How long does your patient stay in hospital?

caliotter3 · Oct 28, 2011

Why do you need to know? It depends on how sick the person is and what kind of conversations take place between the parents and the attending doctor. Look at one to two weeks. Three if the person is good and sick.

Blackcat99 · Oct 29, 2011

Thanks caliotter3. I am hoping it will be only 1-2 weeks. I know his mother does not want him in the hospital. His mother worries that by being in the hospital he will pick up something extra such as a hospital acquired infection.

I hope my other agency will have some extra hours available for the next few weeks.

SDALPN · Oct 30, 2011

It depends. I've seen kids in and out (and usually back in again). And I've seen kids out for months.

I try to never work only one case. I spread myself out so I'm never out of lots of hours. It also benefits you to work other cases to keep up skills. Especially with respiratory season just starting.

The agencies don't care if the nurse has a cold as long as the agency makes their dollar. They never see that having a nurse out for a day or 2 is much better than the patient being out for possibly months. Don't go in sick and be very careful who you are around so you don't carry something to the patient. That will help you out too. Also sanitize EVERYTHING you possibly can. Don't forget the commonly touched stuff. I sanitize bed rails, phones, light switches, door/sink handles/knobs, behind the handle for the fridge, the toilet flusher knob (can't think of what its called), equipment and buttons touched on the equipment, and anything else people can touch. I try to do this or have it done at least once a week or more often if the home has lots of kids, pets, pests, or visitors.

Prevention is the most important!

caliotter3 · Oct 30, 2011

At my case the client is in the hospital on a regular basis. I believe the lack of adequate trach care and sanitary conditions contribute to problems. One nurse always removes the cool mist tubing from the trach collar and drapes it over the bed so it can fall on the floor. The trach collars are never washed or changed unless I do it. Quite often I find the same trach tie, saturated and smelling, on the client on Monday that I put on Friday. I have spoken to the nursing supervisor and have been assured that the only behavior I am responsible for is my own. With this type of a "brush off" and lack of action on the supervisor's part, I just plug along. I am wary about providing education to the parent, because you can't contradict anything her favorite nurses do or don't do. They walk on water as far as she is concerned. I am certainly tempted to lower my standards, even though I am aware that I am not perfect and could do more myself. It gets to be tedious to do things that you know the others do not bother with. It is always best to be on good terms with more than one agency for those times that you are out of work through no fault of your own. Unfortunately in my area all the agencies cry that they don't have any work, except, of course, for those nurses who are on great terms with the staffing coordinators.

ventmommy · Oct 31, 2011

At my case the client is in the hospital on a regular basis. I believe the lack of adequate trach care and sanitary conditions contribute to problems. One nurse always removes the cool mist tubing from the trach collar and drapes it over the bed so it can fall on the floor. The trach collars are never washed or changed unless I do it. Quite often I find the same trach tie, saturated and smelling, on the client on Monday that I put on Friday. I have spoken to the nursing supervisor and have been assured that the only behavior I am responsible for is my own. With this type of a "brush off" and lack of action on the supervisor's part, I just plug along. I am wary about providing education to the parent, because you can't contradict anything her favorite nurses do or don't do. They walk on water as far as she is concerned. I am certainly tempted to lower my standards, even though I am aware that I am not perfect and could do more myself. It gets to be tedious to do things that you know the others do not bother with. It is always best to be on good terms with more than one agency for those times that you are out of work through no fault of your own. Unfortunately in my area all the agencies cry that they don't have any work, except, of course, for those nurses who are on great terms with the staffing coordinators.

That is disgusting that this child is wearing the same trach tie for 72 hours. How have you avoided skin breakdown/yeast infections? Why aren't the parents saying anything about this? We change ties and clean his neck every 12 hours. We don't use 2x2s around the tube and my DS has clear, healthy skin. He is vent dependent so we don't use mist collars but can't you stick it in a clean glove the way you do for the Y of the vent tubing?

ventmommy · Oct 31, 2011

Oh, and to answer your question about hospital stays, we are usually only in for 2-5 days. We have worked very closely with our PICU doctors and regular doctors. They know us. They know our skill and knowledge levels. They know we have good nurses. They know we will call pulm pager or the PICU if we have questions. They try to get us out as soon as possible to avoid getting any hospital-acquired infections.

