Ha! What a fun thread.
You sound alot like me 1.5 years ago when as a new grad, BSN I managed
to get my first job doing pediatric home care with trachs and vents. Some of even basic nursing jobs
in LTC or acute care had 80-140 applicants for 1 spot back in 09.
Ironic huh...spending 4 or more years in school tediously going over the simplest task many many times in order to become competent in those General skills, only to get hired in one of the few areas of nursing where students get little or no in-school experience and end up getting only a few days training by your job in the skills that you do on a daily basis. That tells you how desperate they are in this setting or 'speciality'. This should also tell you something about your agency..it is not a good sign if you constantly being put in situations that are unsafe for you and the patient. Some agencies are pretty bad--they will do whatever it takes to placate the parents and keep a case..some seem at least concerned for their nurses and will draw the line when necessary. Weird too how you are the nurse yet the parents have more experience then you! Parents can be your best resource though...most know 'how it is" with home care training and are glad to help any new nurses for the safety of their child. Most times the parents are diligent and can be trusted for info more then the multitude of other staff members involved in a case as they have been with that child from the beginning, have seen what works, what doesn't---and ITS THEIR CHILD. I have found many charts to be lacking..especially history. Inaccurate at times.---and the supposed office manager type staff spend about 30 minutes per month with the client so dont have a full picture like the parent would. sorry.
You seem to be asking all the right questions though..which is important because In case you haven't noticed you are self taught in many ways.
It is July now, so I am sure you a through the worst part of this. I know it took me awhile before I started to feel relaxed---both for the pt and my license. Not an ideal way to enter nursing...but what you gonna do? Lucky for you, you should have the educational background to figure it out for yourself....some really don't but the agencys are so desperate for people they would just about take anyone I think sometimes! (see the part about doing whatever it takes to keep a case) After four years of school though and a professional license, you deserve employment, and you deserved it in the setting you trained for which was the hospital.
Your experience is the norm with home care...their is little formal pediatric/respiratory training available to nurses (i had a total of 3 peds patients in my 5 years of school) Nursing Schools dont teach these in depth becasue peds has been de-emphasized on the NCLEX..and as for respiratory therapies like CPT, suctioning, coughalators..RT handles that usually in Acute care. So many nurses young and old entering home care are coming in with little experience just like you did and learn on the job.
Hope all is going well. Try to get oriented to as many cases as you can so at least you can learn as much as possible. Peds and trach and vent exp. is valuable in many other settings...icu, er, nicu, picu, general practice nurse practitioner.
I am going to pay the 300$ to take the ANCC CPN test (certified pediatric nurse) and I am going to try employment at a local ped hospital who does hire without acute care exp for many of the reasons i described above.