New PDN; sent in papers now what?

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I am a new nurse and new to private duty nursing. I read the intro forum which was really helpful in getting me familiarized. I am in NY, I have my NPI# and have sent out my medicaid provider number paperwork. I am not employed through an agency, but direct to the patient (adult). So, far I am just doing some "training" evenings.

How long before I can expect to hear back from EMEDNY?

Are their special forms that I need to keep?

Do I consider the training time "free"?

And, sorry if this seems a stupid question, but all documentation for the patient needs to stay with the patient, right? Or, do I need it for billing and have to keep them in a lock box?

I am really excited about this, because it's the kind of nursing I wanted to do, but thought I would be doing later. But, since nobody wants to give an AAS-RN a chance I am really grateful for this opportunity.

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Specializes in Peds, developmental disability.

I have some thoughts. Since you are a new nurse, wouldn't it be better to get acclimated to private duty PEDs as a hired nurse, with training and supervision?

I have done PDN for over two years and I still like having a supervisor to discuss things with, and not just a doctor to call. (You don't talk to the MD anyway...just receptionist and Dr.'s nurse.)

Most of my supervisors have NICU experience. I like being able to draw on that, too, since these fragile kiddos usually start out there.

Then, too, in my state a new nurse is required by law to start out in a setting with coworkers and a sup, to gain experience before doing solo work.

Doing private duty as a brand new grad sounds risky to me.

Please search the private duty forum regarding "new grads and PDN", so you can consider the risks!

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Specializes in Peds(PICU, NICU float), PDN, ICU.

There are tons of posts on this. Its very dangerous for a new grad to do PDN. Medicare/medicaid require at least one year of experience as well.

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I have some thoughts. Since you are a new nurse, wouldn't it be better to get acclimated to private duty PEDs as a hired nurse, with training and supervision?

I have done PDN for over two years and I still like having a supervisor to discuss things with, and not just a doctor to call. (You don't talk to the MD anyway...just receptionist and Dr.'s nurse.)

Most of my supervisors have NICU experience. I like being able to draw on that, too, since these fragile kiddos usually start out there.

Then, too, in my state a new nurse is required by law to start out in a setting with coworkers and a sup, to gain experience before doing solo work.

Doing private duty as a brand new grad sounds risky to me.

Please search the private duty forum regarding "new grads and PDN", so you can consider the risks!

I am not working with a child. It's an adult who is relatively stable but requires 24 hour care and wants to be at home. In an ideal world, I'd have supervision, but realistically there are not many jobs for new grads and not many jobs in any field, period. I have to pay bills. I have to work, somewhere. I have a friend who is an RN, who has done home care for many years who has told me to call her if I have any questions or doubts. She's offered to mentor me. I have considered the risks, which is why I have refused to work with medically fragile children or patients with vents without prior training or supervision.

I searched the forum, but could not find out how long it usually takes to get the number back. I found the answer to my question on documentation in today on the EMEDNY website.

Seriously, they either need to just change the requirements to sit for the NCLEX to a BSN or allow new AAS RN's the chance to practice in a so called safe environment. I have been looking for 6 months. I am about to lose my house. I can't even get a job at Target in my area. Since I have a family and own a home, picking up and relocating with hopes and dreams is just not realistic for me.

I have applied to over 1000 positions inside and outside of nursing.

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Specializes in Peds, developmental disability.

Adult private duty is definitely safer than peds, and I hope this case works out for you. I have family in NY and I know that unemployment is a widespread dilema. It sounds like you have arranged yourself backup. And you can consult with nurses here if you want to. You are creative and determined! Good luck!

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Specializes in Peds(PICU, NICU float), PDN, ICU.

You may need a job. But if you lose your license because of an error, your career is over. Plus the family can sue and you can lose everything.

It seems the odds of not getting a job after 1000 apps is hard to believe. Maybe your area is different though. I just applied to a job and just signed the offer today, just a few weeks after applying. I only applied to that job and one other. I'm also currently employed so that now I have 2 jobs.

Have you tried networking? I have activities outside of work that allow me to network with other people. Plus I have friends that can set me up with work if I ever need it.

