Dont wake me, just let yourself out

Specialties Private Duty

Published

Specializes in Pediatric Private Duty; Camp Nursing.

Anyone ever work an NOC case where you just leave at the end of your shift while the parents are sleeping? This was ok for the last 8 months w my one client because he was in good shape, but after a 3-week hospital stay w pneumonia, this child had not been stable. His HR spikes with his temp, which is all over the place. He's now in the "yellow zone" for the winter and coughs up secretions frequently which need to be suctioned. I wake mom now to let her know I'm leaving, but she doesn't seem to appreciate being woken up. I told her he's been coughing up junk and requiring suctioning every 3-5 minutes for the last half hour, and didn't want to leave him that way. She said he'd just spit it out. Hello? Didn't he just spend 3 weeks In the hospital for ASPIRATION pneumonia? She's majorly in denial that he's been declining. I'm almost ready to quit this case due to her cavalier attitude. I am not going to leave him drowning in his own secretions without someone knowing about it.

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Specializes in NICU, ICU, PICU, Academia.

Continue to wake her up and DOCUMENT that you did so. Be sure your manager is aware also.

I had a similar case a couple years ago BUT the kid was rock-solid stable. I still woke up the parents to cover myself.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Yeah, if you're leaving & don't have another nurse to report to then definitely wake her up. Especially if he isn't doing well.

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I could never leave without handing the child off to someone. I don't care how stable they are. That seems like a huge liability to me.

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Specializes in Complex pedi to LTC/SA & now a manager.

People have lost their jobs & reported to the BoN in both agencies I work at did failing to wake a parent/responsible caregiver to report off to at end of shift whether patient was basic care & stable or unstable post-hospitalization like your client. Document. Use quotes if necessary and notify your clinical nurse manager/supervisor (document notifying the manager also. We have a check box to be used as needed on our paperwork ( "RN/clinical supervisor notified of current patient status/change in status")

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Specializes in Peds(PICU, NICU float), PDN, ICU.

I had a case where I left in the middle of the night. The mom just asked that I turn on the monitor before I leave. The pt was very stable. I would only wake mom if the kid was sick or something. If the shift was routine and there was nothing to report, mom would know because she wasn't woken up. She could wake up to the pox alarming. I guess it depends on the circumstances. I would never be comfortable doing it with a kid that is unstable or on a vent or something. Also have it documented at the agency that you have an agreement to do this.

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Specializes in LTC, Memory loss, PDN.

perhaps the patient can qualify for more coverage with the

change in status

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Specializes in Pediatric Private Duty; Camp Nursing.

I had a big talk w the clinical mgr this evening, she's been hearing similar concerns from the other nurses in the case as well, and has spoken w mom in defense of our duties to follow doctor's orders. She's supportive of waking mom even if she doesn't want to be, and of course, document, document, document.

New question: if, on your way out, you see mom changing parameter settings on the POX and going back to sleep, is that appropriate to document as well?

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Specializes in Acute Rehab, IMCU, ED, med-surg.

New question: if, on your way out, you see mom changing parameter settings on the POX and going back to sleep, is that appropriate to document as well?

Yes, absolutely. No question.

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Specializes in Pediatric.

Yes, absolutely. No question.

Omg yes. Yikes. This sounds awful.

Sent from my iPhone using allnurses.com

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