SBH2

Well, my second day was as horrible as the first. Today there were 3 seizures in the four hour school day and he coughed his trach out even though it neck ties were secure (other nurses that have worked with him have said that happens from time to time because he is such a bad cougher). I have talked to the school nurse, the nurse at the hospital where he lives, as well as the teacher that he had when he attended school at the hospital. They all agree it is not the best idea to be transporting him to and from public school, but all say it is not up to them. After I voiced my concerns about this case to the agency they are going to have me sit with him at the hospital all day tommorrow to "get to know him better", because they feel the more I know him the easier this job will get. I dont think so. I can handle the seizures and trach in an appropriate setting, not in a public school with no backup in case of an emergency. I plan on going to sit with him at the hospital so that they can see I am giving it my best shot, but I think it is best that I just quit this job. I do not want to be any part in this stupid idea of taking such a sick child out of a hospital enviornment and into a public school with only one nurse on site (me) and risk my license if something were to go wrong. If he goes into a seizure when the intercom comes on to announce something at the school what is going to happen at the first fire drill?? Do you agree that this is just a job I should leave, even though it has only been a few days?

Well, I just got back from my first day and it was horrible. He used to go to school at the hospital he lives at, but the county that he came from wanted him to try the local public school; however I do not feel like it was good for him at all. He get startled at any loud noise and sometimes sends him into a seizure..He had FOUR today (including one on the school bus)! There werent any other nurses like I told there would be, and the school nurse said she hasn't even touched a trach in over ten years. Everytime he had a seizure he would cough so bad and need to be suctioned. The whole day I was on edge and worried about something happening to him. His special education teacher thinks this is the wrong place for him and the school nurse is going to call the charge nurse to tell them she is worried about the amount of seizures he is having. However, when I talked to her when I brought him back from school that "he has seizures sometimes, but he will fine." I do not feel comfortable with this situation at all, should I go back tommorrow, or tell my agency that I cannot handle this case?? I am new with trachs, and he is having 4 seizures in about 5 hours, I dont know what to do. I feel like he is too sick to be in a public school outside of the hospital for the first time, and I am not sure I want to be the one responsible if something goes terribly wrong in this new enviornment. Please let me know what you think.

He is 16 years old and I wont actually be at his home. I pick him up every morning at the Childrens Hospital and ride the school bus with him to a special needs school and stay in case of an emergency. There are supposed to be a couple other nurses there with other children with trachs, so hopefully I can ask them for help if I need it. I will take all of your advice and take the first trach class I can find; however I do start tommorrow. I am just praying on my first day he doesnt cough out his trach! I know that you suction when you hear them starting to "rattle" a little bit, but does anyone know about how often that will be?

I was hoping that some assurance from some other nurses would make me feel a little more confident before I start my new job on Monday. I took on a job taking care of a 16 year old boy with a tracheostomy. I very nervous because I have only changed a trach once, and suctioned one twice. Is it normal to be so scared of trachs when you are first starting out? In your opinion, is somebody who has only worked with a trach 3 times qualified to handle this type of job? I may be over reacting just out of pure nervousness; I know the steps of changing in an emergency, and I know how to suction..How did you feel with your first few trach patients?? And what is an estimate of how often a trach emergency occurs?