Shift care nurse - Pt in hospital

[kaliRN]

What is your role when your patient is admitted?

Do you communicate with the hospitalist or any any others physicians from the hospital at all? Does your agency disseminate information to you? Do you visit your patient? Do you rely on patient or family member to give information when they are discharged?

I understand this is agency specific, but would like to get an idea of the different way this is handled. The other RN and I are both new to this agency and home health, Mom is Spanish-speaking and neither of us speak Spanish, neither of us has received good information from the on-call staff over the weekend.

Thanks for taking the time to respond.

[caliotter3]

When the patient is hospitalized, we get a 'vacation' from work and a paycheck unless the agency has fill in work for us. No communication concerning the patient unless the family member keeps us up to date. Usually, just wait to get a call about when to return to work when the patient is discharged.

[kaliRN]

Thanks, caliotter, that seems to be the approach with the agency I am employed with ... but it seems a bit backwards?

I would not expect to intrude on the care being given in the hospital by seeing my patient there - maybe I can even see why talking to the MDs would be seen as a "waste" of their time. But I would love if someone from the agency was keeping us informed. An acute change in the patient's condition that required hospitalization is likely going to make changes in the plan of care. Which would be nice for me to think through before I come back on.

There was an ongoing issue with this patient that I wanted to address with his endocrinologist, the hospitalization is unrelated, but I think the management of his BG as an inpatient would help me make a better informed call.

But I thank you, the other nurse and I struggle a bit with the culture.

[ventmommy]

Our PICU issues a new 485 after every admission. If Pulmo updates his care plan that is included as well. I also get a discharge summary and put that in our care notebook. All our nurses have access to it. As soon as it's available, I get the complete records from the admission and update his medical record binders.

Some of our nurses text to see how my son is, some come to the hospital and visit. When we had MAJOR changes to care, our agency got most of our nurses out to the PICU prior to discharge to meet with attending and pulmo and they were able to ask questions. Our PICU also calls our case manager 24 hours before discharge to give an update.

[kaliRN]

Thank you ventmommy, that makes me feel SO MUCH relief. It's tough that I can't text Mom, as I would with any of my other patients. I am glad a new 485 comes on after every admission, I certainly hope that will be the case here. I have not seen the type of excellence in communication you describe with this agency. I'm hoping there will be good communication at least through documentation after discharge. I was debating on asking staff to have Mom get the complete medical record, now I feel like that's appropriate.

* As an aside: I'm sending some positive thoughts your way for what you are dealing with as a Mother. I have so much respect for you. I'm a daughter to a bedridden, trach and GT dependent father, who I care for at home. I'm his only nurse and I know how difficult and challenging a role it is. I hope you are getting the support and appreciation you deserve.

[ventmommy]

Thank you. I am sorry that you have no help in caring for your father. I can't imagine going more than 48 hours without someone to help out.

I feel like our PICU and our nursing agency are exceptionally wonderful. I see postings here and on FB and the trach forum and so many families have no nursing, not enough nursing, bad nursing, bad DMEs, lousy hospitals.

I definitely feel appreciated by all our docs, especially during an ER visit because I can direct that show and don't leave anything out when giving report. They are always happy to see the meds list, feeding info, diagnoses and pulmonology emergency plan. And my nurses make me feel supported. I share every bit of knowledge I have with them and take the time to train them well, especially the occasional new grad. They show it in various ways - one stays a couple of hours extra so I can sleep in once a month, a couple will make sure anything in the dryer gets folded and anything in the washer gets dried, and a couple will call to see if we are having a bad evening and need some Taco Bell when they come for night shift. I :redbeathe our nurses.

[systoly]

Ref. visiting pt. in hospital.

The agencies I work for don't mind at all, but I think it's a good idea to let them know. Just get parent permission and ask what would be a good time as a lot of parents are getting by on very little sleep.