new grad, PDN, and experience for the hospital

SDALPN · Sep 13, 2013

Its just a very bad idea as a new grad. But to answer your question about your career, it depends on the person doing the hiring. Some view PDN as limited skills. Some view it as the nurse having strong assessment skills and the ability to work with minimal supervision. I'm not sure if it depends on the area you live though.

clearblue3 · Sep 14, 2013

Hi SDALPN! Thanks for the reply! I have noticed that you comment frequently on the PDN board...so I am going to take advantage of your expertise and experience :-)...and ask you a few questions...what past experience did you have that you feel prepared you for working with those on a vent/trach etc? As I said I feel like med/surg etc. would be a fantastic experience and is generally regarded as such, but none of the nurses I know with many years of experience (from a variety of floors in the hospital except of course ICU and such) have any experience with vents or much with trachs either. So would you say, it isn't so much just having the years of experience but rather a certain type of experience?? Obviously all those years of nursing experience would be incredibly beneficial in PDN but how did you get comfortable with vents etc. that you didn't have prior experience with? Thanks!!

poppycat, ADN, BSN · Sep 14, 2013

I've been doing PDN off & on for 15 years (been with my current patient over 5 yrs.). I don't think PDN is a good idea for new grads. Even "very stable" patients can go bad quickly & you are the only person there to care for them. Without any experience will you know what to do in an emergency?

As far as getting comfortable with trachs/vents, I worked acute care Peds, PICU, & NICU for 20 years & did not get comfortable with those until I started doing PDN. I cared for many vent patients in hospitals but RT was always responsible for the vent. In the home, I'm responsible. You need to have extensive vent training before taking a PDN vent case so you know what to do if something goes wrong. You also need to know what to do in case your patient decannulates himself.

SDALPN · Sep 14, 2013

Hi SDALPN! Thanks for the reply! I have noticed that you comment frequently on the PDN board...so I am going to take advantage of your expertise and experience :-)...and ask you a few questions...what past experience did you have that you feel prepared you for working with those on a vent/trach etc? As I said I feel like med/surg etc. would be a fantastic experience and is generally regarded as such but none of the nurses I know with many years of experience (from a variety of floors in the hospital except of course ICU and such) have any experience with vents or much with trachs either. So would you say, it isn't so much just having the years of experience but rather a certain type of experience?? Obviously all those years of nursing experience would be incredibly beneficial in PDN but how did you get comfortable with vents etc. that you didn't have prior experience with? Thanks!![/quote']
I was very lucky. My agency had a daycare for medically fragile kids inside of a regular (high end) daycare. I spent quite a few weeks there and did all of the procedures and handled all of the emergencies there to get comfortable. There were other nurses there with tons of experience who stepped back, but acted as my safety net. After that, I was given a case with a very stable kid with a trach that was at the regular part of the daycare. So the nurses I trained with were right down the hall if I needed help. After I was comfortable, I started covering weekends with the pt in his home. After that, I started picking up more cases that were slightly more complex. Then I got a case with a kid for 4 years and floated when not working with her so I could learn more skills. My first vent case was a kid that used it at night as a cpap. So since he wasn't dependent, if anything went wrong, I could disconnect him.
I really got lucky the way it worked out for me! I've had hundreds of home cases now because I prefer to float and keep one case for a few days a week.
I have worked in the hospital. And really, not many nurses get vent experience there because its a respiratory job and they don't like nurses messing with the vents. I took a class through the equip company on vents that was very thorough. And also spent lots of time with nurses who had experience with vents. One of my friends is a nurse with over 30 years of picu/nicu experience and she also was available to answer questions and enjoyed teaching me.
Hope that helps!

clearblue3 · Sep 14, 2013

Thanks, SDALPN! What awesome experiences you had!! :-) I will keep all this in mind. Hopefully something will work out for me in the hospital setting etc. :-)

ventmommy · Sep 16, 2013

I posted on another thread regarding new grads and PDN. If you are a good learner, have an experienced and well-trained family and are willing to learn from them AND they aren't going to leave you alone the minute you walk in the door, you can do fine in PDN.

