Meeting the parent on a new (1st) case

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    I'm a new grad and this will be my first case in private duty nursing. I've been working as a camp nurse all summer and that was my first job after passing the NCLEX. I've taken orientation classes at my agency and will mentor with another nurse before I go on this case alone. Anyway, I am meeting the mother of my first patient today. What kinds of questions do they usually ask? Any tips on making a good impression? Thanks!
    Last edit by Nurse Connie on Aug 6, '12
    Joe V likes this.
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    They almost always query you about your experience no matter what they have been told by the agency. I found that to be somewhat unpleasant in the beginning. Nothing like going to a case feeling less than confident to begin with, then having the family expecting an expert to impress them.
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    I can tell you that we never took a nurse, especially a new nurse, that said "I think it's too hard to handle so many patients at a hospital/nursing home and just one patient would be easier" or anything to that effect.

    I asked about experience, type of degree, to demonstrate suction technique, whether or not he/she had kids or lived in a place with children (I didn't use nurses with small children because of the germ factor), whether they were back in school and generally looked at their attitude to see if they were going to do things my way and were willing to ask for help or whether they were set in their ways and would never ask a thing.
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    I did peds, medically complex (vent and such) home care for quite some time. My first interaction with parents, I always let them know that I considered them the EXPERT in their child - and that I hoped they would help me become an expert on their child as well.

    It is very different from an inpatient environment where WE are the expert. Acknowledge that difference right off the bat - you'll get along fine! Best wishes. I miss my homecare days.
    somenurse and ventmommy like this.
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    Quote from marycarney
    I did peds, medically complex (vent and such) home care for quite some time. My first interaction with parents, I always let them know that I considered them the EXPERT in their child - and that I hoped they would help me become an expert on their child as well.

    It is very different from an inpatient environment where WE are the expert. Acknowledge that difference right off the bat - you'll get along fine! Best wishes. I miss my homecare days.
    This is what I basically said to the mom. I asked about the routine, what she preferred I do, etc. She never asked me any questions at all, which I thought was strange, but said "OK, I'll see you Saturday", so I thought it was a done deal. But when I called the coordinator at my agency, she said the mom had chosen another nurse. Oh, well. My agency has another 2 cases for me, so I will go meet the families on Thursday. Please, keep the advice coming.
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    Wishing you the best of luck on the other cases. The one thing that is hard about Pivate Care is trying not to take things personally sometimes when you are not "picked" or you get thrown off a case sometimes. Try to remember that if things like this happen, there is always someone else to give you love and care too.
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    Thank you mvm2! I got a call from the agency yesterday and they ate setting me up with a mentorship. I will work with a nurse on a high tech case for a few weeks so I can get signed off on skills. The coordinator said the family is very open to new nurses and the nurse is a great teacher. I can't wait!
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    the truth: NOTE: all cases of private duty nursing are strictly about the "child". not the animals, not the parents, not the siblings, not the friends, not the therapists, not the neighbors........ ITS ALL ABOUT THE CHILD.
    moms only ask for a few things from their nurses. unconditional love, enthusiasm, companionship/playmate for their child, respect, a gentle touch, firm but tender behavior lessons.
    following the original routine the child is used to.
    dropping meds-how mom drops meds - nurses tend to change the routine to what they are used to and that will not work for the child. remember the child is used to a certain way for all her medical necessities being administered. normally the stress of new people in the home taking care of the child is stress enough alone so that is why parents like "routine consistance".
    this may include a variety of daily routines such as placement of braces the child may wear (afo's, scoli soft brace, arm/elbow braces, etc), transfer from bed to wheelchair, standing frame, floor, or any other piece of equipment. the mom will know exactly the best way to do all things for her child. ***BUT DONT LET THAT EVER stop you from adding some of your own input on what you have watched with other families that she might not be aware of. parents appreciate this information because they depend on your "nursing information and teachings" just as you depend on their "parent information and teachings" in which the parent has learned since birth of the child and knows what will and what will not work and you have experienced in different homes or during school that she is not aware that will or will not work.... or work much better that what they have been doing for years!!!
    this is strictly a two way street of information in order to make the child's life the best it can be with what God blessed this child with here during our earthly life.
    moms ask that when you are with their child in their private home which by the way is over abundantly appreciated by us nurses who take their case, but also keep in mind that is a privledge for us nurses to be invited in their private home taking care of their most special child. parents have full trust in us while in their home and they commemorate and appreciate us so much and that is why we do the same for them. there should be no housework, no answering their landline phone, no nothing except complete attention and fun filled days with their child. and i should correct the housework part..... it is our jobs as nurses to maintain the area in which the child lives (bedroom, therapy room, etc.) with light cleaning such as putting away the clean clothes, linens, toys or equipment back in place, stocking medical supplies around patient for easy access, plus when supplies come in from medical supply companies it is our job to unpack them and put them away in their respected place. whatever involves the patient and the patient surroundings is what we as nurses are responsible for. nothing more and nothing less.

