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Discussion

How do you stand the boredom?

Just a vent... I've been doing PDN for about a year and I have 2 main cases split between the week and I've covered TONS of cases over the year. I'm feeling down on myself because I haven't been to a single case that I really liked... Theres just TOO much down time on every case I've been to, even if it's "high tech".

One of my current cases is very low tech and I mean I'd trust my 10 year old self to care for this pt. The pt eats regular food PO, feeds himself, is mobile, potty trained for the most part, and only takes one med in the 8 hour shift that I'm there. He also easily entertains himself on the computer for the entire shift and his parents are completely ok with that, they actually encourage it because "it keeps him quiet"... His only dx is CP. I always wonder how insurance even approves this case for skilled nursing, because it's nothing more than babysitting. The parents actually encourage me to watch what I want on TV, they buy magazines for the nurses to read, and given out the wifi password. It sounded good until I realized I went to nursing school only to watch 8hrs of TV a day...

My my other case is "high tech". Trach/vent, GT, seizures.. I take him to school and although there's more technical stuff going on, it still kills me with boredom. I just sit in the back of the classroom until he needs care which isn't very often. I've tried to help him with arts and crafts or read to him during school hours, just to do something, but the school actually told me I'm only to do nursing care in school and nothing else...

The only reason I stay is because it just works so perfectly with my school schedule. I wish so desperately to leave PDN and never come back. It's just too terribly boring for me. How do you cope with boredom while on cases? Especially ongoing cases where it's the same thing every shift?

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    • Featured Replies

    I earned my BSN and MSN while working boring overnight PDN cases. Online of course.

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    Surfing the internet, catching up on emails, reading (book / Kindle / newspaper / magazine), playing games on computer/tablet, listen to music....

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    • Experts

    Many PDN nurses I know use the downtime to complete online coursework, watch movies on Netflix or Hulu, or surf the internet.

    For many nurses, the downtime is the biggest perk of PDN. Some of us don't want to run around like a chicken with our heads cut off.

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    Would this be a good option for a new graduate nurse? I'm looking for a more slow pace environment for my first job and I've always wanted to do home health type care. I've been browsing the specialties and trying to get a sense of different options. I definitely know I do not want a super intense job like ICU. Just wondering if this line of work is acceptable for a new grad.

    Sorry for hijacking the thread OP. I don't have any advice. I do wish you the best and I hope you find the right place for you.

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    Would this be a good option for a new graduate nurse? I'm looking for a more slow pace environment for my first job and I've always wanted to do home health type care. I've been browsing the specialties and trying to get a sense of different options. I definitely know I do not want a super intense job like ICU. Just wondering if this line of work is acceptable for a new grad.

    Sorry for hijacking the thread OP. I don't have any advice. I do wish you the best and I hope you find the right place for you.

    Not really especially on your own. You are on your own. Especially with trach vent. Kids are good until they are not. There is no rapid response. No respiratory. No charge nurse. No pod mate to ask for help. It's you. Some parents know how to do the work, others do not if they are even home. Calling EMS isn't always a saving grace as these are chronic kids that make many emergency teams who look to you to be the expert on the child's diagnosis, treatment, medications and nuances. You will be asked what the child needs...

    Do you know what to do if a normally stable child is in status epilepticus and not a TV tonic clonic seizure? Or even how to recognize? Staring, mild nystagmus, unresponsive, then twitching of one arm....and the seizure plan isn't working (And keep panicking mom from punching the arrogant police officer who is more nervous than the bystanders)

    Can you stay calm when a kid has their first seizure r/t increasing ICP d/t unknown hydrocephalus with mom sitting next to you ?

    Your 5 yo patient trach/vent & CP ex preemie with ICH. who is now actively seizing, oxygen level dropping, feeding pump clogged, poor air exchange and thickening mucus plug while on a bus home from school with only a driver & transport aide?

    Worse I witnessed this one...a 6 yo with poor cough, so plugged wheezes not audible (really not able to auscultate by putting your ear to the kids chest because you don't know where your stethoscope is) need to deep suction but the new grad afraid to deep suction so only using a yankhauer, didn't think to start a neb treatment but gave O2 (useless if there is restriction or mucus plugs) to the point the hypoxia induced a seizure... The other nurse and I could not say anything as we both work for different agencies and neither the same as her. Thank goodness the teacher called the school nurse who called 911. Kiddos ok as the school nurse started a neb tx but I can guarantee the parents were not happy that kiddo was in the ED 2nd time in a week resulting from a new nurse that didn't know what she didn't know. And thought she was getting a slow pace job.

