How much orientation should I expect to receive in private duty nursing?

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Got a call back from HR about a potential job in private duty nursing. Vent/Trach adults & peds. I'm a new grad with no experience in this area but they said they offer training. How much training should I expect or request as a new nurse? I'm a little nervous about it being limited after reading a few previous threads here. Thank you.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

Don't do it. New grads don't belong in PDN. Read the past posts. I would explain, but time is limited right now. You will be putting your license in jeopardy.

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Specializes in Complex pedi to LTC/SA & now a manager.

12 weeks minimum. 4-6 weeks classroom lab before 1:1 preceptorship on basic cases and at least 6 weeks (3-4 8 hour shifts /week x 6 weeks working with a qualified preceptor)

No trach vent until a year doing basic care (g tube, seizure precautions , basic respiratory).

Only one or two agencies I know do this basically nurse residency training in complex pediatrics. Only a few families willing to permit new grads on cases.

Minimum 12-18 months basic care experience before you can apply to do trach or trach vent training

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Don't do it. New grads don't belong in PDN. Read the past posts. I would explain, but time is limited right now. You will be putting your license in jeopardy.

This! You're not ready for PDN.

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you think they'd throw a new grad into cases that would risk my license and the company's reputation? i'm getting so many mixed messages... i posted in the general nursing discussion about private duty nursing and ppl said to go for it as long as i get proper training... which is why i'm asking here about what "proper training" should look like. meh, so confusing... and a bit discouraging :(

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The only "training" I ever received from a company was an outdated video. Also, orientation on a case is usually a few hours... maybe one whole shift if you're very lucky.

When most of us say you're not ready for PDN as a new grad we mean that a nurse needs real life experience on the floor of either a hospital or other facility. You can't learn some things from videos or books... or even a classroom. The best nursing skills are obtained from real life in the trenches experience.

There is no charge nurse or DON available in PDN to ask for advice, help, etc. .. you're all alone to sometimes make crucial decisions.

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Also, YES!, an agency will throw you out on a case without proper training. Most agencies only care about filling open shifts.

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My experience is that you will receive the training that you demand. You have a right not to accept a patient if your skills do not match the patient's acuity. I have one agency that tests you on medical dummies with various situations, then you have an in-service about the particular vent you will be working with.

I did it for 6 months, had one plug, and had to do an emergency change. Handled it fine because I prepared myself requesting more training and also doing a lot of learning on my own.

Generally, depending on the agency and where you are, you are NOT going to get anything like a year of training. So, again, if you are strong enough to speak up when you need help and get what you need, then go for it. How long they keep an experience RN with you will most likely be up to you. If they throw you in with the training that makes you feel comfortable that you can handle all of the emergencies, know what to bring with you when you travel (even from room to room), have a process to exploring what causes all the alarms and desats and how to methodically check each, then go for it.

Do know that you can always not accept the case or stop the case, never put your patient and yourself at risk for a paycheck.

It can be done.

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Agencies do what they need to do to have adequate staffing so parents don't leave agency. They will send completely underqualified nurses out to complex cases. They don't care about your license, you need to care about your license.

If you search my past posts on this topic, I talk about having new nurses in my home.

*COULD* you safely do complex cases as a new nurse in PDN. Yes, it's possible but also risky. You need to consider the risks. You also need to consider what training means to you vs. what training means to a parent vs. what training means to the agency. You also need to know the difference between being proficient, not competent, proficient in a skill vs. being trained in a 6 or 8 hour vent class.

At a minimum you need to know, by heart and muscle memory, every step in emergency procedures. You need to know every alarm on the vent, what it means and where to start troubleshooting. You need to know what all the settings on the vent are, what you should NEVER EVER EVER touch/change and what all the outputs mean and how to troubleshoot a weird output number. You need to be absolutely spot on with assessments especially lung sounds. You won't have anyone to ask "hey, is this rhonci or rales?"'

You might have a parent that is the foremost authority on their child's meds, diagnoses, equipment and care. Or you might have a parent that relies 100% on nursing, is neglectful and couldn't answer a single question about the care of their child.

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Specializes in NICU, ICU, PICU, Academia.

Well said ventmommy.

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Specializes in Peds(PICU, NICU float), PDN, ICU.
you think they'd throw a new grad into cases that would risk my license and the company's reputation? i'm getting so many mixed messages... i posted in the general nursing discussion about private duty nursing and ppl said to go for it as long as i get proper training... which is why i'm asking here about what "proper training" should look like. meh, so confusing... and a bit discouraging :(

They will tell you what you want to hear. You are a warm body with a license to them. When you mess up or lose your license, there will be another warm body to replace you. Happens all the time. If you ask for too much training beyond what is normal, they will get annoyed and not give you hours.

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Specializes in Complex pedi to LTC/SA & now a manager.

Yes they absolutely would throw an under qualified, inexperienced new grad into high tech cases and risk the nurse's license. Your license is not their problem. They don't consider reputation as they filled the case schedule.

The fact that they want to place you on trach vent rather than basic care is alarming. Neither agency I work for would consider anyone for trach vent with out 12-18 months paid nursing experience.

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