How to Deal With a Bad Nurse

March 7, 2005 6:09 PM

My grandmother hired a woman to help out with my grandfather in the evenings and to put it bluntly, she sucks. How should we deal with it?

She comes in at around 7PM and helps my grandmother clean up from dinner. She then sits down in the den and proceeds to watch television and talk on her cell phone for the next five to six hours. If my grandfather wants to watch something that she approves of (he prefers to use the TV in the den because of the larger size), she stays in the den and watches it with him. If not, she goes into my grandparents' bedroom and watches what she wants. At around midnight, she helps my grandfather change clothes and get into bed. At that point, she returns to the couch where she sleeps with the TV going. Whenever my grandfather wakes up, she is supposed to get him out of bed and into the kitchen so that my grandmother can fix him breakfast. In between these duties, she's asked to do any laundry that's in the hamper. Usually, this is just one or two loads.

The part that frustrates me is that despite the obvious ease of the job, she doesn't even do it correctly. This morning, she left before the day nurse came because my grandparents were still asleep. While she was contemplating leaving, she called the day nurse from the doorway and proceeded to talk (loudly) about her plans for the day. I was trying to sleep on the couch and she simply could not have cared less. She didn't even do the laundry that was in the hamper last night. When I get to the TV before she arrives in the evening, she acts as though I'm intruding on her space, never mind the fact that she's the one who is getting paid to be there. A couple of days ago, she left the water running in a bathroom sink and the thing flooded so badly that the neighbors downstairs complained. When my grandmother confronted her about it, she didn't apologize...she made excuses.

I'll be leaving in a week to move into my house, but I hate what this woman is doing to my grandparents. So, Ask MeFites...do you have any advice other than firing the woman? Am I being irrational or are they (as I fear) being totally taken advantage of?

posted by amandaudoff to Human Relations (18 answers total)

If you don't want to fire her, try being more explicit about her duties with her. Put it in writing, discuss it with her, and make sure everyone understands what's going to happen. I know from some experience with babysitting that sometimes people get annoyed if the sitter doesn't clean up, fold laundry, etc, when they've never made it clear that that's what she should be doing when the kids are asleep.
posted by bonheur at 6:14 PM on March 7, 2005

Your grandparents may be reluctant to deal with the situation because it can be extremely difficult to get anyone to do a job like this one (my grandparents were in a similar situation so I know from experience). Frankly, they may not know how to replace her if she leaves.

The best helper my grandparents ever had was a Ph. D student from the university in our home town. They advertised through the university for a grad student to live in their home (they had a bedroom/sitting room/bathroom in the basement of their condo) for a very cheap rent in exchange for helping with bedtime during the week. It took a long time, but they finally found a very nice man from Bahrain who became a member of our family--he still calls to talk to my grandma (my grandpa has since passed away). He was very kind and helpful and the arrangement was ideal for both parties. When he tried to give my grandma a rent check after the first month she tore it up.

The downside is that he didn't have formal training as a helper, and of course there are inherent risks to entering into a landlord-tenant relationship and having someone live in your home. But helping your grandparents look "outside the box" (much as I dislike that term) for assistance might help them escape their current situation.
posted by handful of rain at 6:22 PM on March 7, 2005

This is sad and abhorrent.

Fire her, but do it in a way that saves face, if possible. Sad to say, she may also be vindictive and/or unstable. If she was hired by a service, tell them you no longer need her.

Call the local Senior Services branch and get assistance on names of services, an/or what might be available to your gp's based on any insurance, etc. they may have.

Good luck.
posted by docpops at 6:24 PM on March 7, 2005

Start interviewing for a replacement now. Do it while this woman is not there. Once they find someone, tell the first one "thank you but please do not come back."
posted by caddis at 6:26 PM on March 7, 2005

This is a woman who too apathetic to even create a facade of usefulness. Fire her. You can find a replacement who might even care about your grandparent's well being.
posted by greasy_skillet at 6:38 PM on March 7, 2005

You're going to have to fire her, but do it gently, for everyones peace of mind. First of all, get together with your grandmother and see what she thinks. Ask her to help you write a list of precisely why she is hiring someone and what she wants this person to accomplish - and specifically, what this person's duties are. I mean specific, as in, "you are not to leave the room for longer than 5 minutes between 8 pm and midnight. Cel phone calls must be limited to less than 3 minutes." And so on.

Then, give the list to this woman and tell her that this is what she needs to be doing, explaining that if she doesn't do it, than she's out. Keep a written record of what does and doesn't happen - probably, after 2 nights of being good, she will go back to not caring.

Also, where did your grandmother hire her? From an agency? If so, then contact the agency and explain what is going on. They are supposed to handle stuff like this - not you.
posted by mygothlaundry at 6:44 PM on March 7, 2005

I would agree that you should find someone else if things continue. Give her a list of things you would like her to do while not actively helping out your grandparents. Perhaps, sweep the floor after he goes to bed each night, make cookies once a week, clean the windows once a month. Something like that.

I've had a job where I was on her end of the job but it was for a guy with Down's Syndrome. The thing was, the family didn't tell me what I was supposed to be doing but I think they just expected us (there were two of us roomates) to do it. What made it worse was sometimes they would come and just do it for us. Since there wasn't any real instruction to go by I had to just watch and try to figure out what to do by what everyone around me was doing. When the family would come and wash the floors I would think, "this is crazy, they even come and wash our floors. I can't believe this job." I would have had no problem if they said that every night I should watch movies with the guy and then sweep the floor but I just tried not to get in the way too much.

So, let here know what you want, even have her sign the list and see how it goes for a week or two. Then you can make your decision.
posted by sirsteven at 6:46 PM on March 7, 2005

If you feel this person is worth keeping (which I'm not so sure of) you could try bringing up the issues in a non-confrontational way. Say "I should have pointed this out to you earlier/been more clear on the interview, but one of the duties of this job is _______." or "We'd really prefer it if you would stay at my grandfather's side while he watches TV, in case he needs anything. Could you please do it that way instead?" If she listens and corrects her behavior, great. If not, don't feel guilty about replacing her forthwith. It is your home, and you are entitled to feel comfortable in it.

A tip: try hiring college students, particularly nursing students. Many of them would jump at the chance to have a job that allows plenty of time for homework.
posted by Soliloquy at 7:26 PM on March 7, 2005

Response by poster: Thank you all so much...I was wondering if it was just me. It's good to know that it's not.

The main problem with firing her is how she got hired. Her husband and son have done "handyman" work for my grandparents for years. They both work at our grocery store, so we see them on at least a weekly basis. Firing her would be awkward to say the least. I think my grandparents feel trapped and I don't blame them...they're in a bad situation.

I was wondering if talking to the other nurses would help. Our day nurses were hired from an agency and are quite simply wonderful. They're kind to my grandfather, they work hard and they're friendly. We were having problems with this night nurse throwing our clothes on the floor and I think it was a mixture of my grandmother and the day nurses talking to her that got it to stop.

Again, thank you all for the advice. This has really been bothering me for a while and I really appreciate the feedback.
posted by amandaudoff at 7:42 PM on March 7, 2005

I'm normally a big fan of second chances, but given what you described and how soon you'll be busy with your move and unable to monitor the situation closely for a while, I'd say you have to act fast and get a new person. If your aide has been getting away with this for a while, and is irresponsible and explotive enough to take advantage this way in the first place, I'm guessing she's going to react badly to sudden strictures, no matter how respectfully framed. The last thing you want is a bitter, angry person in your grandparents' house when you can't be there.

And now that you've clarified the situation, here's my advice: lie. Tell her that she's been a great help, but that your day agency has offered you a special package where the services will be a lot cheaper if you hire everyone through the same place. Grit your teeth and give her two weeks' severance to make up for her loss. That really sucks, I know, but if the other relationship is that valuable, it'll be worth it. Let the day nurses know it's a delicate situation and that they must not talk about your contract terms with this woman, should the chance arise. They shouldn't have to lie for you, but they also don't have to tell her anything that's not her business. Hire your new night person from your trustworthy agency and put this horrible mess behind you.

I hope you can manage it all -- I'm sure it's a terrible stress, especially given your move. Best of luck.
posted by melissa may at 8:07 PM on March 7, 2005

Would it be possible to get a night nurse from the same agency as the day nurses? That way you could let the bad nurse go by explaining that you appreciate all the help she's provided to your family, but that Grandpa has begun to need some medical proceedures in the night-time that only a certified nurse can provide, and insurance is willing to cover it, so you've decided to hire a certified nurse at night.

