brief nurse visits. There was some bureaucratic finagling which needed to occur between our primary insurance, the nursing agency, and our secondary medicaid before hours could be approved. So it was the first week of February before we got a nurse for a substantial shift, and we only had her for about three weeks before Dorrie got sick and we were back to the hospital.
This time when we came home we had joined the rarified trach and vent society, and so our nursing needs were even more specalized and harder to fulfill. But they had secured us a nurse for the daytime, 5 days a week, and assured us that they were looking for someone to staff nights. (They did eventually find a night nurse; that it took nearly 2 months from then for her to finally start working was not atypical as we shall see.)
For a few weeks, things went about as well as could be expected. The fact that I got sick helped a bit; the nurse was able to be essentially on her own with Dorrie for a full week while I stayed upstairs and tried not to contaminate anyone. And as time went on, I grew more comfortable with the nurse, she got more comfortable with us and with Dorrie, and Dorrie grew to know her.
She’d probably been working here for a month or so when she first mentioned that she’d need to leave early one day ‘to take her kids to the dentist’. (Note that she is a currently single mother with 4 children.) This was fine, and to be honest I felt and still feel that 5 days a week is a bit too much nursing for us. So any little breaks we could get were fine by me. In any case, she implied that this would probably be a monthly thing, and it certainly didn’t bother me any. Then one day she came and just looked terrible. I sent her home. I didn’t expect her the next day based on how she’d looked, but as, essentially, her employer, I did expect that either she or the nursing agency would call to confirm that she was not coming. This did not happen.
Things went on like this for a while, with several more illnesses popping up, and more and more ‘appointments’ coming up to make her have to come late or leave early. Most of these we heard about with less than 24h notice and some we never even heard about at all; we were just left to guess when she didn’t show up for work.
In July the nursing agency suddenly called to tell us that she was no longer available on Monday or Wednesday because she’d taken another case. Since she’d given us no indication of any such thing, I was surprised, but welcomed the opportunity to cut down our daytime nursing just a wee bit. I had been reluctant to do so before that because I -knew- she was a single mother, she got on well enough with Dorrie, and I was concerned that if we tried to go to less than full time she might not be able to stay. I had my selfish reasons, too: I didn’t want to have to break in a new nurse; I was used to the one we had.
It was not too long after the switch to 3 days that lack of attendance and lack of communication started to get downright silly, and I felt that I needed to start keeping track.
From August 18-October 14, she was scheduled to work for us a total of 23 weekdays.
5 days she called out with less than 24h notice.
5 days she was late or had to leave early without having arranged it in advance.
Of 6 weekend days she had also arranged to come for 4h, she called out twice and was late once.
Oh, she always had an excuse. Her life is filled with drama. House fires, ex mothers in law, children in the hospital, children missing school buses, evil landlords, crazy neighbors, traffic accidents in front of her house, floods, car trouble, misbehaving teenagers — it was like a train wreck. In fact, I’m surprised she wasn’t somehow involved in an actual train wreck. I began to seriously wonder how on Earth she supported 4 children when she could barely show up at work. Surely her paychecks were affected considerably by having not worked a full week in over a month and a half.
Even I was beginning to get annoyed. It’s not so much that I minded the lack of nurse, but what I did mind was the near constant changing of plans at the last minute. Those of you who know me will know how VERY MUCH this sort of behavior drives me mad. I like to plan out my days. Maybe not every little detail will go exactly as I want, but I at least like to know things like “another person is going to be in the house today” or “I won’t be able to do any work because I have to watch Dorrie by myself”.
But we limped along like this, because, as I mentioned before, I didn’t really want to have to break in another nurse. Even though I was getting annoyed, and even though I was becoming more and more panicked over the idea of her coming in all winter from her home with 4 germy children and exposing Dorrie to who knows what.
And then, rather suddenly, we got another one of those calls from the nursing agency. “She’s decided to work full time at another case.” they said. I was surprised, since, once again we had no inkling of her making such a decision. I decided that since she had said nothing to me, I would say nothing to her. She left on Thursday, called out on Friday, and I assumed that was the end of her.
Until she showed up on Tuesday morning.
What.
We sent her away again, since we hadn’t been expecting her, and on Thursday the Case Manager came over and we all discussed the situation. She swore up and down that she had never said she was switching to the other case, that she didn’t WANT to switch to the other case, and that she fully intended to keep with the schedule she had. Even though I had been somewhat relieved to remove the threat of her germy children from my daughter’s proximity, I made no objections, since I had no guarantees that whatever nurse they came up with to replace her would be any better. What I did say was that if she did decide to switch to another case, we really needed 2 weeks notice of that fact. You know, like a real job, not one you can pick up and drop on a whim.
And so there we left it. Or so I thought. Because the next week we got the EXACT SAME CALL from the nursing agency.
WHAT.
Bob talked to our night nurse (who, after the shaky start had turned out to be quite reliable) to see if she might want to do some days instead. She agreed to try it out.
The agency announced surprisingly quickly that they had found someone else to do some nights for us, and we even managed to get them to come in and orient a couple of days later. The nursing schedule seemed to be falling back into place.
UNTIL.
The first night the new night nurse was supposed to come, we got a call telling us “she might be coming down with a cold” so she wasn’t going to come, and would start the next week. We would hardly want her if she was ill, so we waited. On Monday we got another call telling us that the new night nurse had a “family emergency” and it would be a week or two before she could start.
I’m not holding my breath.
