Quit or give 2 weeks?

enuf_already · Aug 9, 2015

Hi, I am a new LPN and I started my first job at a HH agency.
My patient is a toddler with a myriad of issues, including a trach. I initially wanted a tough assignment so I could learn. A couple weeks in and what I've learned is I don't believe this is a case for a new grad. I really want to find a position where I will be surrounded by a team and not by myself.
I've tried to stick it out the past two weeks and I've asked the agency before if a more experienced nurse should be handling the case. I was reassured I'd be fine but now more than ever I disagree.
So I am wondering should I let them know I'm no longer comfortable and drop all future shifts or should I put in my two weeks? I sincerely do not feel comfortable going back but I do not want abandon the patient. I'm having trouble finding anything regarding this since it is home health and I've technically already accepted the assignment. However, the parents do take care of the patient on a regular basis. The home healthcare is more of a respite type of thing.
Thank you!

It has been my experience that in order for a child to go home with a trach or on a vent, the family has to be able to care for them. Although nursing may only be providing respite care, that care must be done in a safe manner.

It sounds like you have several options. One would be to ask for additional training on skills you do not feel comfortable doing. If you give 2 week's notice, the agency may not give you any more assignments, but won't say you quit without notice.

With peds, you need to understand normal growth and development, the child's specific disease process and the individual care they require. You need to be able to anticipate and handle emergencies on your own, since with most respite jobs, it's you and no one else.

A tough assignment in home health is asking to learn on your own and is usually not a good idea for a new grad. Good luck with whatever you decide to do.

GuEsT78 · Aug 9, 2015

Discomfort is normal when you're dealing with a patient whose situation is new to you and whose troubles may be difficult to handle. That's not the time to panic. That's the time to be objective. Can you list actual situations that might arise with this toddler that you lack the training to handle?

Take out a sheet of paper and create two columns. Head one, "Problems that might arise." Head the other, "What I would do." If for every problem, there's a response you have been trained to handle, there's no reason to fret. And if there is a problem for which you don't have a ready response, can you get the training to handle it ASAP?

Only if there are issues that are beyond your training, should you be concerned. And even then are you should ask yourself if there would be enough time to summon medics who can handle those issues and transport this child to a hospital. You don't have to handle everything imaginable.

Remember that in this case you've got two quite skilled parents to consult. Bring any questions you have to them and always keep handy a contact number for them.

Remember too that you're new and establishing your first habits as an LPN. There's no more important habit to establish than a spirit of 'can do' confidence back up by an eagerness to learn what you need to know for each new situation. Run away this time, and you may find yourself running away again and again. Hang in there this time, and in six months you'll be surprised at all the hard stuff that's become easy.

allnurses Guide · Aug 9, 2015

An agency will attempt to scare or guilt a new nurse into believing it is the nurse's responsibility to make sure the case is staffed. My experience is that when a contract is signed between an agency and a client, the client designates a "primary caregiver" in the event the agency is unable to provide coverage.

The only person who can decide if the assignment is safe in terms of your current skill set and level of experience is you, and I think you are showing excellent judgement in your cautious attitude.

It is always better to give notice rather than not, though. As an outsider to the situation it's difficult to say whether your nerves represent an uncomfortable situation as opposed to an unsafe situation.

I agree completely with enuf_already's post regarding your options here. Best wishes and again, it's a strength, not a weakness to honestly assess whether you can safely handle a particular assignment.

Been there,done that, ASN, RN · Aug 14, 2015

"I really want to find a position where I will be surrounded by a team and not by myself. "

This excludes home health care, then.How long have you worked for the agency?

clonindm · Aug 30, 2015

if YOU FEEL OVERWHELMED U DEFINATELY NEED TO GIVE A TWO WEEK NOTICE. iT WOULD BE UNPROIFESSIONAL TO JUST QUIT. gIVWE THE NOTICE AND GO TO A TEAM ENVIRONMENT WHERE U CAN LEARN FROM COLLEGUES THEN GO ON YOUR OWN LATER.

GOOD LUCK!

quiltynurse56, LPN, LVN · Aug 30, 2015

I had applied for a position doing home care for meds patients as well as a LTC position. Before I accepted either one, I realized that I would do better in a place where I have contact with people so I chose the LTC. Being the nurse for 8 hours with a peds patient would mean long hours with a youngster who may lack communication skills, etc. I also knew someone who had done that and she said that while you may accompany them to school to be on hand for medical care, during the summer and vacations, there is no adult interaction. Therefore, I opted for the LTC.