When you pts have an emergency and need to go to the hospital,does your agency make you go with the parents and child? Most agencies tell us to go,but follow the ambulance in our own car. Some say don't go anywhere;you have to go home because its the caregiver responsiblility.
Agency M tells us to stay until the kid gets admitted or discharged,because leaving would constitute "abandonment". The kids aren't the hospital's responsibility until either admission or discharge.
Another agency says as soon as the kids are in the hospital or ambulance,its the hospital's responsibility and the parents responsibility. You must leave as there is no reimbursement by the insurance companies.
What are your agencies rules?
I'm curious, because I have stayed in the hospital with some of the kids until admission or d/c and none of the nurses who worked for the hospital didn't do any actual hands on care, but they did take vitals.
I had to do all the suctioning of the trachs and changing the diapers.
Almost all of the parents have said when they wait in the ER(about 4 hrs around here) if the Pdn wasn't there that they would have to do everything themselves.
Paramedics can do an emergency intubation but a trach vent kid is beyond an emergency intubation They cannot replace a trach. Most are not qualified to operate a ventilator. When an ETT is placed in the field the crew manually ventilated with a BVM. They can follow PALS & ACLS protocols for cardiac dysrhythmias. But most trach-vent kids are relatively stable and are not likely to need PALS/ACLS intervention than a typical child with asthma on any given day. Has any of your pedi trach vent patients ever required epi, adenosine, or any of the other PALS drugs due to VT, SVT, bradycardia while on a routine transport to a follow up MD appointment.
As far as staying in the ED you need to follow your agency policy but if not getting paid, why stay?
The issue in the other thread was that you never asked for help or asked for needed supplies not that you needed supplies. Polite requests go a long way just like please and thank you. You are the one who stated you steal supplies because your patient/family needs them. Responders went by what you wrote in your posts. You never stated that you asked for assistance just that you thought the staff should " know" that you needed help. Nurses are not mind readers
I stayed to help out the families.
Lots of them are scared(as they should be) and I thought them seeing a familiar face might help.
Also,it may sound strange,but I can explain things a bit better to the hospital staff than Mom can.
Mom usually tells the hospital staff to "ask the nurse".....me of course.
A paramedic can use an ETT through the trach stoma but in most states can not insert a trach tube.
Regarding supplies (which seems to be a carryover from another thread), we were never asked to use our own supplies other than the trach tube and the down-sized trach tube. I used our own trach ties as well because I didn't like the hospital ones. Diapers, suction caths, chux bads, wipes, etc. were always provided by the hospital.
Specializes in Complex pedi to LTC/SA & now a manager.
In this case, I agree with you. The nurse is IF an ambulance/transport service used it must be ALS, as trach/vent is beyond the scope of BLS. This is NOT just in case PALS/defib is needed. Clearly the nurse is exaggerating her purpose and does not know the regulations. If she was right, then how can you take a trach/vent child on the school bus with just a PDN & equipment?
I believe the suit was a trach/vent child transported by BLS/mobility assistance vehicle (basically a driver with a CPR card. & basic first aid). I can search later for the case.
Parent is permitted to transport with PDN. Can you imagine the state mandating CCT for EVERY TIME the child needs to leave the home? What a waste of money and resources.
I also said I think compressions are enough. Besideskids usually have respiratory issues,and then cardiac arrest occurs. Whereas in adults,cardiac issues usually cause respiratory arrest.[/quote']
Yes, if I a child codes it's usually d/t a respiratory arrest. If you initiate compressions that's because the pt lost a pulse or in some peds case their HR has dropped too low. If this was the case for compressions wouldn't you want to give ACLS drugs or defib if necessary? At that point it's become a cardiac arrest and you need to start the heart back to try and fix the respiratory.
Yes, if I a child codes it's usually d/t a respiratory arrest. If you initiate compressions that's because the pt lost a pulse or in some peds case their HR has dropped too low. If this was the case for compressions wouldn't you want to give ACLS drugs or defib if necessary? At that point it's become a cardiac arrest and you need to start the heart back to try and fix the respiratory.
If she was right, then how can you take a trach/vent child on the school bus?/QUOTE]
Yes,some on here are saying a pt has better outcomes with AcLS drugs and a defib,but then we do take the children to school,and we never have that equipment available on the bus(or at home for that matter)then why can't we take them to Dr appointments without it then?
Some of my "kids" have an hour bus ride to school.
A paramedic can use an ETT through the trach stoma but in most states can not insert a trach tube.
Regarding supplies (which seems to be a carryover from another thread), we were never asked to use our own supplies other than the trach tube and the down-sized trach tube. I used our own trach ties as well because I didn't like
the hospital ones. Diapers, suction caths, chux bads, wipes, etc. were always provided by the hospital.
Apparently,a go bag should contain diapers and chux(that's what was told to me on another thread).
I didn't know that,but as I said lots of parents would have a problem with that because home care supplies are just that,home care supplies.
Besides,I thought hospital billing included that stuff anyway?
I know on my own personal hospital bills some things are listed as "other" which I'm asusming includes toiletries.
smartnurse1982
1,775 Posts
I stayed to help out the families.
Lots of them are scared(as they should be) and I thought them seeing a familiar face might help.
Also,it may sound strange,but I can explain things a bit better to the hospital staff than Mom can.
Mom usually tells the hospital staff to "ask the nurse".....me of course.