Ms_Bee

Kyasi- The liability I was talking about was about transporting the patient...

Kyasi-Thats a huge liability!! And what a touch situation to be involved in but I think you did very well. Your main priority was your patient and once tended to you then if needed you could tend to the mother. I agree its a very very fine line sometimes... PsychNurseWannaBe- Very nice and simply put!!

I agree with you all. I do not think its the best idea to become friends on facebook with your patients. There was a unique circumstance that happened to my one of my nursing school friends where she went to school with her patients moms sister (they were acquaintances). They hadnt seen each other in years and then met again through the pt and are now "friends" on facebook. Im kinda on the fence about that one?? "I did PD nursing for 20 yrs and I understand the relationship that develops w/the families. It's difficult to keep that line from being blurred but you really have to. Every time you allow that line to move back, the professional relationship is compromised and eventually someone, the patient or caregiver, gets uncomfortable with it. I see this all the time. There were things that I knew other nurses would do on one case I was on. (ex: transporting the patient from a grandparents house to her house (while the mother was gone) I just wouldn't break policy no matter how close of a relationship I had with the parent... no way, no how. Always error on the side of caution." Kyasi- I know exactly what you mean as far as seeing other nurses do things that cross the line. I have heard of other nurses baptizing their patients, lending their patients parents their credit cards, purchasing furniture for them, working with their niece/nephew etc. And I do agree with you, at times its very difficult to keep that line from being crossed because you spend so much time with these families but its very important to keep it from being crossed. Im pretty new to pdn (

So I have read through various threads on here about being "friends" with your patients on facebook but not from any who work in private duty. I would like to know what is your take on this issue. It my opinion the situation is a little different than meds-surge since we are often in these patients home Monday-Friday for several hours out of the day. My patient is 2 years old so dont really have an issue with becoming "friends" but have heard of nurses becoming "friends" with the patients family (i.e mom, dad, aunt, uncle). I think its important to keep that professional boundary but can see how easy it is to become friends with the family when you've been on a case several years. What do you think? Can you maintain a professional boundary with your patient but not the family?

I had a pediatric patient with muscular dystrophy and a trach. They were very very thin and couldnt put on weight. There respirations were unlabored but they seemed to be slightly uneven. Their right side expanded slightly less than the left. Sats were good. No signs of respiratory distress. They were given a chest xray and were given an ok to go home (no pneumonia/infections). So I am curious as to why their respirations were like that. First thing I think of when I hear uneven respirations is collapsed lung but I am sure they would be in respiratory distress or would show up on xray. Any ideas??

LOVE THIS!!!!

So I just read a thread about the "not so good things" about working in private duty. Im curious to hear about your joys/benefits of working in pd and what makes you stay in it?? (besides the obvious need $$ lol)

Thanks that certainly helped. I am just a bit confused. In school when we would give medications or anything through the g-tube our instructors always told us to clamp as soon as the syringe was empty so that air would not be going into the stomach between meds and flushing. So that is why I thought if you held the syringe above that patient that air would just be filling into the stomach.

Hi I was just wondering how you vent a mic-key button. (1) I have heard that you can attach the syringe (without plunger) to extension tubing, open clamp, lower syringe to allow air to flow out. (2) I have also heard that you can fill syringe and plunger with 10 ml of air and suck air out of stomach using the plunger until you draw back stomach contents. The physician wants to vent the pt 30 minutes after the feeding for 10-15 min, according to the family. If you use method (1) after a feeding wouldn't all the feeding just come out? In order to vent with method (1) the syringe would have to be lowered, correct. Bc if not air would be flowing into the stomach?

Sorry for not specifying but the interview I have is for an agency doing shift-care in the patient home as you stated. I thought PDN was shift care in the home but maybe I was wrong

Wow. Such inspiration!! Im glad you were able to come back after 10 years. I do no have a job in PDN but have an interview on Monday. 8-10 patients seems ridiculous to me too. When I first started my orientation I thought 4 patients was too much but eventually got up to 6 and was managing it. I Thank You for your words of encouragment. I was getting a lot of slack on the general nursing forum for even considering shiftcare/pdn, one said if I couldnt handle med-surge I had no business taking care of babies. The thing is, it wasnt a matter of handling it because I was, I just didnt like the work environment. Thanks again and I am glad you think I could do it. :)

Thank you for the encouragement! And like you said "life is too short to be so miserable". That is one of the things I thought about when making my decision. Its always something I try to go by :)

No need to apologize for other responses. And yes it was a very tough decision. For me, quitting was the best thing to do and I do not regret it. Thank you for your input. I wish you the best too!!

Thanks for your response, what kind of psych issues do you believe are at play? I just want you to know that I am not asking in a mean/rude/defensive way, I would honestly like to know.

Thank you!! I really appreciate your response.

Wow. Thanks for your response, I really do appreciate it but some one your comments seem out of line. I never intended on taking a prn position I was simply stating that it was the only position I had seen open for nursery. I completely understand the reasons for not hiring a new grad into that type of position, like you said it IS for an experienced nurse. "If you can't handle med/surg you do not have the knowledge to care for a little kid on a trach or feeding tube, and how do you think you can work in a nursery? Do you think the nurses spend the day feeding babies and that's it?" That was a very tough decision for me and I don't think it was a matter of not being able to handle it. During orientation I thought there was no way I could handle 4 patients on my own but I did and at the end of it I was successfully managing 6 patients. My preceptors constantly praised me and said I was doing a great job and some after 5 weeks of our 9 week orientation thought I would be fine completely on my own. So once again it wasn't so much that I couldn't do the work or couldn't keep up it was simply that I didn't like that environment. You know some people love med-surge and some people don't. Some people love Labor & Delivery and some people just hate it. As far as your comment "Do you think the nurses spend the day feeding babies and that's it?", seriously?? I graduated with a BSN and you think I don't know what they do? I did several rotations through the nursery so I am well aware that is NOT all they do!! Neonates & Pediatrics are two quite different ballgames from adults and thats probably one of the reasons (labor&delivery, NICU, nursery) don't require med-surge experience. I do agree with you though..med-surge experience is very valuable and I am not trying to say I think otherwise. I give kudos to all those who hated it and still stuck it through, like yourself.

