Private Duty Nurse..

TexasPediRN · Jan 7, 2008

I liked pedi private duty nursing to a certain point. ( I think I got bored with it after about a year- I really just needed a change)

You have to be comfortable with yourself and your nursing skills/knowledge- you are one on one with this patient, no other staff sitting next to you that you can bounce questions off of, or get emergency help from, etc.

Depending on the patient, you can feel like you are working ICU, or being a glorified baby sitter.

The newly trached/vented/g-tube feed/loves to desat and turn blue on a moments notice child, will make your shift go by very quickly and will keep you on your toes.

The child who needs to be decannulated (trach removed), who plays contently by herself and only needs g-tube feeds and 2-3 meds, can keep you feeling like a glorified baby sitter wondering when the shift will end.

A great thing to private duty though, is you see all aspects of care to help the child. PT/OT/ST are usually involved and come visit a few times a week. You may be involved in going to a drs appt - let me tell you how much fun it is to truck around a baby, vent, and all supplies!! (dont forget that emergency equipment!). It really does take 2-3 people for drs appts. Some require ambulance transfers.

I continued to do private duty PRN after I went back to a hospital job (which I was craving to do). A week ago, I sent in my resignation letter just because I no longer have time to give them.

Oh- realize you will be driving to cases - some cases may be far away with bad home conditions (some nurses will request off a case).

On the up side - you tell them the hours you can work, and you pretty much get it.

I hope that helps - feel free to post any other specific questions and I'll try my best to answer them!

annaedRN, RN · Jan 7, 2008

I did pedi private duty for 5 1/2 yrs and I too left because I needed more of a challenge. I agree with what MeghanRN said - she covered the "BIGGIES", but to add a few things.. One pro for me was that there was time for me to study for my RN. Another thing is that it is very rewarding - alot of one on one time and you can form close bonds. The family of the patient is a huge factor -it can make or break the case at times. If you have a supportive easy-going family -it is ALOT easier that the ones that are controlling, "playing doctor"types. Often when a case has a big turnover of nurses it is due to the family dynamics. Anyway, it is a nice change from the fast hectic pace of being in a facility. Good luck to you!

caliotter3 · Jan 8, 2008

I agree with what dhyser said about the family dynamics. As in any home health case, family dynamics will make your assignment heaven, hell, or something in between. Many times I found that parents will contradict each other in giving info to the nurse. This places you in the awkward position of reminding them that you are required to follow the doctor's orders or to document that they requested you to go against doctor's orders, then report to the doctor. This lack of compliance can hamper the progress of the child of course and can make for very uncomfortable interactions with the family members. You have to know when to stand your ground, when to do as the family requests and document and inform, and when to just say you need off the case because their requirements/behavior is too extreme a risk for your license and/or job satisfaction. One thing to keep in the back of your mind, is that parents of children are probably more likely to bring a suit if adverse outcomes occur and they look for the nearest to blame other than themselves or God. That is why I am more prone to ask to be taken off a case where the family is much too interested in bossing me around, tying my hands, and making changes behind my back while not informing me or telling me they are doing something differently days or weeks after the fact. I won't spend much time arguing with these people. It is not worth my time, efforts, or well being to have to face each shift wondering what they will surprise me with this time. There are far too many families out there that are happy to have anyone to help them care for their loved ones.

Jo Dirt · Jan 20, 2008

I've worked private duty more than three years. I have worked peds pdn occasionally and have had all kinds of pts but I'm to the point now I want the easy cases and I am able to pick and choose.

One thing I don't like: it is too easy to be drawn into family drama and if you aren't careful you will be caught in the middle. Also, the vast majority of cases (in my state, at least) are Medicaid but instead of pts and families being thankful for a service they could never afford on their own they have this air of entitlement and act like they are working four jobs to pay your salary. I've even heard "you nurses make SO MUCH MONEY to sit around! Well, I let them know we don't make a lot of money in the bigger scheme of things, and I haven't said but I want to add "and if you have a problem with what we do then you shouldn't use the system...."

PDN can be very easy but it has its share of drawbacks.

Justhere, BSN, RN · Feb 25, 2008

I worked Private duty with a vent patient for 4 1/2 years. Became very attached. He had a wonderful family. Some days were very busy and some days the time slowly ticked away. When he died in 2006 it was like losing one of my own kids. I still dream of him at times and wake up crying. I still keep in contact with his family. But if I had the chance to take care of another child with a good family I would do it in a heart beat.