Working as a Home Health Aide- difficult patient situation

rlgarci2

Hi all!

I am right at the 7 month mark in my first pregnancy and work as a Home Health Aide. My workload is really light (1-3 days a week), since I am about halfway through Nursing School. I have experienced some difficulties with patients telling me I "shouldn't" be working while pregnant; I even had one call my office and send someone else halfway through the shift rather than listening when I was not only capable of performing the duties, but insisted that I would let her know if I was having any problems and call for replacement if needed. This was very upsetting to me (especially being hormonal), but the office was understanding that this was the choice of the patient and not my inability to do my job.

SO my current problem is this:

I notified my work of my pregnancy and intent to continue working as soon as I went to my midwife (around 12 weeks) and assured them I would have a note for release to work, which I have provided (with updated restriction on lifting only <25lbs). I had a regular patient from last August up until about the end of February that I would see once a week. Being a TBI patient, she can transfer very well and requires mostly to have transfers and help with ADL's like cooking and dressing, being driven in her van, etc. This patient has five aides who take turns with doing day shifts, and three of us are currently pregnant. Her routine takes awhile to get used to, and she doesn't like training new people. She requested that I be removed from her schedule back in February because of a miscommunication- the day I told her I was pregnant, she called my office and told them I had "refused to continue taking her in the pool for swimming exercises" when I actually said that I would "most likely be unable to maneuver towards the end of my pregnancy" and would be taking that time off. I was particularly upset about this because she said nothing to me, simply made the office think that I had refused to take her at all, making me look bad.

About a month ago, the office requested I fill in because another aide was sick and no one else was available. I spoke with the patient about why I believed her firing me was a misunderstanding; she spoke with the office and they let me back on her schedule for the time being. Her family went out of town for the last three weeks, so my first day back was this weekend. As soon as I got there, she immediately began crying because she had apparently forgotten that I was pregnant (which she often does forget with her injury), and the last time I saw her I had barely been showing. She is in her mid 30's and was a grade school teacher before her accident; she always wanted to have kids but now may not ever be able to. I feel like my pregnancy in particular is upsetting to her, and throughout the day she would just begin sobbing and apologizing to me because it upset her so much. I spent the whole day trying to avoid any topics that might set her off, but she kept bringing it up and the whole thing made me feel guilty about being pregnant.

Is it wrong for me to want to stop working with her because of this? How do I approach this with my office? I am still able to perform the duties of my job (albeit awkwardly), but I was hesitant about going back to her in the first place because of her previously firing me and the feeling of resentment I carried about that whole situation. I don't feel entitled to taking the rest of my pregnancy off or quitting, especially since I liked my job before and planned to continue working for them as an RN once I graduate. Also, the other girls are still working for her despite difficult pregnancies (not that mine is easy but no hospitalization or other conditions) and I feel particularly "disposable" since I was only asked to come back to fill in. I don't make enough to say it's for the money; but I would like to work with other patients up until my delivery and feel like I would be putting myself in a bad light by simply refusing to work with her anymore without telling them I'm simply too uncomfortable with her emotional response to what is one of the happiest transitions in my life.

Sorry it was so long, but I felt like the whole thing is overly complicated and I really am not sure how to handle this while maintaining a good relationship with my employer. 

AZ123

The patient obviously has some mental health problems. I don't think it is unreasonable to request to not work with her anymore, but you need to ask yourself if it is 100% unbearable to work with her. You only work with her 1x per week. Also, in any work place, you have to work with difficult people so I would first try to work around it, be pleasant with her, don't discuss your pregnancy or any emotions she might be feeling and just do your job. If the situation is still bad, then request to stop working there.

groovygrl

That is a tough situation. However, I would say that one of the things we teach in nursing very early is that you need to be very aware of your own values & feelings & feel comfortable & strong about them in order to provide quality care to others because only when you feel comfortable with your own views/values can you put them aside in order to care for the patient...in this case, I feel like you are focusing on your own needs instead of hers. To stop working for her because you feel that your pregnancy is negatively affecting her health is definitely a good reason. To stop working for her because she is bringing you down is something I think you really need to consider...in your future career, you are going to need to put your own feelings aside to provide care for patients with different backgrounds, belief systems and approaches than your own...I realize being pregnant is not a 'belief' but this patient has had a traumatic brain injury and therefore her thought processes are disturbed (imagine losing your short term memory...) and she has possibly lost something that you so clearly have right now. Remember the challenges that she is facing and that this is not about you but about her. Maybe try talking to someone at work (do you work for a home health agency that also provides RN care? Maybe her primary nurse can help you) about ways to therapeutically approach this patient and talk to her about how your condition is affecting her and decide together whether it is a good idea for you to continue. Just my thoughts, not an attack, just some food for thought. Good luck.

cedenton

I would just describe what's going on and tell them that you think your pregnancy is making her uncomfortable and you want to do what's in her best interest.  Make it about her and not you.  I'm sure they want to do whatever they can to make the patient happy.