Protocol for Going on trip with Patient

Nurses General Nursing

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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!

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

Are you going to FL or Ca? If it's Orlando, then are they staying at the MAW site? I used to do care for pt's there. The families stay in vacation type homes that have multiple rooms. Although it sounds like they must just be staying in a hotel?

The families that I saw, if they had a nurse come with, and needed someone to help on their time off... they were paid extra hours for the trip, as they were working more. They were not expected to be available for free. They continued to have shifts, then were free to do what they wanted on their off time.

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Something sounds a little off.

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Just a side note here. I can never understand why an expired ID cannot be used for identification purposes, does your identity expires ? I think only in America. My wife has a European drivers license, there is no expiration date so it never expires. I hate this kind of taxation.

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Specializes in home health & nonprofit management.

First of all, let me say I love you guys for your thoughts and support. I really appreciate it and need it.

Secondly, both myself and the family are in Southern CA and they'll be staying at the Disney here. Its just a few hrs drive for me and this is my home state so licensing is not a concern. The family originally asked for the Orlando location and pt doctors denied due to her condition. I agreed originally to the Orlando location b/c of the additional support staff there at the MAW hotel. This trip will have nothing like that but I think I'll be OK. No air flight involved.

My understanding is we'll be an regular hotel room and I'm being listed as an "additional adult participant". They've only mentioned one room and its just mom and pt going, so I assume they think I'll be fine shacked up with them. MAw will be paying for the room but told me it needs to be booked in one of the participants name for check in. The parents put in the request a while ago and should have taken the time to get ID's in anticipation. They are kinda leaning on me w/ the urgency aspect, to guilt trip me into using my ID but I wont. I'm taking the advice not to do this.

I have to admit I was feeling like a meanie -what if the child passes while we're squabbling over IDs.....but I have to maintain a professionalism at all times. Besides this is a situation I am not responsible for solving. I appreciate that each of you has reinforced this.

I had not thought of taking hospice orders- thank you NRSKarenRn. I will look into area hospitals. I have a copy of the agencys DNR form for parents to fill out. My insurance is up to date and I will be going to pt home to pack her supplies for mom who is a bit scattered right now. I'll bring extra of course.

I appreciate the suggestion to give parents a schedule of my hrs for them and will do so. The agency has only requested daily report and my scheduled hrs. They've made it clear I only get paid for a daily 8.

I'm saving the links for visiting rn in FL because I know this will come up again- most of my pts are peds.

As far expiring id's- I can only guess its to keep track of folks where about every few yrs.... I lived in another state where they were good for 9 years and the dmv lady told me this I complained about having to come in for new pix!

Thank you again,

Jen

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.

Jen, since you are coming to Disneyland in Southern California, (Anaheim) Childrens Hospital of Orange County is not far away at all in the city of Orange. Also, University of California Irvine is very close by with a very experienced team in the ER should hospitalisation be required.

I trust that you have personal medical or that you are covered by your agency/ employer.

I think it would be most appropriate that you are accomodated in your own room. Sharing a room with a patient and their family is not acceptable from a professional standpoint.

Also the Make a Wish foundation really should be paying all costs related to this trip including your accomodation.

I would definitely follow the advice your colleagues have given you here as we do have your best interests at heart.

Hope everything goes off well.

Kind regards,

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Just a side note here. I can never understand why an expired ID cannot be used for identification purposes, does your identity expires ? I think only in America. My wife has a European drivers license, there is no expiration date so it never expires. I hate this kind of taxation.

Arizona DL doesn't expire until you are 65 years old. When I younger and presented it out of state, people used to laugh at me when they saw the expiration date and ask for my real DL! :lol2: Why can't every state do this?

And thank you for taking care of this child and going the extra mile. We need more nurses like you. :redbeathe:redbeathe:redbeathe

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Specializes in home health, dialysis, others.

Your own room is a MUST. You are entitled to privacy. Do not get guilted into staying with them in their room.

Make sure you stick to your eight hours - - you may not be covered if something happens outside of that time period.

Mom may want to split your hours, and that is something you may want to at least discuss; but let her bring it up, not you. There may be some need for flexibility.

If you are to be with them in the park then make sure they know what you will or will not do. Try to set boundaries if you need to as to what rides/attractions are ok with you. ( I don't go on rides that take me in multiple directions at the same time! Can you say motion sickness?!!!)

Also, the parks often make it easy to go to the head of a line if there are accommodations needed. MAW should make those contacts.

Find out what your daily meal stipend is - don't let them tell you that you would need to eat anyway. Cereal and milk at home is not like breakfast out at a theme park! And try to make sure that your meals are not all taken with the family unless that is your choice.

Try to enjoy yourself!

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Specializes in Emergency Nursing.

I echo the statements of the other users. As was mentioned, it's imperative to have your own room. This would be an issue that I wouldn't budge on, its a matter of privacy and professionalism. Provide the family with your set schedule and let them know that you are only available during those hours (unless in case of an emergency). Have copies of the hospice paperwork and the information about nearby hospitals (telephone numbers and locations) on you at all times. Make sure you have enough of the necessary medical supplies. Make sure that your name or ID isn't being used for their room or for anything else of theirs, you need your own accommodations and should not be responsible for them in that way.

!Chris :specs:

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Specializes in PACU, CARDIAC ICU, TRAUMA, SICU, LTC.
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

I don't know anything about the Make A Wish Foundation, but why isn't this organization booking the room? Don't they pay for the trip? I would do some investigating before I committed to this trip...

Agree with "Caliotter3."

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Specializes in home health, dialysis, others.

Even if MAW pays for the room, someone has to actually check in! And then they need current ID. So mom needs to get it this week.

Please let us know how this unwinds. Keep in touch.

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Specializes in psych, addictions, hospice, education.

Current IDs are required because people's appearance can change quite a bit in a few years...hair style, color, glasses, etc...

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Specializes in home health & nonprofit management.

Hello all, just thought I'd quickly update. I sent an email to MAW this morning telling them I will not allow the room to be reserved under my ID and that I need a private room adjacent to or across from pt d/t acuity. I cc'ed it to my agency. Its been several hrs and no response which seems a bit unusual. Thank you all for the consensus- I hate to admit but this has been a "good little girl" issue for me and I'm feeling nervous presenting backbone. So I appreciate the support! I'll let you know how it turns out.....

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