Caregiver for cerebral palsy
September 10, 2014 5:10 AM Subscribe
Hi, so last night I met a sweet family who hired me to be a companion/ nanny / caregiver for their son who has cerebral palsy. I am not a nurse, I work in a hospital but no patient contact. I have however, a few months of cerebral palsy experience from the time I volunteered in college .
We were talking about money- and she said something : I usually pay my nurses 20/hour , but you know they are nurses. However, I am willing to pay you that if you will learn to do tube feeding. So I guess I am confused with what she said? I don't know how much she will pay me, cause she didn't say anything exact, right? Should I ask or should I let it go and see when she pays me? What would u do?
She is saying she will pay you somewhat less than 20/hour if you don't do/learn tube feeding, and 20/hour if you do tube feeding.
In your shoes I would first decide if I could do/learn the tube feeding, then talk with her about my decision and the corresponding rate of pay.
posted by schroedingersgirl at 5:15 AM on September 10, 2014 [4 favorites]
In your shoes I would first decide if I could do/learn the tube feeding, then talk with her about my decision and the corresponding rate of pay.
posted by schroedingersgirl at 5:15 AM on September 10, 2014 [4 favorites]
You should ask, specifically whether she plans to pay you less until you learn tube feeding or if she plans to pay you $20 an hour from the start with the caveat that you must quickly learn to do tube feeding. This is a business transaction, it's fine to ask for details.
posted by jacquilynne at 5:15 AM on September 10, 2014 [13 favorites]
posted by jacquilynne at 5:15 AM on September 10, 2014 [13 favorites]
It's also fine to say to her "given my experience and the fact that I'm really going to take good care of your son, I am going to expect $20 (or even 25! or 30!) an hour despite the fact that I may learn to tube feed/cannot learn to tube feed. A good baby sitter may charge you much more even if they do not have any hospital experience or experience taking care of children with cerebral palsy."
posted by cacao at 5:32 AM on September 10, 2014 [2 favorites]
posted by cacao at 5:32 AM on September 10, 2014 [2 favorites]
Never start work without knowing before you do the work (1) what rate, exactly, you will be paid at; (2) how often and by what method you will be paid; (3) whether your employer will be withholding your taxes. Preferably in writing, which includes details such as which and how many hours you will be expected to work in a week, what your rate is if you are required to work overtime, and how you will handle time off.
It can sometimes feel awkward in one-to-one people-to-people conversations to treat things like a business transaction, but that is what this is. You need to protect your interests in the transaction, which means knowing (and documenting) at a minimum how much you will be paid, when, and how often. I'm sure this is a lovely family who are trustworthy but you are not entering a social relationship; you are being contracted as an employee--how sweet the family is is completely irrelevant to the details of your employment (it's only relevant to the quality of the work environment).
If your employer anticipates that you will be learning a necessary skill (tube feeding) independently of your employment, you should also work out whether your rate will increase with your skill, whether she will be paying for your skill acquisition (or accommodating your schedule while you learn), how much time you have to become proficient and what happens if you don't.
posted by crush-onastick at 6:06 AM on September 10, 2014 [16 favorites]
It can sometimes feel awkward in one-to-one people-to-people conversations to treat things like a business transaction, but that is what this is. You need to protect your interests in the transaction, which means knowing (and documenting) at a minimum how much you will be paid, when, and how often. I'm sure this is a lovely family who are trustworthy but you are not entering a social relationship; you are being contracted as an employee--how sweet the family is is completely irrelevant to the details of your employment (it's only relevant to the quality of the work environment).
