I saw that there are some old threads about this (and I read them), but I would like to converse with some people who are doing this job now.
I just finished my LPN program and I am waiting to take my boards. I am continuing classes for my RN, and I have applied for a PRN LPN position in Pediatric Home Care. I actually got a call from the manager and we had a nice chat - she told me that working nights and evenings is good for students because the parents are often there for "back-up," and sometimes there is time to study. I am supposed to call her back when I have my license :), so that sounds promising to me.
What can you tell me about the experience of working pediatric home care? Have you enjoyed it? What are the best and worst parts of the job, and what advice can you give me as a new LPN? As a CNA at a large hospital, I have some experience with trachs and patients on vents, and I have assisted with tube feedings during school clinicals. What other types of duties should I be ready for? (Of course I am a pro at turning pts, and changing incontinence briefs. :) )
I would just like to start a dialogue with some nurses, particularly LPN's, working in pediatric home care. Thanks for taking the time to respond!
These cases might have another source of payment rather than Medicare/Medicaid. That's a requirement that's specifically theirs. Private pay and some insurance co's might allow a new grad. Unless you know the source of payment, it's unfair to assume anyone's committing fraud.
I haven't read through all the posts and OP's responses, but I remember a time when I thought I knew about trachs and vents because I had it in nursing school. I did have over a year experience before starting in PDN, and I received a trach/vent case for my very first PDN assignment. I was brave and bold and confident. The nurse who "trained" me could not even tell me what PEEP and PIP stood for, let alone articulate what they meant. This did not even raise a red flag for me, but it should have. I didn't even know what I didn't know. It took me about 6 shifts to realize that I had NO business being on that case. Once I realized there was way more to vents than I bargained for, I got myself off that case and asked the agency for more, formal training before I went back. They had nothing to offer.
Fortunately the next agency I worked for would not even ALLOW me to work a vent case until I had been with them for a year. Then they gave me a whole self-study course with books and videos. Then I needed to demonstrate skills in their lab, THEN I needed (I think, could have been more) about 18 orientation hours with an established vent nurse. And even now I'm not 100% confident because I have not experienced a real emergency situation yet. I cringe when I think about how arrogant I was, that just because I did it in nursing school, that I was ready.
It would be impossible for the agency to juggle which nurses could work for each different insurance. It's not a rule by agency as it can be found in the rules for medicare/medicaid. The person above is right, you don't realize what you don't know and nursing school isn't enough.
This will probably sound nit-picky, but your "tag line" says you have two years of nursing experience, specializing in SNF/Rehab. Do you truly have the two years of nursing experience? Because then the whole proposed scenario of being a new grad with a fresh license is moot, no?
I saw that there are some old threads about this (and I read them), but I would like to converse with some people who are doing this job now.
I just finished my LPN program and I am waiting to take my boards. I am continuing classes for my RN, and I have applied for a PRN LPN position in Pediatric Home Care. I actually got a call from the manager and we had a nice chat - she told me that working nights and evenings is good for students because the parents are often there for "back-up," and sometimes there is time to study. I am supposed to call her back when I have my license :), so that sounds promising to me.
What can you tell me about the experience of working pediatric home care? Have you enjoyed it? What are the best and worst parts of the job, and what advice can you give me as a new LPN? As a CNA at a large hospital, I have some experience with trachs and patients on vents, and I have assisted with tube feedings during school clinicals. What other types of duties should I be ready for? (Of course I am a pro at turning pts, and changing incontinence briefs. :) )
I would just like to start a dialogue with some nurses, particularly LPN's, working in pediatric home care. Thanks for taking the time to respond!
It would be impossible for the agency to juggle which nurses could work for each different insurance. It's not a rule by agency as it can be found in the rules for medicare/medicaid. The person above is right, you don't realize what you don't know and nursing school isn't enough.
Actually,we do know the source of payment most times,because our rates are set that way.
For instance,Medicaid cases pay less than private insurance;its reflected in your hourly pay.
The guy at one company let us know which cases pay less before we work the case.
There isn't a set hourly pay; it depends on pt's insurance.
I currently have 2 years experience as a CNA, not a nurse. I wasn't sure how to specify that on the site. Not trying to be misleading! Should I change it to zero? As there are forums on here for CNA's, LPN's, and RN's, I figured it was OK to put my years of healthcare experience.
To be clear, I have been an aide for 2 years, just finished LPN schooling, waiting to take boards. One more year of schooling for Associates Degree in Nursing, then boards to become an RN. :)
One thing I am hearing loud and clear is that I will need extensive, specific training on vents before working with any patient that has one. This advice has been heard and noted! Also that nursing school is not enough, and that I don't realize all that I don't know. I just want to let you know that I am hearing you on this. The only way to find those things out will be through experience.