    Many cases are basic care but many are medically complex and have the equivalent of an ICU at home. Some agencies are just looking for a warm body with a nursing license excited to be offered a job. Other agencies offer preceptorships with lab and field clinical training.

    As far as OP many experienced nurses enjoy the down time to progress their education and credentials sometimes with support of the agency!

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    • Experts

    I spend time reviewing emergency procedures, looking up info pertinent to my patient's diagnosis/care, studying for online courses, reading, interacting with and for the patient, especially during day or evening shift, at night, more personal activities while the patient sleeps. Even if ok with patient families, though, when doing personal activities, I do it out of sight of the family.

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    • Experts

    Also consider this, better to be "bored" with an income, than to be sitting at home unemployed.

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    Not really especially on your own. You are on your own. Especially with trach vent. Kids are good until they are not. There is no rapid response. No respiratory. No charge nurse. No pod mate to ask for help. It's you. Some parents know how to do the work, others do not if they are even home. Calling EMS isn't always a saving grace as these are chronic kids that make many emergency teams who look to you to be the expert on the child's diagnosis, treatment, medications and nuances. You will be asked what the child needs...

    Do you know what to do if a normally stable child is in status epilepticus and not a TV tonic clonic seizure? Or even how to recognize? Staring, mild nystagmus, unresponsive, then twitching of one arm....and the seizure plan isn't working (And keep panicking mom from punching the arrogant police officer who is more nervous than the bystanders)

    Can you stay calm when a kid has their first seizure r/t increasing ICP d/t unknown hydrocephalus with mom sitting next to you ?

    Your 5 yo patient trach/vent & CP ex preemie with ICH. who is now actively seizing, oxygen level dropping, feeding pump clogged, poor air exchange and thickening mucus plug while on a bus home from school with only a driver & transport aide?

    Worse I witnessed this one...a 6 yo with poor cough, so plugged wheezes not audible (really not able to auscultate by putting your ear to the kids chest because you don't know where your stethoscope is) need to deep suction but the new grad afraid to deep suction so only using a yankhauer, didn't think to start a neb treatment but gave O2 (useless if there is restriction or mucus plugs) to the point the hypoxia induced a seizure... The other nurse and I could not say anything as we both work for different agencies and neither the same as her. Thank goodness the teacher called the school nurse who called 911. Kiddos ok as the school nurse started a neb tx but I can guarantee the parents were not happy that kiddo was in the ED 2nd time in a week resulting from a new nurse that didn't know what she didn't know. And thought she was getting a slow pace job.

    Many cases are basic care but many are medically complex and have the equivalent of an ICU at home. Some agencies are just looking for a warm body with a nursing license excited to be offered a job. Other agencies offer preceptorships with lab and field clinical training.

    As far as OP many experienced nurses enjoy the down time to progress their education and credentials sometimes with support of the agency!

    Okay then.....point well taken. Thanks so much for your response. :up:

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    Okay then.....point well taken. Thanks so much for your response. :up:

    There are agencies that will hire new grads. It doesn't mean it's a good idea. I felt so bad for the new grad. We could hint but can't interfere with a patient not in our care (such as is that your guy wheezing since I just listened to my kiddo and all clear). The parents didn't want to lose a fully staffed schedule so the poor nurse is still there. She apparently likes me and asks me tons of questions! But some of what she asks really should have been taught by her employer/nurse educators.

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    How is reading to him not part of nursing? Increasing environmental stimuli/engaging client to activate certain receptors of the brain/mind, it could be considered Recreational Therapy as well. SMH.

    I think the person who posted that was referring to reading to the child in school. I know the nurses in my agency are always told by the schools that they are there only to provide nursing care, not to do anything school related. I could not handle going with a kid to school & just having to sit in the back of the classroom all day "just in case". Talk about boredom!

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    I think the person who posted that was referring to reading to the child in school. I know the nurses in my agency are always told by the schools that they are there only to provide nursing care, not to do anything school related. I could not handle going with a kid to school & just having to sit in the back of the classroom all day "just in case". Talk about boredom!

    All it takes is one nurse to overstep their boundary for a school to implement that. I've seen PDN argue with teachers and therapists about the way they were doing their job. I suspect my one case may receive such an edict when a certain boundary less nurse increases the hours they work at school. Teacher & therapists were NOT happy. One case I don't mind because of the complexity and need for care would prevent me from doing school stuff any way

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    I earned my BSN and MSN while working boring overnight PDN cases. Online of course.

    LPN to RN. Graduating BSN this semester.

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