If your employer anticipates that you will be learning a necessary skill (tube feeding) independently of your employment, you should also work out whether your rate will increase with your skill, whether she will be paying for your skill acquisition (or accommodating your schedule while you learn), how much time you have to become proficient and what happens if you don't.
posted by crush-onastick at 6:06 AM on September 10, 2014 [16 favorites]
You should ask. Also, would she expect you to learn about tube feeding independently, or would she teach you herself?
posted by shiny blue object at 6:20 AM on September 10, 2014 [2 favorites]
posted by shiny blue object at 6:20 AM on September 10, 2014 [2 favorites]
You know, if you are not a nurse, I think you need to look into the risks and liabilities involved of agreeing to tube feed someone. This is not something I would take on lightly. Even a quick google around the net indicates that's not something all hospitals allow people who are not nurses to handle.
That said, lower than $20 seems low for the type of care you are taking on, even without the tube feeding.
posted by instead of three wishes at 6:25 AM on September 10, 2014 [23 favorites]
That said, lower than $20 seems low for the type of care you are taking on, even without the tube feeding.
posted by instead of three wishes at 6:25 AM on September 10, 2014 [23 favorites]
Just so people know, where I live tube feeding is considered delegated nursing - that means you're trained to do it by a nurse who supervises though they don't need to actually be at the location. You should look into the laws surrounding how you get trained as when I did it I was supervised by the agency nurse (you also needed your skills checked off annually).
But without the training under $20 is good. Heck I made only $9/hr with my delegated nursing training.
posted by Aranquis at 6:34 AM on September 10, 2014 [3 favorites]
But without the training under $20 is good. Heck I made only $9/hr with my delegated nursing training.
posted by Aranquis at 6:34 AM on September 10, 2014 [3 favorites]
Never take a job without know what, when, and how you'll be paid. If you don't know, you must ask. If you don't ask and don't know, you are setting yourself up to be exploited. If your potential employer acts offended by you asking, walk away. This is business, not personal, and it is not rude to ask about your pay.
posted by rtha at 6:36 AM on September 10, 2014 [4 favorites]
posted by rtha at 6:36 AM on September 10, 2014 [4 favorites]
What would I do? I would find out exactly how much I am going to get paid per hour and then get an offer in writing.
posted by Rob Rockets at 6:39 AM on September 10, 2014 [1 favorite]
posted by Rob Rockets at 6:39 AM on September 10, 2014 [1 favorite]
It should be clear before you accept the job if you're expected to do tube feeding, and if not who will be making sure the son has his meals during your shift. It's odd that that's still up in the air. That, and your pay, should both be clearly agreed to before you start. Like, now.
posted by The corpse in the library at 6:58 AM on September 10, 2014 [1 favorite]
posted by The corpse in the library at 6:58 AM on September 10, 2014 [1 favorite]
$20 is higher than standard for home care for someone who is not a nurse. Good for you for finding a well paying home care job. However, do not agree to handle the the tube feeding without delegation from a qualified nurse. Aranquis is absolutely right. You need to work under the supervision of a nurse for delegated tasks. For what it's worth, I know what I'm talking about. Part of my job entails helping families hire and train home care workers. Also, working with a feeding tube is neither difficult nor scary. So don't worry about it, just get the right training (delegation) and make sure to get signed off on the delegation every year (or 6 months in some states).
posted by dchrssyr at 7:20 AM on September 10, 2014 [5 favorites]
posted by dchrssyr at 7:20 AM on September 10, 2014 [5 favorites]
Let me offer you my first hand perspective: tube feeding is easy. Tube feeding isn't like intravenous injections - it doesn't need to be sterile (unless you're dealing with immunosupression) or finicky, just ordinarily clean and hygenic. It doesn't need nursing "expertise" - really, it doesn't. It isn't scary. It's just food, going in through a different entrance.
There are some common sense issues:
- Don't leave large air bubbles in the syringe.
- Don't yank on the tube. Be aware where it is and how it could get yanked.
- Understand how to clip on/off so that you can do that with your eyes closed. (Literally. I do this in complete darkness without waking my son.)
- Try not to make a mess. (Yes, you'll have hilarious accidents that involve spraying yourself, the child, the wall, and the ceiling with food. Been there, done that, not a huge deal as long as it isn't a regular thing.)
