pediatric HH, please help

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I accepted a position as a pediatric HH nurse. It will be 4 shifts a week which I think is a lot, at the same child's home. I am freaking out since I have no peds or HH experience whatsoever, as I come from psych nursing. How do I prepare for this job? From what I understood the training is very limited to stuff like how to care for trach and g-tube. they are so eager to get me out there that I suspect the training will only be a few hours. It all feels rushed and I'm scared I will be sent out completely unprepared. My question is, is there any good book/videos out there to help me learn? please advise I am so lost!

You typically only orient for two hours with the primary nurse or a nurse working the shift you will be joining. A more detailed orientation may be four hours. An entire shift is rare. Remember, the agency has to pay for two nurses to be in the home at one time. They are only reimbursed for one, so most of the time they expect you to "get it" in two hours. That is why you read the 485 first. You can review trachs and g tubes before you start out. Down the road they may start putting you on cases with vents, but they should send you for, or provide you with, training first. My first vent patient came with an eight hour shift with an experienced, competent nurse who made sure I got the basics of vents down. Even she told me not to worry because the patient's father could handle any crisis, and did not mind supporting the nurse.

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Specializes in Pedi.

Here's the hard truth about pediatric private duty agencies- they just want to fill the hours the kids are assigned with a body and they generally don't care to waste too much time on training. I was a clinical manager for a pediatric home health agency that had a large private duty population for 3 years. I did not work on the private duty side but my impression was that all you needed was a pulse and a nursing license to be hired into those cases. One of my colleagues who managed the PDN cases in our branch was constantly at odds with our recruiters and Clinical Director because she would turn away nurses who did not have the appropriate experience from high tech cases like pediatric vents and TPN. I also was often criticized because I wouldn't use nurses who came in and did not have pediatric or oncology experience for my chemo cases. Sorry, not sending someone who's never touched a central line access a port and push chemo on her own in a home.

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Thank you so much Brita01 that helped me a lot. I hope I get a full shift to precept and not just 2 hrs. They only pay me $10/hr for training so its not like paying for 2 nurses on the shift. I dont know why the pay is so low but thats a whole other story.

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You are so right i wish this agency was half as prudent as you are. Im afraid i will get very little training and will be thrown in to sink or swim. I have a bad gut feeling and feel like backing out of the whole thing. As a psych nurse all i did pretty much was give PO meds and do psych assessments. Nothing clinical at all except maybe IM shots. This is a whole new world for me and i honestly dont understand how they could have hired me, i think its irresponsible.

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Here's the hard truth about pediatric private duty agencies- they just want to fill the hours the kids are assigned with a body and they generally don't care to waste too much time on training. I was a clinical manager for a pediatric home health agency that had a large private duty population for 3 years. I did not work on the private duty side but my impression was that all you needed was a pulse and a nursing license to be hired into those cases. One of my colleagues who managed the PDN cases in our branch was constantly at odds with our recruiters and Clinical Director because she would turn away nurses who did not have the appropriate experience from high tech cases like pediatric vents and TPN. I also was often criticized because I wouldn't use nurses who came in and did not have pediatric or oncology experience for my chemo cases. Sorry, not sending someone who's never touched a central line access a port and push chemo on her own in a home.

My agency at the time threw a fit because I refused a case with a central line. I insisted that my minimal experience in school did not prepare me to handle the responsibility alone in the home setting. I also noticed they didn't try to entice me with a high rate of pay for the higher acuity case. I figured out to refuse the case by reading the 485 in the office before agreeing to go to an orientation.

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Specializes in Pediatric Critical Care.
This is a whole new world for me and i honestly dont understand how they could have hired me, i think its irresponsible.

I don't mean this to be rude, but....then why did you accept the job? I'm just a little concerned because you seem to agree that you are likely to be unprepared for the job. If something bad happens, its gonna be your head on a plate, not theirs.

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I know, i totally agree with you! They recruited me, i didnt apply there. Their recruitment process is very aggressive. I was having trouble finding a job in my specialty, psych. I thought lets give this a chance. Only now it has become apparent that they really dont emphasize the training part and cant wait to get me out the door on the case. That is what raised the red flags for me and prompted this post for advice.

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Specializes in Pediatric Critical Care.
I know, i totally agree with you! They recruited me, i didnt apply there. Their recruitment process is very aggressive. I was having trouble finding a job in my specialty, psych. I thought lets give this a chance. Only now it has become apparent that they really dont emphasize the training part and cant wait to get me out the door on the case. That is what raised the red flags for me and prompted this post for advice.

Oh dear! Well maybe now we know why they have to recruit to find people to work for them....hmm. Well good luck - don't let them put your license at risk. Kids are great once you are used to working with them but I can imagine it would be very scary being on your own when the child pulls out their G-tube or trach.

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Specializes in LTC, Rehab.

You can find a video on almost anything on YouTube. And I'm sure text descriptions & photos on other websites. Or actual BOOKS. :^) Good luck.

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Thank you. I ordered a few books..

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I know, i totally agree with you! They recruited me, i didnt apply there. Their recruitment process is very aggressive. I was having trouble finding a job in my specialty, psych. I thought lets give this a chance. Only now it has become apparent that they really dont emphasize the training part and cant wait to get me out the door on the case. That is what raised the red flags for me and prompted this post for advice.

I will bet the rent the agency starts with M and ends with M. Run from this " assignment". No nurse and no pediatric patient should be put in this position.

The agency cares about NOTHING but money in THEIR pocket. You are jeopardizing your license working for these money- grabbing bozos.

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Its MGA

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