Anyone working Pediatric Home Care?

[Baubo516]

I saw that there are some old threads about this (and I read them), but I would like to converse with some people who are doing this job now.

I just finished my LPN program and I am waiting to take my boards. I am continuing classes for my RN, and I have applied for a PRN LPN position in Pediatric Home Care. I actually got a call from the manager and we had a nice chat - she told me that working nights and evenings is good for students because the parents are often there for "back-up," and sometimes there is time to study. I am supposed to call her back when I have my license :), so that sounds promising to me.

What can you tell me about the experience of working pediatric home care? Have you enjoyed it? What are the best and worst parts of the job, and what advice can you give me as a new LPN? As a CNA at a large hospital, I have some experience with trachs and patients on vents, and I have assisted with tube feedings during school clinicals. What other types of duties should I be ready for? (Of course I am a pro at turning pts, and changing incontinence briefs. :) )

I would just like to start a dialogue with some nurses, particularly LPN's, working in pediatric home care. Thanks for taking the time to respond!

[NottaSpringChik, BSN, RN]

I work for a very good agency and they do hire new graduates. New grads get two days or more of orientation on their cases. Also, our clients are classified by Levels. Level 1 has nothing but a feeding tube and possibly oral suction. A new grad or experienced nurse with no experience with a trach start with Level 1 for at least 6 months before being allowed to train and orient a higher level. A new graduate can take care of a Level One client safely.

[LoveMyBugs, BSN, CNA, RN]

I agree, new grads should not do private nursing. For the simple fact that you just don't know what you don't know until later.

I was a new grad and I did pediatric home health as it was the only job I could find at the time, the agency was convinced because I spent 3 years as an ED tech I would be fine in an emergency.

I did ok

But now later after working in pediatric LTC and now pediatric acute care, I really was clueless and I could have provided those kiddos much better care with more experience under my belt.

Not just with trach care and tube feedings, but seizure management and positioning.

If as a new grad you do take on home health....please pleas make sure you have extensive training because again you just don't realize what you don't know until you know it

[Baubo516, RN]

I have now spoken to managers from two different agencies. The first one, I did not ask about the specifics of the clients. With the second one I did, and the patient she is considering for me has a g tube and sleep apnea. Other cares on the client include respiratory and neuro assessments, but no trach or vent.

I appreciate all of the comments, but I have to admit that this thread is depressing me and I think I might be done reading it for a while! I think it is interesting that a few have said that they did home care as a new grad, but now they think new grads should not do it. Of course now that you are an experienced nurse, you realize all that you did not know at the beginning, and you would be capable of doing a much better job now than you did as a new nurse. This would be true of any occupation or skill. I know that I am new, and that I have no idea all of the new stuff I will learn when I am actually nursing. I am looking for a job where I can practice my assessment skills, learn nursing judgement, and also use my practical skills like administering tube feedings.

I am excited about this opportunity, and I am not cocky about my knowledge or skills. I like what Oldest&Ugliest posted about the levels of clients. The client I learned about sounds like a Level 1, possibly a good fit.

I will update this after I pass boards and if I get hired by an agency. Any other useful advice would be appreciated, but if the advice is "don't do it," I probably won't follow it.

[Baubo516, RN]

So far the advice I have heard is insist on proper training until I am comfortable, and get my own Liability Insurance. I would welcome any other practical advice.

I just re-read my original post on this thread, and I noticed that I did not ask if new grads should be doing home health at all... but I guess that is what springs to mind for a lot of people on this forum when a new grad asks about their experience in a certain field.

[Baubo516, RN]

Thank you to the folks who have shared their experiences, and what they view to be the pros and cons!

[CloudySue]

I'm sorry you found this information depressing. I don't think that really was the intent. I'm an emotional, hyper-sensitive person by nature and the one thing that I really had to do my first year in nursing is to toughen my shell. Nursing, by its very nature, exposes a person to injury and illness every day that can scrape you raw if you don't build an inner defense. When you get advice from seasoned nurses, you're getting good information in a "matter-of-factly" way.

The reality people present here isn't presented to manipulate emotions. We all present fact and reality to PREVENT those new to the field from stepping into dangerous pitfalls which will make a person experience more depression and regret than you can imagine. We're just trying to help you prop your eyes wide open, because many agencies would like you to squeeze them shut.

[Baubo516, RN]

CloudySue,

Thanks for your comment. I am definitely an emotional person and I will need to work on developing the "tough skin." Also, I posted the above comments after a long shift when I was tired...always a more emotional time!

It's strange for me - in my work as a CNA, it is not the patients or their families who upset me - they are "customers" and I can take whatever they say or do with a grain of salt. It is part of my idea of professionalism not to let it get to me. But I am way more sensitive about the way coworkers treat me. This may sound off topic, but I guess I am just trying to understand why I may be more sensitive to what people say in this forum. I perceive them as peers or possibly mentors, and therefore I take their words more to heart.

ANYWAY - I get what you are saying and I appreciate the warnings. Having worked with children as a teacher for many years, I am familiar with the idea of CYA. I will protect myself!

[pir8]

Hey baubo516!! Did you end up taking the pediatric home health job? Just curious as to what helped you make your decision and if you are liking the job?

[ezweydorff]

I have worked in Pediatric Home health now for 15 months. It was my first nursing job as an LPN while I went back to school for my RN. I love my job and the company that I work for. I have had 4 clients now and all have been consistent cases. Three of them were full time hours so I had the same client all week and one other client was picked up one day a week with one of the other case hours. For the most part, the clients that I have had have been 'babysitting' jobs. They all received some sort of medication regimen that I had to implement and all include education needs but none of the cases have been critical.

In home healthcare, you do have more choice as far as clients that you will take care of. I have refused more difficult clients that have ventilators and that are more severe, simply because I have not been trained on their conditions. You also have more flexibility with scheduling and can arrange your schedule with the office and often with the parents.

Home healthcare has offered me stability, flexibility with scheduling while in school and a variety of patients. The biggest perk to me has been having all of the holidays off since the clients parents are often home on holidays to care for the client themselves. Most of the parents are better educated that most nurses that I know when it comes to their child's condition, after all, no one has known the patient longer than the parent.

Fair warning for those who begin working in Home Healthcare- you will without a doubt become attached to at least one of your clients. These children have an amazing amount of love to give and they begin to feel like part of your own family.