This presumes that this woman is just a helper and not an RN herself.
posted by bonheur at 8:07 PM on March 7, 2005

Definitely talk to her first. With the daytime nurses, come up with a list with the specific actions that you'd like her to take, as well as any that are discouraged. Phrase it so that she knows you're not entirely pleased with the way things are going, but that since perhaps things have been unclear/unspecified, that you'd like for everything to be up for discussion. Who knows - perhaps she doesn't like the job, but doesn't know how to quit, since she knows your grandparents need the help and that you're in a small community together. If you phrase it so that it sounds like you're trying to find out what's working for both parties, the discussion will be much easier and will hopefully yield better results.
posted by fionab at 8:08 PM on March 7, 2005

I should say, too, that the main thing setting off alarm bells for me was that she left your grandparents alone. The other problems you cite suggest she's lazy and hostile, but this is far worse. What if something had happened in that interval? She endangered them, no matter how briefly, and that's the one thing that someone with her job should never, ever do.
posted by melissa may at 8:20 PM on March 7, 2005

Her husband and son have done "handyman" work for my grandparents for years. They both work at our grocery store, so we see them on at least a weekly basis.

Lots of good ideas already. Here's another thought: present the detailed list of duties and responsibilities, but pitch it as essentially a new job "We realize this is [a great deal more than you originally signed on for | more than is fair to ask of such a good friend]. But it's what grandpa, and this remains the amount we can afford. We would of course understand if you feel that the expanded list of job duties make this no longer the right situation for you." Let her decide whether she wants to take the "new" job or not. If not, thank her nicely and send her off with a hug (and possibly the severance?) for being such a "good sport about our family's situation".

If you're lucky, she can walk away feeling like the heroine of the story while you can be rid of her crap work habits.
posted by nakedcodemonkey at 8:22 PM on March 7, 2005

I'm usually one for second chances as well. But when it comes to my sick granddad--no fucking way. I'd fire her. Giving her a second chance and having to deal with the stress of a potential relapse into incompetence, hostility, indifference, etc... It's just not worth it, not when the people bearing the brunt of the stress are old and sick. Fire her and make a list (as was advised above) for new prospective caretakers. Lie if that will make things easier on your grandparents (I'm not usually a big fan of lying in such situations either, but again, the comfort and peace of mind of ailing loved ones trumps that rule in this case). I would not try and make her leave on her own or use any strategy that drags out things. I would simply get rid of her fast.
posted by crack at 12:07 AM on March 8, 2005

I would lie and fire her. Claim that insurance will cover a nurse hired through their channels, so sorry. You're paying for a nurse, not a babysitter. Go through the agency for the next nurse.

When my mom and grandmother finally got in-home care for my grandfather, it was the night nurses that kept them sane; they were both getting dangerously squirrelly from lack of sleep. They both got terribly thin and easily distracted, and frankly neither one of them have recovered from the exhaustion four months later.

So for the sake of both your grandparents, get them competent help.
posted by Lyn Never at 5:23 AM on March 8, 2005

I absolutely agree with the various lying scenarios. (Which is a little strange to say.)

It would likely upset your grandparents if you flat-out fired her. And how well is she going to take a strict stance on her job duties from a younger person -- what, she's been negligent all this time, but a talking-to is going to whip her into shape?

If you can't get a night-time helper through the day nurses, hire a student. The "new job responsibilities" thing is clever too, if you think it'll work.
posted by desuetude at 6:11 AM on March 8, 2005

This person's not a nurse. She's a "home health aide," by the description of the work that she does - assisting with the activities of daily living like dressing, bathing, going to bed, cleaning, laundry. In New York State, at least, this is a job that requires some training and licensing.

It's also a minimum-wage job and it's hard work. Many of my patients complain that their health aides steal from them, are lazy or abusive, etc., etc. It's impossible for me to judge whether their claims are true. Others become friends with their aides.

Lots of health aides eventually wind up in my office as patients themselves - it's a job that wrecks your lower back.

I guess what it boils down to is that it's hard to find good help these days. Keep looking.
posted by ikkyu2 at 1:25 AM on March 12, 2005