Should I leave this case? Worried. - page 2

by dirtyhippiegirl

2,480 Views | 17 Comments

Mom has some odd ideas about trach care. Kiddo is on a vent but we're weaning her. I guess about six months ago the kid pulled her trach out and mom didn't notice because the trach dressing was covering it. It was pretty... Read More


  1. 0
    Quote from dirtyhippiegirl
    I'm assuming that they didn't unless she lied (she lies a lot) about it.

    Or maybe she's the reason that the company recently changed policy and we (nurses) are allowed to transport kids in our cars to medical appointments if deemed necessary by the parent.
    I would not be cool with that at all.

    Using the ER like a Dr's office instead of utilizing the resources already available ( skilled nurse, dr on call, pcp, case manger etc ) seems to be a common theme. Often times they get VERY upset when the ER won't do anything for them.

    I don't think I have the temperament for dealing with the families anymore. I find hospice a little more straightforward.
  2. 0
    I would suggest you check with your auto insurance carrier and see if you are covered for transporting a patient as part of your work assignment. It has been my experience that if I didn't have a specific rider (at additional cost of course) covering the use of my car to transport patients then I was placing myself at risk of having any claims denied. I was also advised by my insurance agent that no matter what an employer claims about carrying auto insurance on employees using their own vehicles to carry patients the reality is that a claim will be submitted on your personal auto policy first and, if they deny the claim, then the employers insurance will almost always deny it too. That is, if the employer in reality does extend their insurance coverage to the use of employees private vehicles to transport patients.
  3. 3
    Please be careful about the info you post concerning your clients. Although the story about her driving or not driving is certainly interesting, it makes the situation easily identifiable. Would not like to find out that you got in deep trouble because the wrong person read this thread and figured out who was who. Most of the stories posted on this site are generic enough that they could fit scores of people, but this one is kind of on the specific side.
    systoly, luvtwilight, and SDALPN like this.
  4. 0
    I would get out and stay out. There are other cases out there. This is just asking for trouble. Too many red flags. If you must stay on it for financial reasons. Start easing yourself on to another case or float as much as possible. When the time is right, pull off completely.
  5. 0
    Quote from caliotter3
    Please be careful about the info you post concerning your clients. Although the story about her driving or not driving is certainly interesting, it makes the situation easily identifiable. Would not like to find out that you got in deep trouble because the wrong person read this thread and figured out who was who. Most of the stories posted on this site are generic enough that they could fit scores of people, but this one is kind of on the specific side.
    I've changed enough things in the story to make her not easily identifiable. Trust me. :> But you get the jist of the story without me actually revealing specifics that are true.

    txredheadnurse - I hadn't thought about that at all! Thank you for bringing it up.

    tothepointeLVN - have you also run into clients who use the ER as their PCP? It's funny because I actually used to work in the ER so I'm pretty familiar with the mindset.
  6. 1
    Just curious why any trach/vent parent would use the ER as a PCP? They never have supplies, a lot of ERs freak out when you walk in with a vent, you never see the same nurses/docs twice, they can't help you with supplies, they won't change vent settings, they hate replacing g-tubes, etc.
    systoly likes this.
  7. 0
    Quote from ventmommy
    Just curious why any trach/vent parent would use the ER as a PCP? They never have supplies, a lot of ERs freak out when you walk in with a vent, you never see the same nurses/docs twice, they can't help you with supplies, they won't change vent settings, they hate replacing g-tubes, etc.

    Let me preface this by pointing out that I work with a very, very good vent patient program. We have 24/7 access to a direct patient line. And not "just the office nurse" -- most of my families have the attending's cellphone number and we have someone on call for all after-hours questions. As a new grad nurse, this sort of open communication has been vital to my learning.

    But there are a lot of socio-economic factors involved. Many of my parents do not have insurance for themselves. They cannot afford to see a PCP. So, for them, any health problem equals a trip to the ER because it's "free" or at least fairly quick/easy compared to having to wait six weeks to see a doc at one of our safety net clinics. So they extend this belief to their kid.

    On top of that, you might have a parent who is slowly losing hours for the first time. So they're having to parent their vent kid over the weekend without a nurse. The kid gets a cold, needs increased suctioning and maybe some oxygen to keep their sa02s up. Parents freak out because that's a new thing to them because they simply aren't used to having to take care of their kid alone for more than a few hours.

    /shrug
    //I know nothing :P
  8. 0
    It is sad they are put in this position, my client just had hours cut, I have to find another day somewhere cause this isn't cutting it, anyway I just left another case for much of the same reasons, and because mom thought I was nannny for her other two kids, use to leave to run to store and get milk for 3 hours


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