zeebee14

I worked in pediatric home health for six years and never cleaned a family's home. I would clean up any areas where my patient may have made a mess with toys or whatever, but I wan't sweeping the floors or anything, unless maybe there were crumbs from my patient eating or something. I was allowed to do any cleaning associated with my patient, so dishes from meals they ate or their clothes or wiping down toys, things like that. I was also expected to organize their supplies, like diapers and trach supplies, when they were delivered. But I would never have cleaned the whole house, and certainly never anything that didn't belong to my patient.

He was only diagnosed with apnea during this study. He had a home sleep study a few months back to determine whether he needed the vent at night, and that one he passed and was able to come off the vent. I don’t think that at this point, he would be a good candidate for a CPAP. At his age and with his cognitive delays, he would just rip it off his face. I think that is why the pulmonologist is recommending he stay trached for the time being.

I work as a peds home health nurse. My patient is 2.5 years and has Down syndrome. He has had a trach since he was an infant and his parents are eager to have it removed. He is currently off the vent entirely, and uses an Airvo for humidification while sleeping. He wears a cap all day with no issues. He still does require suctioning about 3-4 times a day. He had a sleep study on Monday to determine if he could be decannulated, but he failed due to sleep apnea. The test was ordered by the pulmonologist, who doesn’t really answer any questions and doesn’t provide a whole lot of info. He did not order the patient a smaller sized trach for the study, which apparently is pretty standard in these studies. So now the parents think that he failed because he didn’t have the smaller trach and want to ask his ENT at his appointment Monday to order a new sleep study using the smaller trach. Do you think this would actually help him? My feeling is that if he has apnea and still needs suctioning, no matter the trach size, he will fail. What is the rationale behind using a smaller trach for the sleep study? Thanks!

Maybe try home health, particularly pediatric home health? You only have one patient at a time, and you can work with your agency and the family to find the best schedule for you, so you can work 8, 10, or 12 hour shifts. Most patients are really stable and don’t require a ton of work. You usually just see trachs, vents, and GT. And the families generally really appreciate the help, so you feel like you’re actually doing something positive in your job. Even if you don’t wind up sticking with nursing, a home health job may at least give you a break until you figure out what it is you’d like to do.

I am a home health nurse for a 5 year old that has a GT. When I started with him three years ago, he was on Pediasure for his feeds. He started getting really sick on it, vomiting nearly daily, as well as developing constipation (which I’m sure caused some of the vomiting, he got really backed up). He saw a dietician who recommended that he try Real Food Blends and to stop the Pediasure. The RFB caused him to have several loose stools (not watery diarrhea, just sticky and soft) every day, causing serious diaper rash. Pediasure got added back in at least one time a day just to help with the BMs. After adding that back in, he started throwing up again, not to mention the BMs didn’t really slow down. Recently, he went to a different dietician and she recommended (based on his mom’s preference) that he go on the Kate Farms pediatric 1.2cal formula. He has now been on that for about a week, and the BMs are just as bad and he’s getting a rash again. What could be causing this to occur? What can we do to keep him from having so many BMs? He goes through diapers like crazy and it is so bad for his poor butt. We are at a loss.