Part-time LPN sitter job, what is the protocol?

[blessnme]

Hi to all,

When sitting with a patient that has a trach and G-tube at home are there anything in particular one should be aware of? This is new to me so I would love to your professional opinions.

Thanks

[Reebles]

I am just a nursing student, but the first thing I think of with a trach patient is, if you hear gurgling when they breath, suction the trach (sterile procedure of course).

[TheCommuter, BSN, RN]

How much nursing experience do you have?

If the patient accidentally coughs out the trach, would you know how to reinsert it? If the patient accidentally pulls out the feeding tube, would you know how to reinsert it? Are you expected to perform trach and g-tube care?

Keep in mind that even though this is a sitter job, most state boards of nursing will hold you to the practice standard of your highest level of licensure if anything unbecoming or sentinel happens, which happens to be the LPN license. Good luck to you!

[laughing weasel]

If patient coughs out trach and you can't put it in. Remember your obdurator and make sure to do a trach change with other care giver so you do not end up with patient who has a special way to put it in. ( I had one patient that had false trach passage that would always be the destination unless you cork screwed in counter clock-wise.) Mouth position open or closed will affect the breath rate of an uncuffed trach and can be used to control breath rate. Watch out for mucous plugs. If you patient starts having problems breathing and suctioning is obstructed or totally ineffective then you might need to change trachs. These are just some of the things that can go wrong I hope you get enough training to be comfortable and have good contacts in case of questions.

[Lev, MSN, RN, NP]

Just a student...but make sure that the g-tube is always patent. And with the trach - watch the patient's breathing. Also make the patient doesn't lie on the g-tube, because it can get pulled out.

[blessnme]

This will be my 1st job with direct patient care. So I am really new to this.

How much nursing experience do you have?

If the patient accidentally coughs out the trach, would you know how to reinsert it? If the patient accidentally pulls out the feeding tube, would you know how to reinsert it? Are you expected to perform trach and g-tube care?

Keep in mind that even though this is a sitter job, most state boards of nursing will hold you to the practice standard of your highest level of licensure if anything unbecoming or sentinel happens, which happens to be the LPN license. Good luck to you!

[momtojosh]

i have 12 g-tube individuals and 2 of them have trachs.....was a nervous wreck at first..now i can do care,feedings and reinsertion's with my eyes closed....you will get used to it....