Parents going out of town

enuf_already · Jun 25, 2014

If the agency is aware and has agreed to this situation, they are on the hook to provide care--one way or another--for this child. That could mean the nurse working a shift gets stuck at the home until someone else comes in or another solution is found.

Most agencies have the parents name a backup caregiver who could potentially take care of the child in their absence. It has been my experience that the people named in many instances would not be able to care for these complex kids. In all fairness, the person trained may never have cared for the child so expecting them to be left alone with the child is unrealistic.

These situations can go well (everyone shows up, child stays stable, parents come back feeling confident in child's care, etc) or can get ugly. The cases I worked like this went well because everyone knew the family/agency was relying on them to be there.

The other option is the family taking the child and a nurse with them. That presents another long list of complexities for another thread.

JustBeachyNurse, LPN · Jun 25, 2014

In a case I go to parents are planning a trip next month in which they will be gone 3-4 days, and they are leaving baby with 24hr nursing behind. They have done this before and left power of attorney to a friend (who is not capable of caring for baby), the agency was aware that parents were out of town. Baby has 24hr nursing but what happens if a nurse has an emergency and calls out? What if baby has an emergency? Had anyone experienced this?

A nurse calls out on a 24-hr continuous care case, agency must find a replacement. On duty nurse may be asked to stay. In the larger agency I work for, worst case and on duty nurse HAD to leave a clinical manager or supervisor would relieve on duty nurse while schedulers scrambled to find a competent replacement. Often offering premium pay. I've been the replacement nurse called with 30 minute response because next shift nurse had a major emergency and was being admitted. I have days where I give availability and have a 30-60 minute response time as part of the rapid call team. I don't get on call pay but receive incentive pay (anywhere from base + travel to 2.5x base rate depending on scenario) if I can report to the case & relieve on duty nurse.

What would you do if the parents were out at the store and the baby had an emergency? Follow protocol & call 911 & supervisor regarding change in status as appropriate. It wouldn't be any different. Hospital can get consent over phone from parents or the legal POA if needed. The agency should have a copy of POA/medical poa in file for the child in effect while nurses on duty.

I've done cases where nursing is provided with a friend or family member having limited medical POA including authorization on file at agency for POA to sign nurse time sheets. Clinical management & branch manager well aware of situation. There is always an on call nurse available to consult with field staff as needed ( whether parents home or not). Everything went smoothly. Friend was at the house a lot of the time interacting with the child.

Elle23 · Jun 25, 2014

Can I just say I think it is great that the parents are able to get away by themselves for a few days? I hope it is a wonderful time of rest and rejuvination for them and their marriage, and I hope everything goes smoothly.

caliotter3 · Jun 26, 2014

In the situations where I've encountered this, there were no problems that the nursing team and responsible party could not handle. The agency was well aware that they were on the hook for providing competent care and there were no emergencies other than in one situation, someone was in Europe and had left their wallet ID or credit card or something at home and needed it. Those at home figured out how to help him and that was that. Nothing patient-related. Good idea to do some pre-planning for possible situations.