    but in conclusion, whatever you would want if your were afflicted yourself or if your child were afflicted with some infirmity.... that is all the parent want from you is what you would want for yourself or your child. you will be surprised at how much you can learn from children with different disorders and how truly brilliant their minds are when given the chance to show you as you both learn together. they will teach and bring out traits you may never know existed within yourselves.
    leave your nursing text books at home..... believe me each mom has her own textbook of her child on some shelf in the home!!!!

    ENJOY YOUR LIFE DOING WHAT YOU ARE CALLED FOR. LIVE LOVE AND LAUGH.
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    The best thing to do is go in there confident, but friendly. The keys to survival in Pediatric Private Duty are adaptability, experience, friendliness, and maintaining professionalism. You also have to realize that not every family/home/patient is a "good fit" for you, and likewise for the family/patient. If you do not feel comfortable in a certain home, please have your agency staff you at another home. There are a lot of kids out there that need a good nurse, but get stuck with a sucky nurse. Take the time to learn Ventilators and get the training through your agency or a DME company that services the patient ("shared patient" is what the commonly term it). Getting comfortable with suctioning Trachs, working with G-buttons/G-tubes/NG-tubes, and working with a variety of ages (from birth to 21 in Texas) will allow you to work in any environment and make you very marketable.

    Remember, parents "know their child best," even if they really do not. Use tact and intelligence when teaching parents/family members and respect boundaries. Too many nurses get comfortable in this environment and feel like they are "friends" with the parents/family. Maintain courteous professionalism at all times, keep up your skills and learn new ones, and remember that you ARE making a difference in the child's life.
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    First, you have to be confident. I was a new grad, and told myself that if parents, with no prior medical experience, could become experts in their childs care, then I certainly could with a nursing degree!

    I second what many people have already said: some parents won't hire nurses with small children due to lots of illnesses going around, MANY parents will want to see you suction - and they will all have a different way to prefer it done...you need to have adaptability and realize that the same things will be done many different ways in each different household and you must go with the flow - provided it isn't contraindicated or causing harm to the patient.

    Maintain professionalism and don't let yourself be bullied - some parents forget that this is your job and think that your whole purpose in life is to take care of their child. While you may really love your job, be careful about being forced into extra shifts, etc., especially because if you take time off, their is usually nobody else to fill in, which makes it difficult for the parents or other nurses on the case that may be expected to fill in and pick up the slack. This can be challenging.

    Also, I'm assuming you will want to work in a hospital in the future. Always maintain hospital techniques towards cleanliness when you can. Home care is a whole different ball game when it comes to sterility and cleanliness since their isn't a risk of transferring germs from patient to patient and the children are in their home environment. I make it a point to do things like they would be done in a hospital (as much as I possibly can in the home) so that way if/when I get a hospital job in the future, I have those policies fresh in my head.

    Good luck!


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