Care and feeding of home medical professionals?
February 14, 2014 2:59 PM   Subscribe

This weekend, I'm going to have a home infusion nurse in my house for approximately 4 hours a day while I'm hooked up to an IV. This process is going to repeat every 4-5 weeks indefinitely, to treat an autoimmune condition. What do I do with her?

I've never had anyone I don't know just hanging out in my home for long periods of time. I know she'll have a laptop with her and that she'll be working while she monitors my infusion, but that is literally ALL I know about this process.

(Note: I know all I need to know about the medical aspects of the process; it's purely the social aspects that confuse me.)

What is the etiquette involved? Do I need to feed her? Offer her coffee/soda? Do I need to make small talk with her, entertain her in some way? Do we need to be in the same room at all times? What is she going to do with her time? (Is she going to stare at me a lot while I marathon cheesy sci-fi shows on Netflix??? Is she going to judge my yoga pants and mickey mouse sweatshirt?????)

Of particular interest: If you have had home infusions, what did your nurse do while she was there? What did you do for him/her? If you're a nurse who has given home infusions, what do you expect from your patient? What could a patient do to make the experience more comfortable for you?

I'm an introverted and socially awkward person even among my nearest and dearest; I sense an uncomfortable weekend ahead. Any advice on what my nurse might expect from me, or how I should behave, or how I should expect her to behave, would be welcome.

I do understand the basics - be kind, be generous, don't be weirder than I have to be. It's everything else that I want to know about.

(If it makes a difference, I'm in a house in the 'burbs, in the Northeast, and the nurse will not always be the same nurse. I share the house with my room mate and three cats.)
posted by kythuen to Human Relations (15 answers total)
I had home infusions this fall for about 3 weeks, and I didn't have a nurse at all. 10 hours/day worth. Home health nurses would come every few days to take levels and change my dressing, but that's about all. Do the nurses *have* to come for some reason?
posted by Stewriffic at 3:09 PM on February 14, 2014

You don't need to provide anything for her, but it might be nice to have some bottled water in the fridge. She'll know the etiquette, so let her take the lead. Being in strangers houses is her job.
posted by xingcat at 3:10 PM on February 14, 2014 [4 favorites]

The nurse is a medical professional coming to your home to perform a job. The nurse will know what to do. Don't be nervous. It is an intimate job to be sure, but this is still a professional relationship. You have absolutely no obligation to be a host or impress the nurse or have long conversations. And frankly, the nurse is there to perform a job and they probably don't want to deal with any extended social type thing while they are there either.

You definitely don't need to feed them, but having water available would be nice. Let them use the bathroom. You don't need to make small talk or entertain them. You don't need to be in the same room. They will take care of themselves, and will definitely plan for what to do with downtime if they have it (bring a book, laptop, etc). They are not going to stare at you for watching netflix and they are definitely not going to judge you for your yoga pants. This is a nurse - they literally see this day in and day out. Any decent nurse is not going to judge you in any way.

You are the patient, and you are allowed to ask the nurse for whatever you need, so long as it doesn't make your medical situation worse, including "hey, is it okay if you hang out in the living room while I just watch some netflix in here by myself?"

Really, don't be too nervous. The nurse will know what to do. I hope you get well soon.
posted by Lutoslawski at 3:15 PM on February 14, 2014 [5 favorites]

No good nurse will judge your mickey mouse sweatshirt and yoga pants. He or she is very used to being in stranger's houses and will have food/water for themselves and any other work they need to do. A big part of the nursing profession is the "care and feeding", so to speak, of the whole person, so don't be surprised if he/she wants to assess how you're feeling about the diagnosis and the need for the home infusion.

Also totally possible that she'll be there to set up the IV and then leave for a couple of hours to return near completion of the infusion.

Either way, a nurse is trained to meet you where you are and how you are - ask questions if you're uncomfortable, but I expect (and hope) it will be less awkward than you fear.
posted by Pantengliopoli at 3:16 PM on February 14, 2014 [1 favorite]

The first visit is likely to be the worst. The nurse will have to ask you all sorts of questions for their intake process.

Echoing everyone else that it probably won't be as awkward as you think. Home nurses go into all sorts of crappy situations (picture an elderly patient with no running water) , so them visiting your normal sounding residence will probably be a nice break for them.

I'd offer water, show them where the bathroom is and let them entertain themselves.

Also, not all nurses are created equally so if the nurse does something that bothers you definitely call their home company.
posted by MadMadam at 3:41 PM on February 14, 2014

Many thanks for answers so far!

Not to threadsit, but I don't seem to have an option where the nurse goes away during the infusion. It's IVIG, and they seem very keen on not leaving me alone for it in case I have some sort of unexpected allergic reaction. Until now I've been having these done in a clinical setting, but now they're trying to make my life easier in a minimally intensive setting (bah!)
posted by kythuen at 4:10 PM on February 14, 2014

I don't have experience with this specific sort of situation, but my line to use in all sorts of situations where someone is providing you a personal service and might be able to use a hint on whether their client feels like talking or not is: "I don't really feel like talking right now, I'd like to just relax/distract myself with a movie/get some work done on my computer."

You might want to think about how to arrange your furniture. If the nurse needs to watch you, you might feel less watched if there's a place for them to sit other than the spot where visitors you are talking with would usually sit. Think about how chairs are arranged in a library, rather than a living room -- if there are groupings of lounge chairs, they are a bit farther apart and not facing each other.

Generally, you can't go wrong offering someone a beverage, but you certainly don't have to. You don't need to offer food, and it's likely someone working in stranger's houses makes a habit to refuse food that's offered.