Blackcat99 · Oct 31, 2011

Oh, and to answer your question about hospital stays, we are usually only in for 2-5 days. We have worked very closely with our PICU doctors and regular doctors. They know us. They know our skill and knowledge levels. They know we have good nurses. They know we will call pulm pager or the PICU if we have questions. They try to get us out as soon as possible to avoid getting any hospital-acquired infections.

Thanks ventmommy. :yeah: That's great news. Yes, my patient is doing really good right now at the hospital. His Mom said he should be home in about 2-3 days.

caliotter3 · Oct 31, 2011

About using gloves for the end of the mist tubing, we are limited to two boxes of gloves each month, so mom has a "rule" of only one pair of gloves per shift. If you divide the gloves per box up by the shifts each month, it comes up to that. Ran out of gloves for several days last month and the nurses won't buy their own. The suppliers have said that medi-Cal says two boxes and only two boxes. My patient keeps skin breakdown and yeast infections in spite of the meticulous care that I give. I am only one person. If we did a good cleanup every 12 hours, I am certain that he wouldn't be going to the hospital with pneumonia and tracheitis an average of once every three to four months. I speak to this with the supervisors, and they give me lip service. Glad your patient will be home soon, Cat.

allnurses Guide · Oct 31, 2011

Thanks ventmommy. That's great news. Yes, my patient is doing really good right now at the hospital. His Mom said he should be home in about 2-3 days.

That's great news! My feeling is the mom has a point there. The longer they are in the hospital the greater chance of picking up a nasty bug. On the other hand, some parents wait too long and delay the inevitable when their status is clearly on a downward trend. Sounds like you were worried about him.

When I worked at Children's we had a few babies who stayed for months, but it's unusual nowadays it seems. A big part of that was the family situation.

Caliotter -- I share your frustration . . .if the supervisors don't care you're at an impasse but the care you do give is probably helping to prevent it from getting much worse -- and rhetorically speaking to the slackers -- if you only have one patient why can't you do-your-freakin-job?

Blackcat99 · Oct 31, 2011

About using gloves for the end of the mist tubing, we are limited to two boxes of gloves each month, so mom has a "rule" of only one pair of gloves per shift. If you divide the gloves per box up by the shifts each month, it comes up to that. Ran out of gloves for several days last month and the nurses won't buy their own. The suppliers have said that medi-Cal says two boxes and only two boxes. My patient keeps skin breakdown and yeast infections in spite of the meticulous care that I give. I am only one person. If we did a good cleanup every 12 hours, I am certain that he wouldn't be going to the hospital with pneumonia and tracheitis an average of once every three to four months. I speak to this with the supervisors, and they give me lip service. Glad your patient will be home soon, Cat.

Yes, similiar problem here in Florida. Never enough supplies. Wow!!! only one pair of gloves per shift!!! :eek:

My agency will send us nurses gloves when needed. The nurses here won't buy their own gloves either.

Medicaid here never sends us enough normal saline for suctioning either. They told his mother to make her own normal saline at home but she won't do it. I am planning on making my own normal saline here at home so I can at least have some available for my shifts.

Blackcat99 · Oct 31, 2011

It depends. I've seen kids in and out (and usually back in again). And I've seen kids out for months.
I try to never work only one case. I spread myself out so I'm never out of lots of hours. It also benefits you to work other cases to keep up skills. Especially with respiratory season just starting.
The agencies don't care if the nurse has a cold as long as the agency makes their dollar. They never see that having a nurse out for a day or 2 is much better than the patient being out for possibly months. Don't go in sick and be very careful who you are around so you don't carry something to the patient. That will help you out too. Also sanitize EVERYTHING you possibly can. Don't forget the commonly touched stuff. I sanitize bed rails, phones, light switches, door/sink handles/knobs, behind the handle for the fridge, the toilet flusher knob (can't think of what its called), equipment and buttons touched on the equipment, and anything else people can touch. I try to do this or have it done at least once a week or more often if the home has lots of kids, pets, pests, or visitors.
Prevention is the most important!

You have some great advice!!!! I agree with you 100% :yeah: