The perfect private duty setting

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    I am a prior PDN on the flip side of the coin with a medically fragile foster child. He is vent dependent at night and when napping. Trach, TPN dependent right now due to a recent gut shutdown normally g-j fed) IVIG infusions weekly. We will be bringing him home on Friday. We also have 6 other children so we will definitely need the consistent, reliable nursing care he qualifies for. I know the kinds of things that irked me about prior cases I worked on, but I'm only me... So chime in. Please help a fellow PDN-cum-foster mom and describe your ideal Homecare setting.
    Joe V likes this.
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  3. 13 Comments so far...

  4. 5
    Given that you have six other children, I don't know how much of this would be realistic but having done PDN in a wide variety of settings:

    a clean house, or at least a clean space where I will be expected to take care of the kiddo

    clothes, toys, *esp* medical supplies all organized and marked

    a certain element of privacy. There's nothing more awkward than having to take care of a kiddo in the middle of the family room with the entire family in there, watching you. I get that many parents will hover during the first few shifts to ensure that I'm competent/not sleeping on the job/etc. but yeah.

    Same goes for the other kiddos in the family. I'm not here to take care of them. I like kids, in general, and love fostering interaction between them and my patient but I'm not a catch-all babysitter.

    A clearly delineated list of rules and expectations for your house. If you want me to use a certain bathroom, please say so. If I can use your microwave/fridge for lunch, please say so. If you have more than a couple of rules, please write them down. I think a lot of new PDN parents are hesitant/don't want to offend the nurse by saying don't do xyz, but ultimately I'm an employee in your home.

    If you feel like I'm doing something improperly -- either with patient care, or anything else - please approach me before you approach my manager.

    If you feel like other nurses are being negligent or even abusive, please approach my manager and not me! (true story)



    For your night nurse:

    Don't be offended if I bring something to do. The ideal set-up for me as a night PDN was a comfy chair, a reading light, and a TV tuned down low, of course.

    Also, re. new PDN moms, you don't have to come running every time the baby makes a peep. I promise! That's why I'm getting paid to be up at 3 am. If I need something, I'll come get you.
    SE_BSN_RN, tots24, SDALPN, and 2 others like this.
  5. 0
    Very good advice
  6. 2
    God bless you for taking this child into your home.

    Honestly, a chair, a flat surface to write on, and some form of illumination are all I really need!

    dirtyhippiegirl pretty much covered the list, to which I might add a little heads up on how to approach pets in the family if there are any. One family had the sweetest German Shepherd in the world . . .after you made friends with him. :-) Before that, he was a very intimidating and loud canine.
    SE_BSN_RN and dirtyhippiegirl like this.
  7. 3
    Thank you for the advice! We are clean people even with the kids (except for the playroom usually), the nurse has his bedroom for privacy or the family room in the basement if she doesnt want to be around us, the walkin closet in his room is setup with supplies, shelves, organizer bin (labeled)' mini fridge, microwave, and snack basket (for the nurse). There is a glider with ottoman, desk table, and laptop with Internet in there. Also, a 47 inch tv. I am going to request certain channels when he's awake though. The room light is on a dimmer switch and there a two lamps in there. I appreciate all the input! Anything else?
  8. 0
    Quote from kiyasmom
    Thank you for the advice! We are clean people even with the kids (except for the playroom usually), the nurse has his bedroom for privacy or the family room in the basement if she doesnt want to be around us, the walkin closet in his room is setup with supplies, shelves, organizer bin (labeled)' mini fridge, microwave, and snack basket (for the nurse). There is a glider with ottoman, desk table, and laptop with Internet in there. Also, a 47 inch tv. I am going to request certain channels when he's awake though. The room light is on a dimmer switch and there a two lamps in there. I appreciate all the input! Anything else?
    If you also happened to tell me that I could nap but "turn up the apnea alarm" I'd say that you were the best PDN family that I'd ever had. (Never took them up on it 'tho, and would have felt awful doing so.)

    I think the hardest part will be separating your own feelings and actions (as foster parent and previous PDN) from the PDN.
  9. 0
    Oh, I know! The nursing agency I spoke to last week told me there are two nurses who are qualified to do the case but they won't even recommend them because I'm a nurse, too. I guess some nurses don't care to work in the home of another nurse. I worked in the home of a MA but she wasn't home much so we didn't butt heads until the end.
  10. 4
    For overnight shifts, Wifi access is a very nice plus. I have an iPhone which is ok w 3G, as long as the home is in an area where it's accessible. Wifi is much better when it comes to Netflix access.

    I am afraid of dogs, I know it's mostly irrational, but please don't tell me your huge, barking, jumping-up dogs are harmless. Please keep them away from me, especially when I first walk in.

    If a med or treatment is due, please trust me to do it. I had a case once where the family did it all. The only thing they wanted me to do is play with the child the entire shift. While I don't mind entertaining the child, that's not my primary/only function. Trust me. I'm a professional. Take a load off and enjoy the respite.

    On overnight shifts, if I'm off at 8am, please be sure you are awake and ready to reassume care. It's awkward for me to knock on your bedroom door and wake you up at 8a. By the time you wake up, dress, pee, put in your contacts, etc. it's already 8:10. I've already been at your home 12 hours. My own kids need me now. Go to bed earlier if you can't get up after your 3rd snooze alarm.

    Please keep your nurses straight. If someone else forgot to do something, please be sure you have the right nurse. I'm tired of being accused of something other nurses did. I always clean the TF bag and change soiled sheets.

    Oh, and my crystal ball seems to not be functioning correctly. I reported it to the FDA, but in the meantime, I need to be told things.

    I know you already considered these issues, I just like any oppty to vent a bit... LOL! Thanks!
    SE_BSN_RN, nursel56, tots24, and 1 other like this.
  11. 1
    I agree with what the others have said. I work overnights, so give me clear house rules, a comfortable place to sit, adequate light, a place that is "mine" (whether that's a chair, desk, whatever), and WiFi is nice.

    Just a quick question--have you/your child's doctor looked into doing sub-q IG infusions? You can do these at home and they just run overnight. It might be a nice way to keep your child who needs consistency out of the hospital!
    SE_BSN_RN likes this.
  12. 0
    Quote from tots24
    I agree with what the others have said. I work overnights, so give me clear house rules, a comfortable place to sit, adequate light, a place that is "mine" (whether that's a chair, desk, whatever), and WiFi is nice. Just a quick question--have you/your child's doctor looked into doing sub-q IG infusions? You can do these at home and they just run overnight. It might be a nice way to keep your child who needs consistency out of the hospital!
    Thank you for your input. It was IVIG while he was inpatient every 3 weeks. Now it is weekly SubQ. Sorry for the confusion.


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