Quote from caliotter3
Patients at home are deemed stable, however, that does not preclude a patient being discharged to the home prematurely or inappropriately. One needs to be ready for the unexpected. I always mentally "practice" emergency actions on my own and regularly with the parents. Should be one of the first teaching sessions that you provide.
Yes, the patients who are sent home are "stable" but complications can happen fast and be devastating. Also it really depends on what their other issues are. A cardiac baby/child with a trach can have 10 seconds of resp distress and go into a full blown cardiac arrest without warning (actually cardiac kids can go into cardiac arrest for no other reason than that they have cardiac issues trach or no trach), or a kiddo with neuromuscular issues may not be strong enough to cough and plug very easily. I am glad you mentally practice emergency situations on you own. I with others did so as well and I urge people caring for these patients to never underestimate their ability to go bad in the blink of an eye. Kids compensate for things much longer than adults do and before you know it they are dead in your arms.
I sent a kiddo home once, trach/vent. Happiest little guy around, had the biggest smile that would light up a room, we held on to him probably way longer than necessary...he was the only ICU patient on the unit who spent time during the day up in his baby walker! He went home for a week, plugged, nurse/parents didn't change out the trach, he coded for three hours in the ER, received an ethically questionable number of Epi doses and now he is neurologically devastated, neuro storming constantly. His parents refuse to believe his prognosis so he went home but his spirit and life are no longer there.
OP I certainly don't want to discourage you from pursuing this career path, you sound like you definitely want to take all precautions to be ready for an emergency and so long as you are always prepared for the worst you will do fine! I am sure these events happen very infrequently, I am only aware of them because I see the kids after then are admitted. I wish you lots of luck!