New to PDN, please lend your wisdom

meanmaryjean, DNP, RN · Apr 16, 2015

The great thing about PDN is that you finally have the time to what I call 'fluff and buff'. You get to do all the little things that sometimes got neglected in a busier work environment.

Sometimes it IS boring, but if you get a family/ client you really like- it's almost 'wrong' how much you'll start enjoying your job!

MY PDN case is winding down (kiddo got off the vent and is going to live happily ever after) and my PICU job is currently consuming me. I like the balance of the two and should start looking for another case I guess.

middleagednurse · Apr 16, 2015

Make sure you develop a great relationship with the parents. Open your ears and listen respectfully to everything they say. They know the child better than you do.keep in mind it's their home, not yours. Respect their environment, ask permission to use refrigerator or microwave. Give the child as much attention as you can. do whatever you can to help child grow and develop. Learn about CP. They may have crazy expectations. Deal with it. Keep childs environment and equipment clean.

middleagednurse · Apr 16, 2015

Take a book or something to entertain yourself when the child is sleeping. If child has PT or OT make sure you do the prescribed exercises.

brillohead, ADN, RN · Apr 23, 2015

Things I've learned about PDN:

* Be completely self-sufficient for your own personal needs. Don't assume that you can drink their water, use their coffee machine, eat their snacks, etc. I look like I'm moving in when I arrive... there is no locker room in PDN work, so you have to bring it with you! I have adequate supplies of snacks, beverages, change of clothes, personal hygiene items, my laptop, my Kindle/tablet, charging cables, clipboard, pens/highlighters/little O-ring stickers for reinforcing pages in the binder, etc.

* Remember that this is NOT a facility -- it is someone's home, and they are used to providing care for their child. They may do things differently than you were taught in school or how you did them in your last job, but as long as they're not actually causing harm, it doesn't matter.

* Along those same lines, if something is happening that is contrary to the Plan of Care -- bring it to the attention of your nursing supervisor. If you go in there trying to change the world, you'll quickly find yourself pounding the pavement. Let your supervisor either work on educating the parents *or* changing the PoC to match the way that things are being done. You're not paid enough to risk the wrath of the parents (and risk your job security).

* Make sure you have a clear understanding of what you are/aren't allowed to do by your agency. I have a client who has his own supply of towels and washcloths, separate from those used by the family. I have no problem folding and putting away those items, as they are directly related to his care. Ditto with putting away the monthly medical supplies when they arrive at the beginning of the month. However, I don't fold the family's general laundry, and I don't mop their kitchen or scrub their toilet, etc. If I'm putting away my client's towels and there are a few items of the family's laundry in the basket as well, I just set those aside -- the family can fold those items and put them away. None of my agencies allow me to shovel driveways/sidewalks in the winter, for example -- too much liability for injury.

And yes, you do sometimes look around and think, "I'm getting paid to sit on my butt and read a book / surf Facebook / read emails / study for school while my client sleeps.... this is unreal!" But there will be other days when you're doing the same boring repetitive task for the 842nd time that month and you can feel your brain leaking out of your ears. It balances out, eventually. And if you do find yourself getting bored with the same assignment all the time, you can always ask your agency to switch you to another client a couple shifts a month, too.

CloudySue · Apr 27, 2015

I wanted to build on Brillohead's thought about having all that down time at work. I need to point out that although third shift jobs can be quite easy, third shift life is hard. I am constantly having to flip my sleep schedule back and forth to try and keep a normal life that includes doctor's appointments, my children's parent/teacher conferences, family weddings, etc. that all take place at, what feels like to my circadian rhythm, 3am. It's not even worth taking a day off because I keep my sleep schedule 7 days a week and nobody's awake to hang out w me, no friends, no family. All I have is a handful of other night nurses to text or PM with for company! So yeah, I might watch a lot of Netflix and get paid for it. But it's the lifestyle that I have 24/7 for which I feel I'm getting compensated.

caliotter3 · Apr 27, 2015

There are many threads about extended care home health nursing in the forum that can provide insight. After doing some looking around and reading these threads, you may conclude that not much changes in this nursing area.

ptcwhit · May 6, 2015

Your patient sounds almost identical to mine except mine is 17. For me yes time drags by. My patient sleeps the majority of the day so it's a lot of free time which sounded nice when I first started but now I'm going crazy. I think you'll be just fine though, just remember to take stuff with you to read or your laptop. I'm sure a toddler will be more alert so maybe you'll be busy which is good. And bring food to eat....remember with PDN at least in my experience there's no lunch break to go get something so come prepared!

Adele_Michal7, ASN, RN · May 20, 2015

I echo what everyone else said... Come back and update us, if you see this....