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Discussion

PDN Vent

So I had to precept a nurse last night. She is a brand spanking new LVN/LPN (less than 6 months) and has zero formal training in vent or trach and she will be with a very high acuity vent baby. She did not know anything. She told me the company told her to watch a YouTube video on a vent and training on a trach. She didn't know how to suction NOTHING. She has never touched a g-tube. I told the parents this morning that I am very concerned. All of her training was a 12 hour "shadow" watching me. She starts in a day. I feel bad because this nurse needs a job, however, I feel like the baby's well being should be considered.

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That's really scary. That's why I always tell new nurses never to do PDN because the company doesn't care if you have experience or not, they just want a warm body there. I hope the family says something. I have been let go from a very less complex case with more experience.

  • Expert

No, no, no. The agency owes more to the nurse, the parents, and more importantly the patient. This is the wrong case for this new nurse and the agency DPCS and clinical supervisor know it.

This is scary... Can't the agency at least give her another training shift?!

  • Author

I think that she needs to have at least another 36 hours of OTJ training and take a vent and trach class. I had to get certified in vent/trach four years ago and I was still very "green" and would panic (on the inside) my first year as a PDN. I have to recert each year on vent and trachs as well. If they let this nurse come on and take shifts, I will be looking for a new case,possibly a new agency too.

This is why PDN isn't for new grads.

Notify your supervisor of your concerns in writing to CYA. That is all you can do. You could also scare the nurse with horror stories do she thinks twice about it. When it no longer scares her, she is ready for the case. If it doesn't scare her, she more dangerous than you thought.

Its good if the parents know do they can monitor things too. Hopefully its not a parent that bases the skill of the nurse on how nice they are.

  • Author
This is why PDN isn't for new grads.

Notify your supervisor of your concerns in writing to CYA. That is all you can do. You could also scare the nurse with horror stories do she thinks twice about it. When it no longer scares her, she is ready for the case. If it doesn't scare her, she more dangerous than you thought.

Its good if the parents know do they can monitor things too. Hopefully its not a parent that bases the skill of the nurse on how nice they are.

That's the problem. The family is basing her skill level because she's a "good ole country girl." She didn't even know how to use a pedi ambu bag. She was asking me very basic questions about it.

  • Expert

Your best course of action is to get yourself off the case. You do not want to follow this nurse or report off to her without an entirely different set of circumstances.

Nurses should come with a skills profile that the parents see prior to meeting. Maybe they would base more decisions on nursing skill/experience. All it takes is one mistake.

  • Author

Yes, I see a new case in my future, near future! And yes, nurses should be accountable of what skills they can do. I am all for nurses to learn new things, that is how we grow. However, we as nurses should have the basic fundamentals down before taking on a case that is new territory.

I was NOT allowed by my agency to take care of vent/trach infants and children even though I took the vent/trach training class and peds training class. I was kinda mad about this at the time. They placed me with a child with a g-tube. I had a year and a half of LTC experience prior to this. Then I was sent to adult vent patients and did a 40 hour orientation with a client and his nurses. I felt ready to take on his care after this and 8 years later I am still one of his nurses. :sarcastic:

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