The only serious issue is what happens if you accidentally pop the button out of the gastrostomy. That has the potential (potential) to be painful, traumatic, and probably a trip to the ER. OTOH, I have changed a (Nutriport) button myself, at home, with minimal fuss, after such an accident with a careless nurse, and it is very possible that your child's parent knows how to do that too. Talk to them about this - has it happened before? How do they handle routine button replacement? How often do they do this? (We replace every 6 months or so at home, no fuss.)
Finally, for all the responders asking you to get a formal written offer, families who have special needs kids operate on a whole other level of "frazzled". Do not expect Fortune 500 levels of professionalism. But of course you should know exactly what's expected and what you'll get paid, how often, etc.
All this to say: based on what you've said, you could go back and say sure, I'll learn to tube feed as long as you (or one of your qualified nurses) can properly teach me, I expect a pay rate of $X and I'll be working Y hours on Z days.
(Feel free to Memail me if you have specific questions...)
posted by RedOrGreen at 12:57 PM on September 10, 2014 [4 favorites]
There are some common sense issues:
- Don't leave large air bubbles in the syringe.
- Don't yank on the tube. Be aware where it is and how it could get yanked.
- Understand how to clip on/off so that you can do that with your eyes closed. (Literally. I do this in complete darkness without waking my son.)
- Try not to make a mess. (Yes, you'll have hilarious accidents that involve spraying yourself, the child, the wall, and the ceiling with food. Been there, done that, not a huge deal as long as it isn't a regular thing.)
The only serious issue is what happens if you accidentally pop the button out of the gastrostomy. That has the potential (potential) to be painful, traumatic, and probably a trip to the ER. OTOH, I have changed a (Nutriport) button myself, at home, with minimal fuss, after such an accident with a careless nurse, and it is very possible that your child's parent knows how to do that too. Talk to them about this - has it happened before? How do they handle routine button replacement? How often do they do this? (We replace every 6 months or so at home, no fuss.)
Finally, for all the responders asking you to get a formal written offer, families who have special needs kids operate on a whole other level of "frazzled". Do not expect Fortune 500 levels of professionalism. But of course you should know exactly what's expected and what you'll get paid, how often, etc.
All this to say: based on what you've said, you could go back and say sure, I'll learn to tube feed as long as you (or one of your qualified nurses) can properly teach me, I expect a pay rate of $X and I'll be working Y hours on Z days.
(Feel free to Memail me if you have specific questions...)
posted by RedOrGreen at 12:57 PM on September 10, 2014 [4 favorites]
I want to second RedOrGreen - tube feeding is easy, and worth learning to get the $20/hr rate. Check your state's guidelines to find out what kind of training paid caregivers need (and if there's a cost, I would ask the mother to pay for this training) and also ask the mother to teach you how she wants it done specifically (I wrote a guide with videos for my babysitters, and also showed them in person how I do it). At the bare minimum, you should know how to replace the tube if it comes out because it's not the kind of thing that can be left for hours without being fixed, but it's also not the kind of thing that generally requires a visit to the emergency room ($$$!).
Regardless, you need to verify your pay rate before you start for sure. Really, you should draw up a contract to cover your entire working relationship with this family - expected hours, expected pay, frequency and method of payment, sick days/vacation time, taxes, notice from either party required to end the relationship, etc.
Feel free to memail with tube feeding questions as well.
posted by peanut_mcgillicuty at 2:54 PM on September 10, 2014 [2 favorites]
Regardless, you need to verify your pay rate before you start for sure. Really, you should draw up a contract to cover your entire working relationship with this family - expected hours, expected pay, frequency and method of payment, sick days/vacation time, taxes, notice from either party required to end the relationship, etc.
Feel free to memail with tube feeding questions as well.
posted by peanut_mcgillicuty at 2:54 PM on September 10, 2014 [2 favorites]
This thread is closed to new comments.
posted by Rock Steady at 5:14 AM on September 10, 2014 [10 favorites]