Quote from Blackcat99
Is it hard to find a full time LPN job in home care? When they have a trach and or vent do you have to suction them frequently? What do you usually have to do to care for these ped cases? Thanks
I was not in the position to need full time work, but it seemed to be an opportunity for LPNs to do so in my area if they chose to. My pediatric patient had to be suctioned and receive a nebulizer treatment (albuterol and pulmicort) every 4-6 hours, however, if I would do it a bit more often if necessary. It varies what you have to do. A few weeks ago, my agency called and asked if I wanted to care for a 3 week old baby with cleft palate and for $30 an hour. I didn't accept it because I felt that the child just got home from the hospital, this was a heavy adjustment for the parents who I am sure were devastated and feeding is really an issue with them. I was not confident to take that one on right now.
The agency is supposed to tell you the diagnosis, treatments and medications the patient is on (adult or child). There was a care plan in the home with the MAR. You should familiarize yourself with the meds before you go, have the phone number of the agency's nurse, the patient's doctor, the pharmacy, and nearest hospital (the latter should be made available when you get to the home). Also, I was honest with my agency and they knew I didn't have a great deal of experience, yet, they were gentle with me for that time. Take time to read about the condition before you go, or have a book with you so that you can see if the condition is worsening. What I would do is see the case before you go WITH THE OTHER NURSE PRESENT, so that she can orient you to the daily activities and can give you hints about the family. I say be sure the other nurse is there, because if something happens, she is responsible to intervene.
Many times, it seemed to be more babysitting, but keep in mind that this is your client, and it can't be taken lightly. I used to take mine to the park, she would ride her bike in her yard, play movies, play with her with her toys, clean her up, kiss her wounds and sometimes, I used to sing to her. She loved that...I can't sing worth a lick. Keep the environment safe, microwave small meals for her. There should be documents provided to say what you did, a systems check, sign the MAR stating that you see the medications, etc.
One thing to keep in mind at the home; it is more casual there. Do not be surprized if the family asks you to administer something that is not on the MAR. My client had on her MAR to administer Tylenol if she had a fever over 101. The mother told me that she responds better to Motrin, and was about to leave the house. I told her that I can't go against the MAR and do what I want, so, she had her grandmother administer the Motrin. Of course, I documented this fact. A few months later, when I was a bit more comfortable with the mother, the child had a fever again. This time, I said to the mother (because no one else would be home) that I would only consider administering it if she understood that I would NOT document that I gave it, because it is not on the MAR and I also didn't see a medication bottle with her name on it and dosage. She agreed, I gave it, child was fine. But, I also knew that Motrin was not going to kill her.
You have to know who you are working with, know your skill level, because even as an LPN you are more autonomous there, and basically on your own. Be sure that you have all that you need, know where the medications and emergency equipment is. I noticed that they changed the client's room around every few weeks without telling me. I had to tell the family to leave what I need in a specific area, or leave a note on the refrigerator letting me know where things are, because otherwise, I feel like I am invading their space. I don't wish to be accused of anything being missing. Anyway, I know that I carried on and made this a long post. Good luck. And, do not take a case that you are uncomfortable with. It is YOUR license, your bread and butter and your conscience. Especially with kids.:spin: