Should I look for different work??

pagandeva2000, LPN · Dec 15, 2008

This is one of my first posts..let me start by saying that I received my license in 1995 and am proud to be an LVN..
The problem is I work/have worked for a home health agency that mainly focuses on vents and trachs.
I told the company that I was not too familiar with vents and trachs though I had a rotation of about 4 weeks in my nursing program.
They hired me anyway thankfully.
But I am scared of vents and still don't know how to change a trach tie.
Wouldn't you know they wanted to "challenge" me so the recruiter signed me up for a vent client (after having taken their vent class). I sucked.
I was scared of everything (the tubing, the machine, the water level, the client coughing, etc). I felt like a failure.. the mom had to come in and show me how to do certain things for the client which is better than hurting the client but it made me feel, well incompetent..
They have been calling me for more assignments but I can't seem to work up the nerve.
I have worked at LTC/SNF for about 1 1/2 years about 7 months when I first got my license in 1995 and about 8 months in 2006. Should I look for another position which could be difficult because of my employment history or keep asking for more training from the company or try another profession?

I had a similar situation where I had a child who had a trach and was nervous as heck, but I was honest and told the agency and the mother that I had no experience, in fact, this was 4 months after I got my license in 2006. The agency told me that the mother is very proactive and would show me. I decided to ask the parent if I can go to the house to see the case while another nurse was there, during the time she was suctioned to witness her care. It was scary to me, but again, I was honest and after a few visits, I felt comfortable enough to be left alone to handle the suctioning...in fact, this 3 year old used to also show me what to do (now, that was funny, but she was correct) and would come to me and tell me when she needed suctioning. I never changed the trach ties alone, I would be sure that the mother or the nurse from the previous tour was there.

What I noticed in home care, as with anything else in nursing, the facilties or agencies are just willing to have a warm body to show up. That is unfortunate, but that is the deal. Each time a nurse is not at the home, they risk losing the insurance coverage. In any event, I would probably either ask for different cases, or work in another place that you are more comfortable in. And (this is my opinion, only), I don't mind taking on certain challenges because it gives me experience and I am not as afraid the next time, so, I would ask the agency if there are other cases that are similar where the nurse is on duty that you can shadow to master these things. You'd be surprized, some agencies welcome this, because it helps to retain nurses. Because it is home care, you are basically on your own, and there are not many inservices to update people the same way as it would be in a hospital where there are support staff to assist when you are in a jam. Maybe ask if you can volunteer 2 or 3 hours, around the time when the procedures are expected to be done and you can be present to watch what the nurse does.

It can also be that some cases are just a turn off. That is okay, too. I know plenty of nurses that hate suctioning! I decided that I don't want anymore pediatric cases, because it is hard to reason with most of the children...they are resentful of being sick, especially if there are healthy siblings and many of them misbehave, maybe not intentionally, but they tend to be restless and I don't have the patience. I am glad I have the trach experience, however, because now, I would not be afraid, but I do desire to one day be able to work with vent patients, also. I just didn't get the opportunity because my primary position is in a clinic, and I would do these cases on weekends for extra money. My agency was more than willing to work with me by sending me to their best nurses to show me things, but because I work Monday thru Friday, it was hard for me to take time off to do this. I don't think you need to leave the profession, just gain some confidence and get a bit of exposure in a comfortable way. Good luck! :yeah:

Thornbird · Dec 15, 2008

I have found that the parents in home care cases arereally wiling to work with new nurses til they are comfortable. They are well aware that the agencies send nurses without much experience. Don't be scared of the vents. We can't change the settings. It's all just monitoring and maintaining the circuits. Parents and nurses already on the case are very protective. I always ask for orientation with a nurse who knows the case before going on my own. It is scary at first, but you get used to it.

Give it a try and if you're still not comfortable, then you van make a change. This area of nursing is the one that really does have a shortage.

systoly · Dec 16, 2008

How is it your fault that you did not receive adequate training and or orientation. Your heart is in the right place. That is the one thing no one can teach you - everything else you can learn. There is no shame or show of incompetence when getting training from mom or other PCG. Usually moms are experts and have a lot to offer when it comes to taking care of their child plus you'll learn how they would like you to do things. Don't quit.

The harder the climb, the sweeter the triumph.