New Grad PDN

Hi I worked private duty not as a new grad but after working LTC and rehab for a few years. I studied for my RN but then I stayed as a private duty nurse. In LTC I was very burnt out taking care of 30 patients. The post hospital rehab patients were hard too. Private duty is easier but can get boring. I miss seeing coworkers all day but not the 30 patients. 
Since you worked in a hospital and AL you should be fine. Request an orientation on EVERY client. My company has a long orientation process for ventilator patients so I would take that class too. Give PDN a try. 

Hey thanks for sharing that! I actually just worked at the hospital for about a month on a med-surg floor, and only did a week at the other job—I'm not planning on staying there though. Do you think that's enough experience to start with private duty? I know it's a big change but it sounds a lot less stressful than LTC or rehab, for sure.

Since you've done it for a while, do you have any tips for starting out? Like stuff to watch out for or things you wish you knew at the beginning? Also they said I  would have  2a days of training but if that's not enough they then said I can train as long as want. My orientation day is from 9-5 for a day but I'm going to get clarification on training.

You will be OK if it is a basic care client but ventilator training should be longer. Ask for more days if you need them. Always go and meet a client first before taking a case. Make sure it's a good fit first. Take a variety of clients because they go in and out of the hospital and then you will be without money. At least two or three patients. Hope this helps

That actually helps a lot, thank you! I ended up finding a full-time case with a G-tube and seizures, so no vents for now. I'll definitely make sure to meet the family first and get a solid orientation. I didn't even think about clients going in and out of the. I'll try to pick up a second case once I get settled into this one. Appreciate all the advice! I'm just so nervous but I think I can do it! 

You'll do fine! Best of luck 

I see you mentioned wanting your RN. What do you want to do once you get your RN? Me personally if I were you I would have stuck out the med surge position since your end goal is RN. The hospital would have paid for you to get your RN and BSN and you would've already had a hospital job post graduation  . 

Yes, private duty is a safer environment for LPNs, in my opinion, if you're with an agency dedicated to training you before you're alone. The agency should have a clinical manager on call at all times to help you make decisions when you detect changes in condition. Be sure you follow another nurse until you know the patient's routine, meds, and can perform all skills, before you are left alone.

Here are a few hints:

Baclofen pills dissolve almost instantly – no crushing needed.

The senna pill is hard to crush. It helps to split the pill first, before you crush it.

The crushed Vitamin D doesn't mix into water very well. If he takes calcium, crush the vitamin D pill and mix it into the calcium before putting it in the feeding tube.

The easiest way to clean under the trach in the morning is to put on gloves, take a 4x4, pour a little of the trach care vinegar solution (or whatever solution you use for trach care) onto the 4x4 "legs" and use that to clean the stuff off his skin. Do this before you use Q-tips to clean around the trach.

To slide him up in bed in his bedroom, put a slippery satin-like sheet under the cloth drawsheet. He slides up fairly well. But do remove that sheet when you're done, or he will slide right back down.

Know where all the emergency equipment is. (O2, AMBU, suction, etc.)

Know where the Go-Bag is and be sure it's stocked.

Know where the vent manual and "cheat sheet" are kept. Know how to trouble-shoot the alarms.

Especially when starting with a new client, I write out a little schedule. On a sheet of paper, I write in the times (hours). Next to each hour, I note any meds that need to be given. Depending on the client, I either write out the individual meds or I simply write "med". I add in any scheduled therapies, feedings, etc. (Yeah, time management was my biggest challenge when I worked in the hospital!)

Kitiger said:

Here are a few hints:

Baclofen pills dissolve almost instantly – no crushing needed.

The senna pill is hard to crush. It helps to split the pill first, before you crush it.

The crushed Vitamin D doesn't mix into water very well. If he takes calcium, crush the vitamin D pill and mix it into the calcium before putting it in the feeding tube.

The easiest way to clean under the trach in the morning is to put on gloves, take a 4x4, pour a little of the trach care vinegar solution (or whatever solution you use for trach care) onto the 4x4 "legs" and use that to clean the stuff off his skin. Do this before you use Q-tips to clean around the trach.

To slide him up in bed in his bedroom, put a slippery satin-like sheet under the cloth drawsheet. He slides up fairly well. But do remove that sheet when you're done, or he will slide right back down.

Know where all the emergency equipment is. (O2, AMBU, suction, etc.)

Know where the Go-Bag is and be sure it's stocked.

Know where the vent manual and "cheat sheet" are kept. Know how to trouble-shoot the alarms.

Especially when starting with a new client, I write out a little schedule. On a sheet of paper, I write in the times (hours). Next to each hour, I note any meds that need to be given. Depending on the client, I either write out the individual meds or I simply write "med". I add in any scheduled therapies, feedings, etc. (Yeah, time management was my biggest challenge when I worked in the hospital!)

Yes, private duty is a safer environment for LPNs, in my opinion, if you're with an agency dedicated to training you before you're alone. The agency should have a clinical manager on call at all times to help you make decisions when you detect changes in condition. Be sure you follow another nurse until you know the patient's routine, meds, and can perform all skills, before you are left alone.

Excellent post. Thank you. You should train nurses ?