Pediatric HH Nursing

It depends on the agency you work for. I am home Health nurse and we see patients of all ages, I currently have 2 patients who are infants, preemies, one who was failure to thrive and one who is getting monthly Synegis injections. We do coordinate/supervise LPN's who do the day to day shift work you described as well. I see one girl with Rett's syndrome every 2 weeks for RN assessments and LPN supervisions.

You will find a variety of types of pediatric cases in home care, from short term to long term. Families vary in their involvement with the child's care. Some will do everything, you are only there for backup. Others will let you do everything and may not even be aware of what is on the plan of care. I find that there is usually a family member in the house. Very few will leave you alone with the child until they learn to trust your abilities. You will be given a copy of the plan of care and the med sheet to look over before you visit the home to orient with the child. You can always turn down the case if there is something that does not seem right for you. Families are usually, but not always, eager to help you feel at ease so that they get the help they need. One of the hardest aspects of peds hh is learning how to balance the family requests to do things their way when they contradict the doctor's orders. Often you may find yourself biting your tongue, doing it their way, then doing the extra documentation required. If they go past your line in the sand, you may have to leave the case in order to protect your license. Don't expect your agency to back you up. They generally don't care what happens as long as the clients don't complain and you don't bring any problems to the supervisors to solve.

Hi Ittybitty. I am a pediatric in-home nurse and I love it. I have never worked in a hospital before, so I can't compare the stress levels, but I would guess that taking care of one patient at a time is less stressful! You will have to reverse your thinking and way of doing things, i.e, sterile vs. clean procedures, and always having the family around watching. I work full-time with one child. The nurses I've seen who came from hospital or LTC backgrounds appreciate the lack of politics and the more laid-back tempo of home health. You really get to make a difference in these families lives, and it's extremely rewarding. I just love that I get to take such good care of one client; I can be thorough and careful.

The downside is that around here at least, the pay is less compared to hospitals, and the benefits are not all that great. But for me, it's an ok trade-off, at least for now!

Good luck in whatever you decide!

I am an extremely happy new grad pediatric home health nurse. I decided to enter directly into this job rather than go for the hospital setting. Finding your rhythm amidst the chaos of divorced parents, three kids, after-school, doctors appointments, and everything else is difficult at first, yet very rewarding.
I would definitely recommend it.

Can any of you guys tell me about the orientation of peds. home health?

I would really appreciate it.

Orientation is essentially whatever the agency personnel make it. You have to be proactive in asking for sufficient orientation. You will be oriented to the agency procedures, how to do the paperwork, etc. Usually no problem. You will be oriented to each case that you consider. They should give you a copy of the 485. The 485 is the plan of care. It contains the doctor's orders and other pertinent info regarding the patient's care. You should also get a copy of the MAR. You can read over the 485 and MAR. Look up any meds or procedures you are not familiar with. Ask all the questions that occur to you. If there is a procedure that you have never done or are not familiar with, this is the time to ask about it. The supervisor or primary nurse for the case will give you a verbal introduction to the patient. You will go the home and receive an orientation from the nurse on duty or a family member. The family will interview you. If the family is not comfortable with you (or vice versa), after you have made that first "get acquainted" visit, you can decline the case, or the family will tell the agency that it doesn't appear you will be a good fit. You should receive enough orientation for you to feel comfortable with beginning care. Usually an agency will pay you for two or maybe four hours of orientation to the case. You can request more unpaid orientation, but on unpaid orientation you can not have physical patient contact. You can only observe and talk with the nurse on duty. It is up to you to make sure the agency doesn't just throw you into a case before you are ready. Some agencies are good about orientation, others are not. HTH

Thank you caliotter3-that helps a lot! The company that I am going to work for is a Children's hospital in my area. It is their home care branch. Thanks again!

luvmyguys

Hope you have a positive experience with this agency and with the cases to which you are assigned.

Well, I sure have said "might" work for. She pretty much sounded like I have the job if I want it. But, I would prefer to be in a hospital fresh out of school. In my area, the hospitals are on freezes and it might be my only option or move out of state. We'll see. Thanks again.