Nursee1234

I have worked as an LVN since 1983 and spent much of that time in private duty pediatrics providing skilled nursing services to one patient at a time through a nursing agency who handle billing and staffing issues. I can decide how far I am willing to drive, what lift limit I want to put on my body and what shift I prefer. Once you find a case that is a good fit it can be quite nice. Have been with my current patient just over a year. Cute little 3 year old who walks on his own so minimal lifting. I drive 5 miles to his house from mine and work 7am to 4pm Monday through Friday. Many days he will nap for 2-3 hours of my shift. Those are my Netflix days and ordering from doordash? Hospice also uses LVNs to care for patients at end of life for twelve hour shifts if the patient needs frequent nursing interventions to manage symptoms. That is also done through agencies usually although some large hospices will sometimes have their own nurses hired for that level of care. Think outside the box. I raised 4 daughter's working through agencies as a private contractor for decades. Best of luck to your girlfriend.

Exactly! And a pharmacy label on a bottle or blister package never seemed the same to me as actually seeing the physician order. In home health we used to be able to enter a med on EMR from the pharmacy label and include the Rx number which counted as physician signature. That is no longer allowed per QA in the last six months or so.

A nurse should only go with the mg ordered regardless of how many mls or tablets may be involved . In my current agency we are not even allowed to write a verbal order in our tablets or transcribe to MAR without the dose clearly stated "give xxx mg" What you posted is really a med error looking for a place to happen. I would totally consider that order to be for 500 mg. Period. If what I have on hand is 250 mg tabs well...we kind of learned how to handle that in nursing school ?

Amen to the challenging adults. It has taken a year on this case to set the boundaries with mom. I guess I have a good situation being in a pre K class with only 8 kids and an aide and good teacher. If all the demons are having a wil day I will sometimes step in to discipline with my kiddo. Just simple things like signing no or stop that or kneeling behind him if he is wiggling and won't sit still during circle time on the floor. And I only do that if the aide is doing the same with two other kids who are not mine to touch. It's a balancing act. Not a horrible way to earn a paycheck. Some days are better than others!?

Since starting this thread I have actually begun going to pre-k in a special deaf education program with my 3 old patient. Loved the advice to keep some stuff at school. They are very kind about giving me some room for supplies. Rolling suitcase I purchased does the rest and navigates well in hallway. The teacher is deaf and the aide signs and hears so we muddle through and really communicate very well. PT wears a backpack with feeding pump and teacher and aide know that if he starts scanning the room for me it is because he hears the pump beeping. They think it is adorable. The first day I let them know that I would be handling all of his incontinence care,feeding pump ,meds and any nursing interventions that were needed but try to do so in a way that would not disrupt other students and also keep him engaged as much as possible. I would NOT intervene with teaching/ redirecting over classroom issues so as not to undermine the bonding he needed with teacher and aide. It has worked out very well so far and I do enjoy the mornings out of the house. Why would the teacher think you were trying to keep the pt out of school?

Thank you all so much. Yes. My agency is involved and doing their thing with school district and nurse supervisor. I have basically told the family that I will not ride the bus but will walk through the process with them to see if it is a good fit or not, logistically and schedule wise for me. On that note, let family and agency know that a back up nurse oriented to this patient is well overdue. Mom requires meet and greet and for a month now has not had a nurse if I am not on duty. It will all unfold as it will. Kudos to traveling with all the baggage with vent patients. I am only 5 feet 1 inch and a 105 pounds and find that daunting!

Wow! Awful. Did they report that as a HIPAA violation?

Thank you. Those are exactly the things I have had going through my head. Pros and cons to any situation. I think what is stressing me most is mom. She is decidedly high strung and does things her own way. We manage fairly well at home. Some days are better than others. I just don't see her having a realistic view of this situation. Three hours a day of school is NOT going to free her world for her to get a job outside the home and go to school. Especially with the 5 year old sibling starting kindergarten. She originally thought she could just give me a key, put corificeat in my car at morning drop off at school and I would drive pt home and carry on with the shift. When informed that my agency policy does not allow for transport of patients (and something I would not want/take liability for personally) she reconsidered the school bus. I really don't want the school bus scenario for myself. Sorry I'm rambling. The mom waited until yesterday to pick up the paperwork from the school district and is not communicating anything with agency staff. So frustrating. I called the info into staffing coordinator before my shift today so I will just wait and see how it plays out. I just felt really ambushed by mom wanting me to commit on the spot without any concrete details about shift times and travel logistics etc .We shall see...

Any wonderful or horrible experiences going to school with a patient? I have alternated between pedi private duty and hospice since 1983 but have never gone to school with any of my pedi patients. Have been with this three year old for 8 months and mom is pushing to get him started in special ed at local school. Not sure why but I feel less than enthusiastic ? Any insider tips on what it's like?