Are my pts "brain dead"?

Nurses Relations

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I apologize if I am sounding stupid now,but I am just curious. We have all heard about the case in California with the 13 yr old,and how she is brain dead. Of course,she is on a vent,and the family wants her to get a trach and gtube.

I have several pts that are "unresponsive" meaning they don't talk, blink their eyes, nothing, no purposeful movement, nothing. All but one is on a vent, and all have trach and gt. At least one doesn't even use a gtube. She has been on Tpn for 1.5 years now for all her nutritional needs. One boy is a Dnr order, but with the understanding that we are to rescucitate him using the Ambubag, but if his heart stops, we do nothing. (I haven't seen a Dnr order like that before, and this is the first one I've seen like that)

It also says "at parents discretion", meaning that they could change their minds and make us do chest compressions. (according to nursing supervisor). This same boy had an EEG,and it shows no activity.

Anyway,I'm not seeing the big issue with the California case as I have several kids with vents, trach, and gtubes that are well...I'm not saying the words.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Nevertheless, it seems like that poster has an inaccurate grasp of what it means, based on what she just wrote here.

Specializes in Complex pedi to LTC/SA & now a manager.
Nevertheless it seems like that poster has an inaccurate grasp of what it means, based on what she just wrote here.[/quote']

I agree She has posted that she has worked pediatric private duty for 9 years.

Specializes in HH, Peds, Rehab, Clinical.

I'm wondering now long it will be before this child's insurance carrier decides to stop paying. Seriously.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I'm wondering now long it will be before this child's insurance carrier decides to stop paying. Seriously.
I'm sure they already have.

I too would imagine they have already.

Specializes in Complex pedi to LTC/SA & now a manager.
I'm wondering now long it will be before this child's insurance carrier decides to stop paying. Seriously.

I am guessing you are all referring to the CA case. Family claims insurance is still paying. No one can refute due to privacy laws and parent won't consent to disclosure.

Specializes in Public Health.
I am guessing you are all referring to the CA case. Family claims insurance is still paying. No one can refute due to privacy laws and parent won't consent to disclosure.

Of course they won't. This case makes me so upset. They are really manipulating public opinion by controlling what the "facts" of the case are. Denial ain't just a river in Egypt.

My agency has NEVER,EVER,gave continuing education courses except for new vents. They only require a one yr inservice. I wouldn't even know how to find info on nursing conventions,and I don't have $$$ to pay for them either. Private Duty isn't know for paying out $$$. The agency isn't going to pay for it,I know that for sure.In the original post,I did state that my nursing supervisors didn't know either.....most have said the children mainly have AW/AS cycles,and we are supposed to chart that under activity.In any event,they aren't in a PVS either.

Specializes in Oncology; medical specialty website.

There is no reason you cannot do CE on your own. Just because your employer doesn't provide it does not excuse you from keeping up to date on nursing issues/practice and remaining current within your specialty. Most states that require CE for license renewal require 20-30h CE every time you renew your license. There are multiple CE providers that will offer +100hrs CEU for ~30-40 dollars a year. Surely you can afford that.

All I have heard from you is excuses: I didn't know/no one showed me/they never taught me that/I don't have time....The onus is on you to provide safe care and to be up-to-date on your practice. All I needed to do was type a few key words into the search function, and I found several CE courses, some free, some you had to pay for. Several of them dealt directly with brain death.

At the very least, do you subscribe to a professional journal? (Not "Advance," or "Nursing Spectrum," etc.) Take some responsibility for your learning. It's not just going to fall in your lap from the sky.

Specializes in Complex pedi to LTC/SA & now a manager.
My agency has NEVEREVER,gave continuing education courses except for new vents. They only require a one yr inservice. I wouldn't even know how to find info on nursing conventions,and I don't have $$$ to pay for them either. Private Duty isn't know for paying out $$$. The agency isn't going to pay for it,I know that for sure.In the original post,I did state that my nursing supervisors didn't know either.....most have said the children mainly have AW/AS cycles,and we are supposed to chart that under activity.In any event,they aren't in a PVS either.[/quote']

Then how have you renewed your nursing license? NJBoN requires 30 hrs/2 years for ALL LPNs& RNs

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
My agency has NEVER,EVER,gave continuing education courses except for new vents. They only require a one yr inservice. I wouldn't even know how to find info on nursing conventions,and I don't have $$$ to pay for them either. Private Duty isn't know for paying out $$$. The agency isn't going to pay for it,I know that for sure.In the original post,I did state that my nursing supervisors didn't know either.....most have said the children mainly have AW/AS cycles,and we are supposed to chart that under activity.In any event,they aren't in a PVS either.
That is what sites like this are for...to help you. There are many resources online and free CEU's just Google them.

PVS is just a term to describe a coma/Level of consciousness....

[h=2]Persistent Vegetative State (PVS)[/h] A vegetative state can be defined as "a clinical condition of unawareness of self and environment, in which the patient breathes spontaneously, has a stable circulation, and shows cycles of eye closure and opening [that] may simulate sleep and waking" [Working Group of Royal College Physicians, "The Permanent Vegetative State," The Journal of the Royal College of Physicians 430 (1996): 119-21]. Since patients in such a state sometimes show behavior that could be interpreted as evidence of consciousness, the diagnosis is not always self-evident. Additionally, the condition of being in a vegetative state is similar to that of other conditions that involve the absence or partial absence of awareness of self and the environment, such as coma, locked-in syndrome and akinetic mutism
What Is A Coma (comatose)? What Is A Persistent Vegetative State? - Medical News Today
Specializes in Critical Care,Recovery, ED.

Continuing education is the responsibility of each practitioner of the profession. It is a never ending responsibility. It is never the responsibility of the employer.

If you don't continue your education after graduation from your basic RN program, you are doing yourself, your colleagues, and your patients a grave disservice.

These are general remarks and are not aimed at any specific poster on this board, but all members of this community should avail themselves of the educational resources found here and elsewhere.

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