night shift anyone?

I need to fill three night shifts for Maggie. Night shifts are generally not easy to fill. For some reason, people like to sleep at night. Maggie has had the same nurse five nights a week for many many years. Now it looks like she is going to take another assignment for three of those five nights. It’s not just finding someone, which is difficult enough; it’s also dealing with the loss of a reliable fixture in Maggie’s care.

Up until about a month ago, an agency provided the nurses. They unceremoniously dropped Maggie and several other kids. The agencies cannot make any money on the amount the State of California pays for nursing care for the most vulnerable kids like Maggie. In reality, the State is saving thousands and thousands of dollars every year by not having to pay for institutional care. But that argument doesn’t sell. California is 77 days overdue passing its budget. Money is tight. Budgets are being slashed everywhere. Kids like Maggie, who cannot complain and do not have a voice in Sacramento, are easy targets.


Now we have to do this on our own. The State reimburses us, but only after we lay out thousands of dollars. In addition, the entire administrative responsibility falls to me. Now I have to find a nurse or nurses to fill three night shifts. Right now, we are the only family who has undertaken this task on our own. We are lucky to be in a position to set it up. Many families will not have the resources or tenacity and the children will suffer.

The nurses working here actually make more hourly than they did working for the agency. I don’t take a cut and can offer them a higher wage. However, I cannot offer any benefits and they are responsible for their own taxes. The agency does not provide any real benefits either, there’s no vacation or health insurance, but there are two paid holidays and dental insurance. They won’t get that from me, I am not an employer, just a vehicle for the money to pass through. The benefits are not that big of a deal the 25% increase in salary more than covers the difference.

In in the case of this nurse it is the responsibility for the taxes and her mistaken belief that her tax liability is greatly increased working here. It’s not, but it seems like it is. From a psychological standpoint, taking money you actually receive and putting it aside for taxes hurts a lot more than simply receiving a net amount after deductions. But I know I cannot take that on the responsibility of paying taxes for the nurses.

So one has jumped ship, or at least partially jumped. Arrgh. Ironically, she is going to be caring for someone I know. His name has not yet come up on the cut list but it will. It is just a matter of time before his hours are also cut. Kids all over the State are being affected, but they’re starting here in San Francisco. San Francisco is feeling it first because of additional fees that businesses have to pay in this city. When this boy’s name comes up in the next month or so, this nurse will likely want to come back. If there are open shifts I will take her in an instant, but I cannot wait for her. She knows that. She’s rolling the dice too.


Seems to me that home care for the most vulnerable and medically involved children should be given a little higher priority. It should be less of a game for the patients, the nurses and the families.


So if anyone out there wants to work 11PM to 7 AM three nights a week and can do all the skilled care Maggie needs all night long and be loving and caring, let me know. Perhaps we can work something out. There's no dental, but you can park in the driveway. In San Francisco that's a HUGE benefit.