Becoming a teacher was nothing like student teaching, or my teacher education, so I get the idea. I will look out for myself and do everything I can to be prepared for any position that I am hired for.
Specializes in Pediatric Private Duty; Camp Nursing.
I think the reason I'm so adamant about getting proper training is that there are too many agencies that WILL let you go in cold with little orientation. All they care about is warm body w a license filling a shift for which they will get paid. If something happens, they will have NO problem throwing you under the bus.
And on that note, ALWAYS carry your own Liability Insurance. It costs about $100/yr. Don't rely on any employer to ever back you up. They say they have insurance, but it may not necessarily be for you. Again, the bus.
I think the reason I'm so adamant about getting proper training is that there are too many agencies that WILL let you go in cold with little orientation. All they care about is warm body w a license filling a shift for which they will get paid. If something happens, they will have NO problem throwing you under the bus.
And on that note, ALWAYS carry your own liability insurance. It costs about $100/yr. Don't rely on any employer to ever back you up. They say they have insurance, but it may not necessarily be for you. Again, the bus.
Keep in mind that in an unplanned legal episode, while the employer legal counsel may represent you in the beginning, that does not mean they will represent you throughout the proceedings. They can, and will, drop you when it suits their case. And in all things, they represent the interests of the employer, which may not be the same as representing your interests. So, you need your own Liability Insurance.
Liability insurance is a great idea. I used to get my own policy when I taught private voice lessons - for that purpose, I purchased a one year business liability policy. I will definitely look into that if I get an LPN job.
Do you recommend holding my own Liability Insurance if I work at a large facility as well, like a long-term care facility?
Liability insurance is a great idea. I used to get my own policy when I taught private voice lessons - for that purpose, I purchased a one year business liability policy. I will definitely look into that if I get an LPN job.
Do you recommend holding my own liability insurance if I work at a large facility as well, like a long-term care facility?
Yes! Never forget that they are all businesses and their main goal is to make money and not lose what they have. You are replaceable, their business isn't as easy to replace. If a Dr, hospital, agency, etc decide you aren't helping them win their case, they will burn you. Having plan B (malpractice insurance) is your safety net. I think I remember reading somewhere that correctional nurses and LTC nurses were sued the most.
I posted this in the past as a reply on another thread:
I worked in Pediatric Home heath as a LVN. I enjoyed the job at first, the money was great, the hours were perfect - at the time I was going thru an RN program, but for me I needed more. By the time I left, I was bored and felt like a highly paid babysitter. I applogize if I offend with my last statement.
I did not do "visits", I was actually in a home for a 8,10, 12 or sometimes 16 hour shift taking care of a child. Since I was PRN I never had a "regular" assignement, I was floated to whatever home needed a nurse - this was my choice. The kids I came across had a variety of disorders - CP, trach & vents, feeding tubes, brain injuries etc. I administered meds, feedings, breathing treatments, ROM, ADL's etc. Sometimes the parents were home but most often they were tending to other siblings, at work or if I worked a night shift they were sleeping. Most of the homes I went to had a nice setup for the nurse - space in the fridge for my lunch, comfy chair, TV etc, but be prepared for the opposite. When I worked during the day I really didnt have much downtime, but at night I had alot of time. I always carried my laptop or a good book to get me thru those slow times - especially when everyone is asleep.
I usually went on any assignment that was offered to me. But I have to admit, some assignments I requested not to be sent to again - bad neighborhoods, parents that I got a weird vibe from and even one home where the mother actually did everything for the kid and I was supposed to clean up after them, do laundry etc.
It takes a special person to do this. You will get attached to the kiddos. I actually became good friends with one of the families I worked for. If you have any other questions let me know. Good Luck.
You should always maintain your own Liability Insurance, it makes no difference what type of setting where you work or volunteer. Some employers even require you to prove you have your own insurance as part of the hiring process (separate from car insurance).
I have done a variety of different disciplines throughout my career. Currently I am doing pediatric home care again. I like the current case I have. I echo the other comments that you never know what you don't know. Time is a wonderful teacher and I learned a great deal of skills while on the job--ones that I had no previous experience with. This is not the ideal way to get knowledge as I am sure you can all attest to, but it is a reality that most home health care companies are not great at being over achievers in the area of training. I think the experience of working this type of job varies widely depending on which company you are with. I wish you the best of luck!
SDALPN
997 Posts
It would be impossible for the agency to juggle which nurses could work for each different insurance. It's not a rule by agency as it can be found in the rules for medicare/medicaid. The person above is right, you don't realize what you don't know and nursing school isn't enough.