Is she going to judge my yoga pants and mickey mouse sweatshirt?

He or she might judge the sweatshirt if they have a difficult time pulling it up to get at your arm. Wear something that will make whatever body parts need to be accessed easy.
posted by yohko at 5:00 PM on February 14, 2014 [1 favorite]

She's a home nurse. A professional nurse doesn't judge people who are covered in vomit and diorreah, even when they are covered in both at the same time. Offer her some liquid: "There's water in the fridge, or feel free to make yourself tea. I'll just be in my bedroom / on the couch when you don't need me." That's it. Be hospitable and let her lead from there.
posted by DarlingBri at 5:03 PM on February 14, 2014 [1 favorite]

I havent had a home infusion nurse, but I have had infusions in my doctor's infusion suite every few weeks for a few years now (for rheumatoid arthritis). The nurse will probably want to be in eyesight of you, to be sure you aren't having any problems with the infusion and she will be checking your vitals every half hour or so, but she won't even need to talk to you to do this, if you'd rather not. Watch movies on your laptop with earbuds in, or close your eyes and "pretend" to sleep if you'd rather not interact. I'm sure she will have charting and tons of other paperwork to do, and she probably doesn't want to have to make conversation with you any more than you want to with her. Agree with offering her bottled water and do be sure you show her the bathroom, so she won't have to ask. Other than that, it's fine to just do your thing and let her do her's.
posted by SweetTeaAndABiscuit at 6:05 PM on February 14, 2014

I had home health nurses for several series of infusions in 2012, one of them was so good with my quirks that we became friendly and I trusted her greatly (so much so that I asked if she could name a specialist she would consult if she were in my place; subsequently I changed all my doctors and have recovered much health thereby) which I mention to emphasize they are professional and extremely good at supporting you exactly as you are. They are, in my view, the cream of the crop in nursing because they have extremely good skills in helping you to be comfortable with them and the procedures they are there to perform. Remember, if you think about it, they come there alone and take the responsibility for your care; that's pretty brave. They are not people you have to please. Remember they signed on to care for sick people and most of them take pride in doing it well.

It really was better than going to the infusion center; even when the nurses weren't totally simpatico, they were never bothersome and were always kind and professional. In the down time they do a lot of paperwork and telephoning, so just let them know if the telephoning bothers you so they can step into another room for phone calls. Try not to worry about it. Mine always brought their own water! The intake paperwork is tedious but that's just the first time. Keep your folder so you know how to get in touch with the service if you have questions.
posted by Anitanola at 6:34 PM on February 14, 2014 [1 favorite]

Slightly off topic, but be sure the agency knows you have cats! Even when they know you can end up with a nurse who is allergic.
posted by cat_link at 8:06 PM on February 14, 2014

Don't sweat it. You'll be glad they are there if you have a reaction or feel sick or something. Like someone said upthread, watch tv/movies or listen to music on headphones.

The annoying thing about this is you probably don't feel well so you wouldn't have visitors anyway. So you are stuck with this person. But they are there to help you.

I found having a trashcan ready for them to throw away stuff helped. Then they didn't have to wander into my kitchen to find one.

I had a couple of nurses that were super chatty. Just politely tell them you aren't energetic that day. Or you can just give short answers and hopefully they get the hint.

I would try requesting the same nurse for each time. Especially if you don't mind the person who comes the first time. In my area they work in certain geographic areas. So unless they go on vacation or have a day off, you may get to have the same person. That helps build familiarity and they will know that you don't want to chit-chat.

I suspect they will have a ton of paperwork to do on their computer. They usually have a bunch of patients they've seen will see that day. So it will be nice for them to get some stuff out of the way.
posted by hot_monster at 10:20 PM on February 14, 2014

If this person is coming to your house for a while, I'd be friendly and sweet to him or her.

Ask your nurse what they like to do while watching you. If you want to read, do that. If you want to flop on the sofa and watch Maury, do that. your nurse should be more than happy to have you do whatever makes you feel comfortable.

You'll get used to each other and you'll find a rhythm.

I'd have some stuff on hand and if I were making lunch, I'd offer to feed the nurse. That's me. I'm a weirdo, and I like to cook. If you're feeling shitty though. Microwave yourself some soup and make no apologies.

Make your fridge and microwave available at the very least.

At the end of the day, do what makes YOU most comfortable. My Mom had a home health professional come to the house and they just did not click. If for whatever reason, you don't click with your nurse, ask if you can have someone else.

Feel better soon!
posted by Ruthless Bunny at 8:54 AM on February 15, 2014

I had one five day sequence of ivig at home. With work papers, laptop, and books strewn about my bed, I told her that I was pretty self sufficient and that she should feel free to use the t.v. in the other room etc. She would come in when needed to check b.p. and to change the ivig bag etc. No problems.
posted by Kevin S at 9:27 AM on February 15, 2014

Just to follow up - things went well - I had a different nurse each day, and both seemed lovely. The first one was pretty chatty, but it wasn't too bad. The second one mostly watched HGTV with me and commented on people's choices in furniture. :)

I offered drinks and snacks; Nurse #1 accepted, nurse #2 only accepted tea.

Unfortunately, it looks like I'm going to be stuck with this a while. It needs to be done at home to appease my insurance company, and it needs to be done with monitoring the full time to appease my doctor. I think the risk of allergic reaction is particularly high with this kind of infusion, and they don't trust me on my own yet. They're wiling to revisit after a couple of months.

Many thanks for all the great answers!
posted by kythuen at 11:36 AM on March 3, 2014 [1 favorite]

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