Please explain why a nurse is needed...

Specialties Private Duty

Published

I just returned from orienting on a new case. It's a Medicaid paid case with 24 hour nursing care. Mom does not work, is a fully competent caregiver and there are no other children in the home. The child is under 5 with a gtube. No other issues. She is mobile, mentally with it.

While I don't mind being paid for working the case, for the life of me I cannot understand why MY tax dollars are being spent like this.

It is a mystery I don't understand. Another thing I don't understand is the attitude the family gets that they will not provide anything for the child unless they can get someone else to pay for it. Are there limitations that are imposed upon the money they can spend on their child out of their own funds if they are receiving government assistance? The parents of this child are very well off financially. I get that some families are under severe financiial stress but thiis is not the case with this family. The child has clothes but for example, he loves music and other audio material. He has a cheapie sound system, reject CDs. His pillows are the cheapest worse things, the positioning supports are made out of plastic garbage bags, his hospital bed mattress is a worn out thing bought used. I don't get it. He doesn't even get birthday or Christmas gifts.

That's horrible! It sounds as if the parent view him as nothing but a financial obligation rather than their child.

Specializes in Pedi.
Hey, enjoy it while you can. I, too, am perplexed by who get approved and who does not. Speaking of tax dollars, one of my cts' parents works for a notorious major box chain store that doesn't pay workers enough to afford the company's own health care, so they have no choice but to get assistance. I just love my tax dollars subsidizing big business' profits.

I don't think there is any rhyme or reason sometimes as to who gets hours and who doesn't. I mean, I know we have some patients on service for seizures and they are seizure free but they still keep their hours. We have one family that has a ridiculous amount of hours (something like 80/week) for children who had medical issues at birth but are now toddlers who take oral meds and have PRN oxygen that hasn't been touched since they were infants. I have referred several of my patients (kids who just get visits) and had them screened out in one phone call. These kids were, by all objective measures, more complicated than some of the kids who have and keep their PDN hours. I'm talking about kids with feeding tubes, severe respiratory compromise, aspiration, seizures, post or waiting for organ transplants and, in one case, severely incompetent parents. There was CPS involvement in that case too. The Case Managers for Medicaid said that parental incompetence did not factor into their decisions and that that was a CPS issue, not a medical one.

Yes, CPS will pay through their Family Preservation fund for CNAs or PDNs if it will keep a child in the home. We fostered a child and did not get nursing care (we got his meds and therapies on track, worked on weight gain, etc.) for a few months while DHS was working to reunite the family. They spent money on psych care for the parents and had PDNs 24-7 for the first 6 months he was back at home. It was very, very slowly weaned. All that funding came from Family Pres, not through Medicaid.

Specializes in Pedi.
Yes, CPS will pay through their Family Preservation fund for CNAs or PDNs if it will keep a child in the home. We fostered a child and did not get nursing care (we got his meds and therapies on track, worked on weight gain, etc.) for a few months while DHS was working to reunite the family. They spent money on psych care for the parents and had PDNs 24-7 for the first 6 months he was back at home. It was very, very slowly weaned. All that funding came from Family Pres, not through Medicaid.

Not in my state. They are paying for one of the children in question to go to medical daycare right now but they will not pay for a PDN. A significant portion of my caseload has CPS involvement and we get NO funds from them. The children's visits/PDN hours are strictly through their health insurance.

I think it all comes down to the Pdn role.

I thought we were in the homes to provide rest periods for the families?

Wouldn't it be unreasonable to expect one parent to provide 24 hr supervision to one child,esp if there are other children in the home?

I am not sure of the Pdn role to be exact,becuase i was told 2 things.

The first was above.

The other reason was that we were there to provide teaching.

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