Have you put your resume on craigslist, indeed, career builder, etc? Or have you tried a temp agency? I have a friend who is a new grad and got hired with a temp agency. She ended up working for a Dr office run by Duke. The Dr office has asked her to sign on with them when her contact is up. But she decided to renew her contract so she can have a week off between the contracts. She's making $25/hr plus overtime. She works M-F. So there are jobs out there for new grads.

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You may need a job. But if you lose your license because of an error, your career is over. Plus the family can sue and you can lose everything.

It seems the odds of not getting a job after 1000 apps is hard to believe. Maybe your area is different though. I just applied to a job and just signed the offer today, just a few weeks after applying. I only applied to that job and one other. I'm also currently employed so that now I have 2 jobs.

Have you tried networking? I have activities outside of work that allow me to network with other people. Plus I have friends that can set me up with work if I ever need it.

Have you put your resume on craigslist, indeed, career builder, etc? Or have you tried a temp agency? I have a friend who is a new grad and got hired with a temp agency. She ended up working for a Dr office run by Duke. The Dr office has asked her to sign on with them when her contact is up. But she decided to renew her contract so she can have a week off between the contracts. She's making $25/hr plus overtime. She works M-F. So there are jobs out there for new grads.

I can make an error in any setting of practice that could cost me my license. Congrats to your friend. The offices that have been hiring here all have asked for venipuncture experience, which I do not have. In my area, they tend to take on NP's or PA's any way.

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Adult private duty is definitely safer than peds, and I hope this case works out for you. I have family in NY and I know that unemployment is a widespread dilema. It sounds like you have arranged yourself backup. And you can consult with nurses here if you want to. You are creative and determined! Good luck!

Thank you! I have arranged a few options for back up among my colleagues and former professors. And, I might be getting a couple of overnights with an agency that I signed up with a few months ago. I hope the client remains stable enough to go home, because this will get me the trach/vent experience that I would like with an adult. If it comes through I will train with the main RN for the day and then do my nights. Keeping my fingers crossed. And, I can have some money in the mean time until the medicaid gets set up.

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Specializes in Peds, developmental disability.

Teach and vent changes my opinion. Sorry. You are getting into deeper water.

My PDN agency gives and requires LOTS of training, including days with a preceptor, before we can do that level of care.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

Where is ventmommy?.....

I agree you can lose your license in any setting. But PDN is completely different and it seems nobody understands that until something happens on their shift. Just read through other posts on the same question. Very scary!

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Specializes in Pediatric Private Duty; Camp Nursing.

New nurse? BRAND new graduate alone w a trach/vent pt? Seems like the makings of a horror story/law suit. I've heard enough stories to know.

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I'm here. Was super busy with a new foster baby (which might make me pop over to the diabetes forum if there is one)!!

Anyway, to the OP, infant/child/adult trach/vent patients can all experience the same complications: plug, accidental decan, vent malfunction, aspiration. Any of those conditions can be life-altering or life-ending if not managed appropriately.

I am assuming your adult trach/vent client is not a walking/talking/alert adult because they rarely get loads of nursing hours, if ever. I know on the trach forum, there are several adults and they get a combined total of exactly zero hours.

As is well known on this forum, I did accept new nurses into my home but I (or my husband) was home 24/7. I enjoyed training them. And they learned a lot.

Before I would even consider showering when a nurse was here, they had to: know how to suction, had assisted me with a trach change, had done a trach change with me assisting, demonstrated a knowledge of OUR emergency procedures, knew all the parts of the vent, knew how to trouble shoot a LOW PRES/LMV/SENSE-DISC/HIGH PRES/LOW PEEP/HIGH PEEP alarm, know how to set up a neb for the vent, demonstrated their ambu-bag technique.

Having someone to call and ask a question is not good enough if your patient is turning blue, multiple alarms are going off and you're not sure of the next step.

Basic understanding of a trach patient is not the same as trach/vent proficiency.

I understand that finding work is hard. I understand that you can make a mistake in any setting. But if you make a mistake or don't understand an alarm and you are on a vent unit, you can push a button and an entire team will come running. If you are in a home alone and make a mistake or don't understand an alarm which can lead to life-altering complications, there is no one to rely on but yourself and 911.

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