If you are inexperienced and can't troubleshoot a vent, trach, g-tube, feeding tube, IV site, feeding pump; don't understand all the settings and outputs on a vent; don't have emergency procedures DOWN PAT and have practiced on a real live human as an emergency, then you should not be left alone until you have gained that experience.

In the PICU, respiratory and the docs were the only ones that touched the vent. When my son needed an emergency trach change (I was suctioning and it just felt wrong and he had two desats in 5 minutes), the nurse was MY back-up and just handed me stuff and helped only when I asked for something. She was fully competent and one of my favorite nurses, she just believed that a parent knew the intricacies better and the entire PICU encouraged parent involvement in care. Our hospital didn't put anyone with a trach on a non-critical care unit so I don't know how much trach/vent experience you'd get there.

clearblue3 · Sep 17, 2013

Thanks ventmommy! It is neat to hear from the parent side of things. I will just have to see what types of jobs surface. Like I mentioned before, I would love to get that experience of med/surg in the hospital, but even those jobs for new grads have become hard to come by....the hospitals around here want a BSN and experience...or you have to have an "in" somewhere. I really don't want to sit around for months trying to get a job or take a job in an understaffed, unsafe LTC situation. I currently do PD but only as a caregiver (CNA). I had talked to someone about a job for an adult on a vent and they emphasized that no experience was necessary, there would be a vent cert class, and on the job training...but I just wanted to get some advice from you all as to whether it was really possible to have a vent job that was "no experience necessary." I suppose I can always check the job out and if it does not feel safe, then just don't take it! :-) Thank you so much for your thoughts!!

SDALPN · Sep 17, 2013

Thanks ventmommy! It is neat to hear from the parent side of things. I will just have to see what types of jobs surface. Like I mentioned before I would love to get that experience of med/surg in the hospital, but even those jobs for new grads have become hard to come by....the hospitals around here want a BSN and experience...or you have to have an "in" somewhere. I really don't want to sit around for months trying to get a job or take a job in an understaffed, unsafe LTC situation. I currently do PD but only as a caregiver (CNA). I had talked to someone about a job for an adult on a vent and they emphasized that no experience was necessary, there would be a vent cert class, and on the job training...but I just wanted to get some advice from you all as to whether it was really possible to have a vent job that was "no experience necessary." I suppose I can always check the job out and if it does not feel safe, then just don't take it! :-) Thank you so much for your thoughts!![/quote']
The majority of parents will say hi while walking out the door if you are lucky. Ventmommy seems like an amazing parent. But don't expect that to be the norm. If you have an emergency the first day, it may not end well. If the nurse training you doesn't have much experience...this happens all the time...you could end up in a bad situation as well.

clearblue3 · Sep 17, 2013

yes, I will keep that in mind. The person who was emphasizing the "no need for experience" was actually the patient herself. I thought that was interesting since if it was myself I would want people with experience if possible. Maybe she has a hard time finding nurses. who knows. Don't worry, SDALPN, I won't take a case that I don't feel experienced enough to handle :-) I am a worrier by nature so believe me, if I felt nervous about the situation I would turn it down. I was more interested in finding out IF for some reason I felt COMPLETELY safe taking a certain case, would it be a smart move career wise, or would it lead to even more difficulty getting a job in the hospital setting down the road. Thanks for your thoughts!!

CloudySue · Sep 17, 2013

Working on a vent "seems" easy at first. It took me about 5 shifts to realize I had no business working on a vent case. That said, my "training" was minimal and on site at the ct's home.

eeffoc_emmig · Sep 17, 2013

My company sent me to work a vent case. I was told to watch a video and take a test online. It taught me NOTHING! I went to the case because I needed the money. I took thorough notes when the other nurse oriented me. I spent that night studying the manual. I have since become very knowledgeable on the topic and have handled several situations with ease - no thanks to my employer. It's scary the way nurses are sent to cases they are not properly trained for. The family never asked of I had prior experience or I would have told them. The other nurse didn't ask either as she probably knew.