I have never heard of anything like that. Makes no sense for a nurse to have to pay for something a patient stole.

thank you!! i really needed to hear that...that at least i will still have some back up. i have no intentions on becoming a case manager lol, at least not anytime soon . all i want is a job that truly makes me happy and like you said where you can feel the rewards of appreciation. after all, thats why i went into nursing in the first place...to make a difference! :) just wondering whats a typical day like for you? whats it like having only one patient for 8-12 hours?

Congratulations on obtaining your RN! I would have never thought of craigslist until a family member mentioned it to me. I saw an add for PDN for national nursing & rehab so applied and have an interview on Monday. Since they gave me an interview, I am assuming they are at least considering me for the position without the year experience. How was it for you going into PDN having come right out of LPN school? What is a typical day like? Thanks for your response :)

That is what I am most scared of, getting into a situation where I dont know what to do next and not have anyone there to ask. In my area they do hire nurses specifically for nursery. I have seen one months ago but it was a prn position and was told my HR that they do not hire new grads for prn positions. Right now there is no positions for NICU either so Im kind of just stuck. I dont mind working with adults at all. I just didnt enjoy the med-surge environment. I felt like I was constantly running around just passing meds, doing assessments, and charting that I didnt get to spend quality time with my patients. It wasnt a matter of not being able to handle the patient load or anything like that I just, at the end of the day, wasnt happy. I've always told my self that I wanted a job that was going to make me happy whether it be a job that pays millions or whether it be flipping burgers. Thank you for responding, I really appreciate :)

So, Ive been reading this site for months now but just recently decided to become a member. Im a new grad (graduated in May with my BSN) and started working at a local hospital (med-surge). I quit after about 3 months working. It was a very tough decision but just couldn't take it anymore. I was crying a lot of the time and couldn't enjoy time off because I was constantly worring about work. I get that its expected for new grads but I couldn't take it. I simply wasn't happy working med-surge and knew day 1 that I never wanted to work med-surge but accepted the job thinking I could handle a year of it to get experience. Ever since I can remember I have always wanted to work in the nursery and later going into NICU. Unfortunately there has not been an opening in Nursery since I began the job hunt in March. Its has now been 3 months since I have left my med-surge position and I am getting worried that I will never find a job or that someone wont hire me because I have been without work for so long. I recently got a job offer but declined due to unsafe work practices. I have an interview next week for shift care in the home (pediatrics). After reading through different posts for PDN I thought it might be a good fit for me since one of the reasons I hated med-surge was lack of time spent with patients. But I also read posts saying that people don't recommend going into PDN without experience in med-surge. I have some experience but is it enough? Before interviews I tend to do research about different positions and scare myself into thinking I cant do it. So I just don't know what to do anymore. All my life I have wanted to become a nurse and I'm scared to think that maybe this is just not for me. I often get obsessed with all the "what ifs" and all the things that could go wrong in a situation which make me feel like I cant do nursing ☹. I would hate to give up on nursing but if I cant do med-surge and its not recommended to go into home health/PDN with such little experience, and there is no Nursery positions open, I don't know what to do? What do you all think, could a new grad with 3 months experience be successful in PDN? Sorry for the rant I just kind of needed to vent and hear another nurses opinion on my situation. I appreciate you all taking the time to read this and hope you can give me your opinions on my situation.

So, Ive been reading this site for months now but just recently decided to become a member. Im a new grad (graduated in May with my BSN) and started working at a local hospital (med-surge). I quit after about 3 months working. It was a very tough decision but just couldn't take it anymore. I was crying a lot of the time and couldn't enjoy time off because I was constantly worring about work. I get that its expected for new grads but I couldn't take it. I simply wasn't happy working med-surge and knew day 1 that I never wanted to work med-surge but accepted the job thinking I could handle a year of it to get experience. Ever since I can remember I have always wanted to work in the nursery and later going into NICU. Unfortunately there has not been an opening in Nursery since I began the job hunt in March. Its has now been 3 months since I have left my med-surge position and I am getting worried that I will never find a job or that someone wont hire me because I have been without work for so long. I recently got a job offer but declined due to unsafe work practices. I have an interview next week for shift care in the home (pediatrics). After reading through different posts for PDN I thought it might be a good fit for me since one of the reasons I hated med-surge was lack of time spent with patients. But I also read posts saying that people don't recommend going into PDN without experience in med-surge. I have some experience but is it enough? Before interviews I tend to do research about different positions and scare myself into thinking I cant do it. So I just don't know what to do anymore. All my life I have wanted to become a nurse and I'm scared to think that maybe this is just not for me. I often get obsessed with all the "what ifs" and all the things that could go wrong in a situation which make me feel like I cant do nursing ☹. I would hate to give up on nursing but if I cant do med-surge and its not recommended to go into home health/PDN with such little experience, and there is no Nursery positions open, I don't know what to do? What do you all think, could a new grad with 3 months experience be successful in PDN? Sorry for the rant I just kind of needed to vent and hear another nurses opinion on my situation. I appreciate you all taking the time to read this and hope you can give me your opinions on my situation.