Need an advise.

[Marga777]

I'm a new nurse .My first job is home care. It's not my dream job but it was the only place that took newgrads. I have a patient with muscular distrophy. Most of the time his o2 is good but than it can suddenly drop to 82. Sometimes I'm not able to get through with open suctioning. It feels like I'm already down there but it too still high.Nothing comes out.I call his mother and she uses saline and cough machine. The problem is mom is not always home and I don't understand what I'm dealing with.Is it a plug?Will saline helps to get rid of it?What to do to not panic and if I can't break it?

[LoveMyBugs, BSN, CNA, RN]

Oral suctioning?

Trach?

Nasal?

Age of pt?

What does you agency say?

Do you have an educator to guide you?

Saline will loosen mucus, but if you haven't done it before or without an experienced nurse to show you.........

You are alone with the patient and don't know what to do when his sats drop?

I don't mean to offend you OP, but this is why new grads should not do home health

[Marga777]

Patient has a trach he is 25.Of course I know how to suction but I don't know how to manage the plug.In theory you should break it with saline and cough machine and suction the rest of but I never did it myself.Im even not sure that it is a plug .It's my diagnosis.It is my first job first patient and he is a new patient to the agency.Im planning to call the charge nurse and respiratory therapist but from my experience as an HHA agencies usually don't care much.You should be very persistent.