Nurse anxiety + parent anxiety

[BriannaM.]

Hello, I just need a little advice. I've been a private duty RN for going on 8 years. I also worked NICU for about 2. I recently went back into PDN . I got a part time job with a baby who is fairly stable but on a vent overnight. He was discharged from our NICU and his current caregivers are from the NICU and know/cared for him. 

From the start I could feel there was an immense amount of anxiety and distrust coming from mom which is understandable (PS I have a friend currently in the NICU who applied, was interviewed, showed up and then got sent home because mom didn't feel comfortable with her). I never got any formal training with this patient, it was sort of just a show up and start working situation. I felt my entire shift, mom was constantly hovering over me and came in throughout the night whenever an alarm beeped, suctioned, or baby cried. I heard mom staying awake listening in the start of my shift at 9pm until about 4am. Maybe I am too sensitive but this treatment really made me feel incompetent and gave me immense anxiety caring for this patient. I have never experienced feeling this way when taking care of a patient.

The previous night, baby was tangled in his vent tubing when I went to transfer him so I disconnected it and reconnected it immediately as it was pulling on his trach. No desats, he did fine. Parents were watching me on the camera and reprimanded me for this and explained that he has to be on his vent at all times while asleep which I understand. Tonight was my second shift. I disconnected baby from vent to connect his suction which wasn't hooked up, but did not connect vent to suction T piece (to be honest I was so anxious because I knew once I suctioned him someone would come running in, which they did). He didn't desat, and I reconnected him right away. Mom came in and told me they were going to let me go. I absolutely realize my mistake, but I can't help to feel frustrated that I wasn't given a fair chance from the start and that mom was waiting for me to do something wrong or mess up and knowing this, I think it made me lack confidence in myself. I have never felt this amount of anxiety caring for a patient in PDN.

I did tell family that I think that having one or two nights training with another nurse to learn about the patient  would have been very helpful . They were willing to do this as they wanted to keep me because they wanted me to stay due to my experience, but I think at this point that this positive is not good fit for me. I already work full time with another PDN pt who is even higher acuity and has a trach (there has been no issues).

Has anyone ever had an experience like this I guess is what I'm looking for? Also maybe just a little support that I'm not as incompetent as I feel like I've been made to feel.

[JKL33]

Don't think there is one right answer here. I have not done PDN, but a few general thoughts:

I would think it kind of normal, in this situation, for parents to want to vet a new caregiver. The question is, are they (just) doing that--or are they watching like a hawk waiting to complain that yet another caregiver can not take proper care of their sweet angel. There's a difference.

Next, your comfort level does matter. I know for a fact that if I got any vibe that someone was watching me on camera looking for something to criticize I'd would say a hearty no thanks. Life's too short for that and I don't care what kind of low intensity or high intensity situation is, I simply just don't want to be treated that way. And that would be my prerogative. I am also resistant to falling into guilt trips about who's going to care for so-and-so if I don't. That is not my problem, and if it's that important for me to be involved then a compromise (on the parent/patient's part) will be needed.

It's your prerogative to make those decisions if you want to. You could say something like, "I'd love to continue taking care of [child] and can request arrangements to train with someone for a couple of shifts, but if we decide to try that, I need you to know that I'm not willing to work in a situation where someone is going to watch my every move and waiting to criticize my nursing judgment." ?...yes, you can actually say that. If they don't like it that'll be the end of you having to worry about it. If they get your message and are willing to compromise, it might be viable.

Try not to let people/situations like this absolutely fill you with self-doubt. That is often inappropriate. And also keep in mind the thing about sharks and blood in the water. Or maybe that's the wrong analogy but the idea that if some people sense weakness it's over; they can't develop trust . It'll be an uphill battle with them and better to just walk away.

Good luck ~