Pediatric Home Health

  1. I've been debating about whether to apply for a pediatric home health job. Can anyone tell me what kind of things I might encounter with this? I've always worked with adults, except for a few I've saw in the last year working in a small town ER. We've been lucky enough to never have a really sick child thus far. My nurse friends say no way would they try this. The company has adult home health and hospice, but peds is the only area open right now. This would be a good way to get my foot in the door-but no guarantee how long I'd be working in peds division. I'm just worried that I don't have enough peds skills to be good at this-anyone have any thoughts?
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    About MontanaRN

    Joined: Dec '01; Posts: 9


  3. by   nur20
    In my opinion....The best thing since sliced bread,but proceed with caution,YOU WILL FALL IN LOVE WITH THEM!!!!! If you are a kind and fun loving person and with your background you will be fine.I made the transition from adult to peds care and i love it. Some diagnosis that i have come across are: cerebral palsy, seizures, hiv/aids, down syndrome,developmental delays,shaken baby syndrome which can include some of the above, just to name a few. You're more than likely to encounter such diagnosis as pneumonia(quite often aspirational), rsvp, often seen are g-tubes,ng-tubes,trachs,suctioning,oxygen,nebulizer tx. apnea monitors,pulsox, sometimes vents,meds and injections.ot, pt and speech therapy sometimes has an extension program for the nurses to do in between their visits and chances are you will learn all the greatest CARTOONS
  4. by   lpnandloveit1
    I have been doing home health nursing with peds for 10 years now. I love it. the only drawback is how deeply you do fall in love with these kids. It is great and I am finally doing what i became a nurse to do.
  5. by   flpednurse
    originally posted by montanarn
    i've been debating about whether to apply for a pediatric home health job. can anyone tell me what kind of things i might encounter with this? i've always worked with adults, except for a few i've saw in the last year working in a small town er. we've been lucky enough to never have a really sick child thus far. my nurse friends say no way would they try this. the company has adult home health and hospice, but peds is the only area open right now. this would be a good way to get my foot in the door-but no guarantee how long i'd be working in peds division. i'm just worried that i don't have enough peds skills to be good at this-anyone have any thoughts?
    [b]i have been a peds home health nurse now for about 4 years. i never thought that i would love it but that goes to show people that you never know something until you try it. i have been on cases where the child was as young as 6 months old. each one is very special and they do find a place in your heart. most of my experience is with trachs, g-tubes, and bi-paps. i have worked with one on a vent. needles to say, that if you have children at home you will find yourself hugging them more. most of my cases have been with children who where not born this way and they are the ones who show me more then anyone else. i hope you find your answer and i wish you luck in the direction you choose.
  6. by   kids
    You have NO idea how many Nurses I have hired in the past 6 months that said after a couple of weeks on the job "I wish I had tried this years ago".

    Imagine...spending a 4/6/10/12 hour shift 1:1 with a medically fragile child...going to school, giving GT feeds, playing, suctioning trachs, reading, rocking, doing ROM, laughing, riding bikes, playing games...I still have days where I still can't believe they pay me to do this.

    Yes, the pay is less than in other fields of Nursing but the stress is so much lower.

  7. by   DiOB
    I just started a position as a HH Director of a new Pediatric (and OB) program. I have been an OB/Peds RN for 30 years - mostly in the hospital. As I develop this new program, I am doing most of the visits and loving it.
    Any thoughts from other HH supervisors - words of wisdom - would be appreciated.
  8. by   Carolyn T
    Hi, I'm new to the list. I'm a home health pediatric vent nurse. I have been with a 2yr old who is dying for a couple of years now. He contracted MRSA and pseudomonas in the hospital and they are sending him home tomorrow so he can die there. Has anyone dealt with MRSA in the home care? There are 2 other kids, a twin and a brand new baby in the home. I also have 2 new grandbabies and worry a little about it. Any advice from others who have been in this position will be greatly appreciated

  9. by   kids
    I have a couple of kids on my case load with MRSA colonization, one for 6 years, the other for 2...just follow universal precautions...and encourage/enforce good hand washing of all members of the family...and face washing of the siblings.

    The nurses we have assigned to our kids also work with other trached kids and we have yet to have a cross comtamination, also we have not had a problem with siblings catching it.

    I am curious why this babe is being 'sent home to die' it the MRSA/pseudomonas? Have they tried tobramycine med nebs? Is he symptomatic other than purulent sputum? Colonization is not necessary a death sentance...I worked with adults who were colonized for years with one or the other or both...when theygot sympromatic they got a culture and were give a loading dose of Rocephin then switched to PO/GT Cipro or Floxin...were asymptomatic before the cultures came back.

    I would also do a search of the CDC website for tips on reducing cross contamination in the community...our kid who has had it for 6 years has been in public schools (and pre-schools) for 5 years, CDC is where we got our info to educate the school staff and to write the care plan.

  10. by   Carolyn T
    The baby that is being sent home to die has full blown MRSA infection, respiratory. Also pseuodmonas and he has no trach. They cannot trach him because of deformity. He has microcephaly, severe seizure disorder, blind, deaf, septal optic dysplasia. He was born dead, revived and has crashed numerous times. He's a real little fighter and refuses to give up until he is ready. This last hospitalization was really bad. They called his family over from as far as Puerto Rico to say goodbye. He was intubated, on a vent and had dopamine to maintain bp and zebutamine (sp) to maintain heart beat. His parents had him full code. They tried taking him off the vent and meds. His bp bottomed out, sats went down to 58 and he was pretty much gone. Mom said to put him back on vent and hang meds until family came but to make him DNR. Then when family got here they went to take him off vent and he was doing fair on 4L oxygen. Then they slowly took away the meds and he is doing ok without them. Of course he still has active MRSA and psuedomonas infection and aspirates his own secretions. He can't make it long this way. He also does not tolerate feeds well enough to maintain proper nutrition. He just had a 14 day run of Vanco so the hospital says he doesn't need to be there. Parents want him to die at home with me because I've been there since birth and he responds to only a few people.
    I will check the cdc site for cross contamination with active MRSA. I know they used to be resp. isolation but I've heard they changed that. Just want to know for sure. They have a 3 wk old baby to think about too, and of course the healthy twin
  11. by   nur20
    Yes, i agree. The basic would be universal precautions, and if there is a likelihood of spilling or splashing you should wear mask and gown.You have the potential for harboring the pathogen for months so it might not be a bad idea to get a culture.I worked with a 10 year old with MRSA and a TRACH, NEBS and a G-TUBE,in HH. There was quite a bit of cross contaimination going on. Had i been the only nurse on the case i would have stayed, but he had nurses around the clock 24/7, and i had my suspicions of lack of proper care.I would be restrictive with smaller siblings and teach good hand washing etc. In hospitals MRSA patients should only be placed in rooms with others with the same
  12. by   mznurse
    Montana RN, I have been doing pediatric and young adult home care for the psst 8 years on and off (more "on" the past 5 years) and I wholeheartedly agree that you will fall in love with these kids in short order. All of the ones I have cared for have the biggest hearts, enjoy life to the max, and are the most loving, affectionate kids you could hope to spend your time with. I have to agree, it's hard to believe I get paid what I do for the "work" I do. I work with vent dependent kids, all total care, and would not trade them for anything. I had done corrections, LTC and hospital M-S prior to "taking a chance " on HHC, and once I did, I wondered why it took me so long to do so. I think having a good nursing background certainly helps, as children respond to illnesses differently than adults, simply because physiologically and physically they are so much different than adults, but just the basic desire to want to help these precious kids counts for an awful lot. Good luck to you if you choose to try it. I don't think you'll be sorry.