Please explain why a nurse is needed...

eeffoc_emmig · Mar 2, 2014

Same thing w SSI Disability benefits... My husband has severe rheumatoid arthritis and is turned down for benefits, and suffers every day at work, while others spend their "disabled" lives playing golf and actively enjoying their lazy lives. No rhyme or reason as to who gets what.

I'm afraid I'll be in the same situation in a few years because of my awful knees. The system has major issues!

**Elektra6, ASN, BSN, RN** · Mar 4, 2014

I have adult patients whose primary caregivers are the moms who are pushing 70. I wonder if they will qualify for more nursing care if mom is unable to do care? I would hate to see them in LTC.

BuckyBadgerRN, ASN, RN · Mar 13, 2014

How about this? I don't care for MY tax dollars providing a job for OP? =) It seems that those dollars could be sent in another direction to a child more in need of assistance?

I'm confused as to your user name. You seem to be calling yourself and LPN, yet your profile says you're not even a nursing STUDENT yet. You wouldn't be in violation of AN rules I hope...

How better can your taxes be spent than to provide you a job? I'm confused.

JustBeachyNurse, LPN · Mar 13, 2014

How about this? I don't care for MY tax dollars providing a job for OP? =) It seems that those dollars could be sent in another direction to a child more in need of assistance?
I'm confused as to your user name. You seem to be calling yourself and LPN, yet your profile says you're not even a nursing STUDENT yet. You wouldn't be in violation of AN rules I hope...

The trend is coming for Medicaid & Medicaid HMOs to start cracking down. Both parents home & at least one a qualified caregiver? No skilled nursing needed unless the qualified caregiver is working or child in school (which is district responsibility). Both parents accompanying patient to multiple specialist appointments = no nurse needed. Basic GT only with scheduled ( non-continuous) feeds & qualified caregiver parent home = no need for nursing.

PA and other states already implementing these logical changes. NY & NJ will soon. It won't be long before the rest of the states become more (realistically) strict on approving skilled pediatric nursing care just like commercial insurance. Several states already have regulations that skilled nursing is not child care or basic ADLs only. There are some pedi cases in both agencies I work for that were downgraded from skilled nursing to CHHA with RN supervision as parent did the meds & feeds so no need for nursing in an active relatively well child that needed ADL help & safety precautions.

eeffoc_emmig · Mar 13, 2014

I'm all for tax money being spent wisely and those in TRUE need receiving nursing care.

ventmommy · Mar 17, 2014

My vent-dependent son had 16-24 hours per day the whole time we had him (mostly just 16 though). My baby that I have had for several months was offered 12 hours/day. Her only issue is DM1. I am not sure why that requires nursing care.

JustBeachyNurse, LPN · Mar 17, 2014

My vent-dependent son had 16-24 hours per day the whole time we had him (mostly just 16 though). My baby that I have had for several months was offered 12 hours/day. Her only issue is DM1. I am not sure why that requires nursing care.

Is the baby a foster child? Some states have a blanket policy to offer PDN for any foster child with a "significant" diagnosis failing to account for foster parents that are experienced qualified caregivers like yourself. Someone without medical experience may not understand the importance of BG checks, proper diet and use/storage of insulin. If this is a child that was removed from the home due to neglect, medical neglect or parental incompetence, the state may want to ensure the child is cared for. At least in this case I can understand but not necessarily 12hr shifts but perhaps for a limited basis to educate the parents and facilitate competent care.

But child with basic GT only care like the OP, perhaps skilled intermittent nursing ("traditional home health") for parent teaching & follow up for an hour or so daily reducing amt/frequency of visits. I cannot see the point in 12+hrs a day for an indefinite amount of time for basic care with no significant comorbid factors such as severe reflux/intractable vomiting, seizures, parental incapable of providing safe & competent care due to cognitive or physical disability. Basic GT feeds with a physically & competent stay-at-home parent truly seems a waste of resources.

ventmommy · Mar 17, 2014

Yes, this is a foster child that we are adopting. There is no mandate here for nursing care. The bio-father is jailed and the bio-mother is incapable of care due to mental illness. They voluntarily relinquished rights. The baby is currently on Medicaid but will switch to our insurance after finalization. I am fully capable of BG monitoring and insulin dosing. I am doing a very healthy baby-led weaning diet with no added sugar and no "junk" type stuff. (I make my own bread, no sugar cereals, no commercial baby food. I make my own teething biscuits and cookies.) I'm not trying to toot my own horn. I just know so many families IRL that are begging for more hours and they legitimately need the help and can't get them. I agree that only a GT does not require continuous nursing. If a parent is that incapable of providing GT care, I would question their ability to parent at all.

JustBeachyNurse, LPN · Mar 17, 2014

Too bad there aren't more parents like you & your husband. Based on your posts, it would be an honor to work PDN for one of your precious children. In your case they likely offered as a matter of policy/procedure. Clearly you are competent.

A friend of mine has a DM1 son and just qualified as a foster parent and her first child is kinship care that the adoption will be final in a month. She was asked to care for a new-onset DM1 toddler with no insulin pump. They offered PDN for 12h/day at least to start. She said DCF has to offer PDN at least initially during the transition for certain medical conditions. She was able to decline because she could demonstrate competency & knowledge to safely care for a DM1 child. DCF said they had to offer as a matter of policy. At least I can understand short term PDN being offered in a foster situation that perhaps the parents may not be experienced with what can be a complex diagnosis like new onset DM1 to educate the family and nursing can document education & competency with a definite discharge from PDN plan.

CloudySue · Mar 17, 2014

Ev'rybody, Imma gonna let you finish, but I want to hijack this thread for a moment to say "Congratulations" to Ventmommy for the adoption of your new child! I wish you and your family a wonderful, happy life together!! xoxo

ventmommy · Mar 18, 2014

Thank you CloudySue!

JustBeachy, I think that the DCF your friend works with had an excellent policy regarding SN children and PDN care.

NottaSpringChik, BSN, RN · Mar 21, 2014

It is a mystery I don't understand. Another thing I don't understand is the attitude the family gets that they will not provide anything for the child unless they can get someone else to pay for it. Are there limitations that are imposed upon the money they can spend on their child out of their own funds if they are receiving government assistance? The parents of this child are very well off financially. I get that some families are under severe financiial stress but thiis is not the case with this family. The child has clothes but for example, he loves music and other audio material. He has a cheapie sound system, reject CDs. His pillows are the cheapest worse things, the positioning supports are made out of plastic garbage bags, his hospital bed mattress is a worn out thing bought used. I don't get it. He doesn't even get birthday or Christmas gifts.