Neonatal Home Care

[VEVINA]

Hi,

I have worked in a neonatal ICU for several years. We have a group of nurses volunteered ourselves in the home care service. And we provide home care to babies whom discharged from our unit, which require special care like tube-feeding, gastrostomy feeding and home with oxygen etc. As it is a volunteer service, we do not collect any money from the parents. I am just curious to know whether any of you are doing this as part of your unit or on permanant basis? And how do you assess the home nursing care and any documentation required after each home visit? Are there any hospitals' neonatal units providing the home care service like us too? I am really keen in learning more about this area.

[fmrnicumom]

I am not a nurse, but my son was sent home on O2 and monitors. The hospital set up home care with a NICU nurse, but it was paid for by insurance. I'm a member of our NICU Family Advisory Board and there is talk of setting up something similar but it has yet to move past the idea stage.

[Gompers, BSN, RN]

Our unit does provide home care visits, but it is definitely not a volunteer thing. We have a half dozen or so staff nurses that work part time in the unit and part time in home health. If a baby goes home with special needs (feeding tube, oxygen, TPN, etc.) then we send our home health nurses out for visits. They visit the day after the baby is discharged, then 2-3 times a week until things settle down, and after that every 1-2 weeks just to do a check-up. They contact the baby's pediatrician if any changes need to be made with the baby's plan of care. If a baby goes home with a trach (with or without a vent) or on dialysis, then the family gets 8-24 hours of private duty nursing instead, and are not seen by our home care team. Both the NICU home care visits and private duty nursing are covered by insurance or Medicaid.

I can't imagine doing it for no pay - it is a hard job, running around visiting all these babies and working with their families! There are a few nurses that babysit our graduates for free, but I would never do that personally - too much liability!

[BittyBabyGrower, MSN, RN]

Are you guys covered legally? That would be first and foremost in my mind.

We have home health care that goes out, we don't do that.

[VEVINA]

Are you guys covered legally? That would be first and foremost in my mind.

We have home health care that goes out, we don't do that.

Well, sad to say we are not covered legally and we are not even pay for the transport allownace too. Sometimes, we are also faced with problem like: the baby's mom will call us if she had ran out of feeding tube and of course we would buy it for them from our own pocket first. We never claimed any money from them or the hospital later. we just don't know how to let the parents know that we are just render our service by volunteering our free time and expenses.

[suzanne4, RN]

I suggest that you speak with your risk management dept first. And clarify this with them. One major point to consider is that the families are considering you to be an extension of the facility, and if any problems do occur, you are going to be in a pickle.

It is quite commendable to want to do something like this, but make sure that you and your group are covered to do so. Especially, since it is being done on off shift time and your malpractice umbrella from the hopital would not cover you for this, and you will need your own coverage.

You are still practicing as an RN, whether you are getting paid or not. And you need to be covered to do so. Not sure ifd anyone from your group thought about this.

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As a volunteer, you can take the mileage and expenses from your taxes. But again, make sure that you are legally covered.

[kitty29]

I would Not do anything like this without liability coverage...and some type of pay and travel reinbursement. You are a skilled professional!