Just want to sat hi!!

Traveler · Jan 22, 2005

Welcome! Isn't it funny how we never know where we will end up- you ended up at the other end of the lifespan than you thought you would. I only do occasional peds at my hh agency- children present an interesting challenge. It takes a special person to be able to work with kids.

Ann

bonjon · Jan 22, 2005

Welcome! Isn't it funny how we never know where we will end up- you ended up at the other end of the lifespan than you thought you would. I only do occasional peds at my hh agency- children present an interesting challenge. It takes a special person to be able to work with kids.
Ann

Hey Ann,

Good to hear from you. You're right, it does present an interesting challenge. Most of the kids I take care of are either in a vegetative state, or were injured in car wrecks. Most of my kids(that's what I call them) have gb's, jb's or trachs. Some are on vents. Each one is completely different, so you have to know exactly what to do if a situation arises. Sometimes it's really hard because you can't help but fall in love with them. You're with them all the time. You have to try to emotionally distance yourself from getting too close to them. One of the ways I do it is to know that if anything happens and they pass, you know that they are no longer in pain. That makes it easier. Keep in touch. Love to hear from you again. Bonnie

hoolahan, ASN, RN · Jan 22, 2005

Welcome bonjon. Would you read my thread on homecare shift nurses? I'd be interested in your opinion.

Or I can just ask you here. How do you document meds/med changes in the home? Do you use a kardex sign-out type system like in the hospital, or just make a list and update like visit nurses do for the chart? If you use a kardex, would you expect parents to sign out meds on it if they did the 3-11 time period?

If the parents read your notes, does it change the way you document? I had to review a chart for my job in quality, and there was virtually no mention of parent-child interaction good or bad. It struck me as odd, until I noticed mom signed all nurses notes. Do you keep other notes elsewhere? Do you have an "office chart" and a "travel or home " chart like visit nurse agencies do?

Thanks!

bonjon · Jan 23, 2005

hoolahan,

Good to hear from you. The policy @ the company I work for , is that if there is a change in meds or new meds ordered, we fill out a Physician's Order sheet, not unless your patient is in the doctor's office, then he fills it out. One copy stays in the patient's chart in the home and the other two go to the main office to be sent to the doctor for his signature. Then one signed copy is sent back to the home to be put in the chart and one copy is put in the patient's chart in the office. We do keep kardex's, but, it's mainly for the other nurses to be on top of all changes. But, that doesn't always happen. Some nurses do as little as possible, and don't document real good. Sometimes my boss sends me to different clients to do what I call "commando nursing", to get everything in order the way it is supposed to be. It's kinda aggravating taking up other people's slack, because it's the client and the family that suffer.

With my company, the only thing that gets signed by the family are the time sheets, but copy's of all nurses notes are in the home chart. That way, if mom or dad want to read what's really going on, they can. Most of the time, one or both of the parents are there when I am, so they know exactly what's going on. If they happen to be gone most of the day and then come home when my shift ends, I give them report, and then they can always go into the chart and read my notes.

The parent's reading my notes has no bearing on the way I document. But if mom says that she wants a certain med not given or a change in care, I will document that. For example: "pt's pm dose of x-lax held per mom's rquest". That way they know that the pt. didn't get her scheduled med because mom didn't want her to have it that day.

Hope that kinda answers your question. Nice to hear from you. Keep in touch.

Bonnie

JustBonny · Jan 23, 2005

Hi,
Bonjon here, & just registered with the site. I've been working with a pediatric home health care agency for about a year, and I love it. I never thought I would be working with pedi's, because I just wasn't interested in working with babies. When I was in nursing school, I didn't pay awhole lot of attention to OB/Pedi, because at that time I knew I didn't want to go there. I was more interested in geriatrics, which I also love. I just happened to be offered a job that payed double than what I was making in a NH. So, I applied, and got the job, even though I didn't have zip experience. Now, I can't see myself doing anything else. Just wanted to drop a line and introduce myself and say hi.

Hi Bonjon,

I just registered with this site today too. I work as a pediactric vent nurse (for an agency) and love what I do. I, too never expected to love peds, but I would not want to do anything else now. I look forward to the future postings on this site. It looks great!

hoolahan, ASN, RN · Jan 26, 2005

Bonjon, yes thank you very much, that is exactly what I needed. So basically, cardexes shouod be updated but aren't. I suspect it is because the same nurses stay with a pt for a long time, in many cases, so they "know" the pt. Your answer was very helpful!! Thanks!