Protocol for Going on trip with Patient

[Gingilly]

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!

[Gingilly]

Ok, very quick- MAW now says there are alternate means of ID the parent can use along with her expired ID, such as library card/ insurance card etc. So they've agreed not to use mine. They also said I will have "separate sleeping quarters" and since the trip is not yet booked I take this to mean either a different room or a family suite with a separate room for me. I will clarify this when we get closer to booking.

However things have gone down hill fast over the weekend for pt so its not looking too good on the trip at this point.

But I have gained valuable knowledge on handling this type of situation, thanks to all. And I have 2 excellent hospitals in the Anaheim area on my cell. Gotta get back to work

[Gingilly]

Hello all, just wanted to update and conclude this thread I started. Just getting back form trip with Pt who got a special pass from MD to go. It was terrific for pt who had a blast! Most of the time pt was infusing and very weak but managed to spend several hours at the park in total and it was worth it for them.

On the nursing side- the advice received here was excellent. MAW does provide a separate room which you must have. You will need your own restroom, won't want pt to hear your business in there and need to keep your meds/ toiletries from mingling. Remember meds bottles have your address on them!

I'd suggest a room across the hall- none of that door in btw because they'll feel comfortable walking in on you...Also please keep strict hours and have them written down. That way any time outside this will be understood as extra time and more appreciated. I had a verbal "understanding" with pt for 8 hour shift done in 3 increments with no set start/ end times and she would conveniently forget the times I was working. very frustrating knowing she was trying to work me to death. I ended up working a total of 18 hours in a 24 hour period in small little increments because of this.

Make it clear you are providing nursing care not companionship and baby sitting services. Pt thought because I was there anyway, I should watch child while she went out. Watch out for resentment/ attitude when you leave to go about your own life- "on their time/money".

I hate to say it but you must keep lines btw you and pt. because they'll take advantage if you dont. Stay professional and don't forget that when youre on free time with them its still a professional relationship, no matter how chummy they try to be. They'll use it later to manipulate you into more time...and any time youre w/ them youre still an RN and legally responsible!

And do not use your car to give pt rides to store etc. Let them provide for that. MAW will send limo for transport to and from and they will need to figure out how to get around elsewhere.

If you plan on time off and are clear about this, it can be a real fun time for all. MAW loves RN volunteers and I'd highly suggest it!

Thank you to all who shared knowledge- I learned so much and it helped make the trip smoother for me.

Jen

[caliotter3]

Sounds like the trip turned out to be more enjoyable than not. Glad you got some of this straightened out along the way and that it helped matters.

[Simply Complicated]

Thank you for coming back and updating. Like anything else, nursing is an ongoing learning process. Next time if you do a trip, you will know much better how to handle the situation!

Did you have the adjoining room? Just curious as you mentioned them feeling comfortable walking in on you.

[diane227, LPN, RN]

I am sure they are trying to be nice and offering to include you but I would keep it on a strictly professional level and find my own activities to do apart from them.