Protocol for Going on trip with Patient

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Specializes in home health & nonprofit management.

Hello, need suggestions on how to set boundaries on a case. I have a pt that will be going on a 5 day Disneyland trip via Make A Wish foundation and I have agreed to go to do infusion care. My shifts are 8 hrs, 6 of which are treatment and thats all I am paid for. I think the family wants me to be w/ them out and about in the park but I don't think this is appropriate. I'm wondering if I should be spending my off duty time with them which just means I'm on call for them. I'm also wondering if I should request the Foundation provide me with a separate room? I feel a bit uneasy about being at pts beck and call 24 hrs a day and sleeping in the same room. Also because family doesn't have proper ID they want me to book room in my name. Anything sound weird about this situation? Whats the normal expectation when you go on trips with Pts? Do you get off time? I'm going to be the only RN on the case and there will be no other medical personnel unlike at DisneyWorld. Any thoughts appreciated!

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Request the separate room, and if you are not accommodated, do not go. You are not required to be with the patient night and day, you are allowed to have time to sleep. Although only paid for X amount of hours, it is understood, that on a trip, there will be "extra" time that you will be "donating" to the cause. It kind of comes with the territory. I would never be booking the room in my name. They don't have proper ID? What is the problem? Don't make it your problem. Do you want to end up paying for the room upon checkout? I would not go under these circumstances and would seriously consider ceasing to work with this family. JMO

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Specializes in Med/Surg, Ortho, ASC.

I absolutely believe that you should request a private room. And I think you should provide the family (in advance) with the hours/days that you are scheduled, beyond which you will be unavailable.

The only other way to look at it would be if you were feeling particularly charitable and decided to donate on your own to the "Wish" and planned to give more freely of your time.

The lack of family ID does weird me out a little. Do you know the family at all? Do you know why they have no ID? I personally wouldn't be willing to put their hotel room in my name.

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

This whole scenario sounds fishy. Contact Make a Wish and find out what you are covered for. My cousins daughter was one of their kids and the foundation had specific rules as to how and what was proper.

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Specializes in home health & nonprofit management.

Thank you Early Birds! This was keeping me up all night and I am very grateful for the advice. The ID situation has been explained to me as the parents has expired and they haven't had time to go to dmv w/ pt being so sick. For 6 months now. I have been on the case 2 months, pt is impoverished, no car etc etc so it seems plausible, but I'm not using mine. MAW actually suggested this on behalf of family to expedite things since pt is now hospice but I'm not comfortable with it and do not feel it is professional. We are in the middle of paperwork and I will request the separate room before signing anything. Thank you for the confirmation on this- I was worried this might be an unusual request.

I do understand and expect to spend extra hours working but I was hoping not to have to spend my sleeping time on call. I get the feeling I'm expected to be constantly available and need a door to shut. I have given this family a lot of love and service and they lean on me quite a bit. I've never done a trip w/ pt and trying not to be a martyr.

Jen

p.s., yes this is a duplicate post- wasn't sure many would be browsing in speciality over the holiday:coollook:

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Specializes in psych, addictions, hospice, education.

It would be crossing boundaries of professionalism, kind of in a reverse way, if you shared a room with the patient. Where would you have privacy at all? This is not ok.

Never ever use your ID for someone else's purposes. That's a big red flag for potential trouble. You could get stuck with the bill for the entire stay. In fact, wouldn't you have to pay anyway and hope they pay you back? If it's a Make a Wish trip, shouldn't MAW be paying the whole thing and shouldn't they have arranged things with the hotel, etc.?

It's not reasonable for you to be with the patient 24/7, or to be on-call 24/7. Is no one else going on the trip? They need to figure this out and not depend on you to do everything.

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Specializes in Psych ICU, addictions.

Something about this whole thing seems really off. I'd contact MAW before you do anything else. Also, even if MAW suggests you use your ID to expedite things, I would refuse to do that.

And if after talking to them you still have an unsettled feeling about the trip, then don't go.

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Specializes in MDS/ UR.

Are you licensed to practice in the state? How are you covered if something, G-d forbide, goes astray?

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With the TSA rules, if the family is flying to Disneyland, they will need a picture ID to even check luggage, let alone get on a plane. Advise them to get their IDs when you are with the patient so they have the time to go and not worry about their child.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

my colleagues have well advised you. since patient in hospice, obtain copy of hospice orders to take with you, identify local hospice/hospital in case of emergent issue. make sure up to date. pack extra medical supplies.

fla bon permits visiting nurses with completion of this form:

[color=#052a73]visiting nurse requirements (doc - 81kb)- florida statutes provides for visiting nurses, less than 30 consecutive days.

california requires: temporary license and interim permit verification

please make sure all loose ends especially re identity resolved as you will be the sole medical provider they rely on. many nurses have been in this role giving children one first or last memorable trip.

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You absolutely need a separate room. And the parents can go down to the DMV, one at a time, and renew their driver's license while you are there taking care of their child. One parent and you stay at with the child, the other goes to the DMV. If a parent works, they can stop on their way home from work. They will not be able to board a plane with expired ID's.

Be sure you are licensed for CA also or at least check with the Nursing Board to make sure you are covered.

MAW should be paying/reserving the room, not you. What does the agency you work for say about all this?

You should not be on call, at their beck and call, 24/7. What do they do when you are not at their home? Do they really need 24/7 nursing call? If you don't feel comfortable giving them your cell phone number, I would give them my agency's phone number, with instructions to call them if an emergency arises, and have the agency call you.

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For California you will need an endorsement...

http://www.rn.ca.gov/applicants/lic-end.shtml

I would suggest a cheap pre-paid cell phone for use while on the trip, to avoid giving out your personal number. You should be able to find Virgin Mobile phones for less than $20 at the local 7-11.

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