Pediatric HH RNs - what type of patients?

jnette, ASN, EMT-I · Dec 4, 2007

We don't usually see peds cases with our ageny except for an occasional fx. so I really can't help you out here.. perhaps someone else will come along soon and give you some info on this. :)

caliotter3 · Dec 6, 2007

The agencies that I have worked for did not have cases that were considered RN level. Most of the RNs did LPN/LVN level care in the homes because that was the level of case that the insurance companies set the case up, criteria wise. About the only thing that the agency might send an RN for specifically, would be if they had a client with an IV or very high risk and they needed an RN with the required amount of experience. Otherwise, pretty much the same for both levels of employees.

As far as types of cases: usually lots of premature children with complications from prematurity, birth defects, traumatized by accidents and ventilator dependent, progressive congenital or genetic diseases with homebound status. You see a lot of children with cerebral palsy. That's about it, as far as what I've seen.

ArwenEvenstar · Dec 7, 2007

Since you asked about duties on a night shift, I am assuming you are talking about private duty cases? I am a RN and I was on a pediatric private duty case for about 2 and 1/2 years. It was evening shift during the school year, and day shift during the summer. Parents were on their own over night. This 9 year old child was born with a rare chromosome defect (17Q). She was essentially a quadriplegic, had a tracheostomy, was ventilator dependent, got frequent nebulizer treatments, very frequent trach suctioning, chest PT, bolus PEG tube feedings, urinary straight cath QID, bladder irrigation BID, etc. She was high maintenance! Believe it or not, she was not mentally impaired, could talk, and she went to school! Another RN was with her at school all day, and I was with her in the evenings after school. Except in summer when I worked day shift.

I left this case, and now work an adult case (a 23 year old). But another peds case that they were looking for RN's for was graveyard shift for a ventilator dependent child. They told me the child's O2 sats tended to drop at night, and that is why they needed a nurse overnight.

I talk about this on another post some. Even though I like private duty, one big con is the possibility of dysfunctional coping and complex psycho-social dynamics on the part of the family. As you can imagine, having a severely disabled child affects a family in a lot of ways. Different families can respond and cope in VERY different ways! You must be ready for this. It is imperative to maintain a firm professional boundary! I can't emphasize that enough. If you don't have a firm and consistent professional boundary, you will lose objectivity and you may not even realize it because you have been so "sucked in" by the situation.

MommyandRN · Dec 7, 2007

Thanks so much for the info. It sounds rewarding and challenging. I am definitely planning on making a switch to peds, but not sure about the home care anymore. I know I am going to focus on school nursing as a goal so I think I should probably stick with good ol' hospital nursing in the meantime rather than get caught up in a completely different field. You HH nurses are so great!