Special Needs Child and Incompetent Parents. (VENT!)

[TexasPediRN]

Let me start off by saying I LOVE pediatic private duty nursing- but today I'm so frustrated and annoyed with the fact that incompetent people should not be allowed to raise children, let alone children with special needs.

My patient today is 2 1/2, former preemie, trach and gbutton. Honestly doesnt need nursing care, but receives it anyway. Gbutton use only at night, awaiting decannulation in the spring. (Hes so cute though- hand him his PMV and he puts it on himself!)

Was with this patient last Thursday, gave the last dose of Pulmicort Thurs AM (ordered BID) and informed parents they need to get more. (pt also receives xopenex treatments).

Come to work today, Monday- THERE IS NO Pulimort - Child sounds like Darth Vader. Congested, Wheezes, you name in. But o2 sat is good! 98% on R.A. To top this off- THERE IS NO FOOD FOR THE CHILD TO EAT. Ugh. Parents leave at 0915 to get food, return at 1130- meanwhile I bolused child with 6oz pediasure and 2oz water- kids got to have something in his stomach (refused to drink or eat anything- even tried to have him eat some applesauce I had with me!) Look through cabinets and fridge- no milk, no bread..no food..empty. Child is extremly picky with food- loves baby food. Stage 2..parents dont want to advance him, but yet he eats chips and pizza. But thats a whole other story.

(He is on a night drip- thank god, I think he gets most of his nutrition with this)

Spoke with father upon return him- Pulmicort is ready, your son needs it- hes congested and wheezing. Agrees. Sits down and watches TV. UGH

1530 rolls around, my shift is over at 1700. Stress importance of medication-child needs it. Informs nurse he has no car..wont take the bus to pharmacy because it takes too long! Spoke with nursing sup yet again for today- she loved the no food/no med story. Agreed with my choice to bolus him (did have an order)- Didnt like that I gave him some of my food but that I didnt care- it was a little extreme. There wasnt anything else to give him.

1600. Decides to come out and do sup. visit. Sets parents straight. Tells father he needs to have medication tonight, or he can loose nursing care. (Yay nursing supervisor!)

1640- ATTEMPT to contact drs office to let them know of situation again- answering service woman is not helpful. Call back again- "I need to speak to the on-call dr"..12 minutes later..off the phone, will be suprised if they call back. Luckily, the nursing sup. gives her cell number to speak with the doctor..

Spoke with Primary care doctors nurse today as well..yes.. CYS has already been notified..I beleive once- I think we need to do it again. Nurse hates this case- informed that there isnt even baby food in house for child- also loves hearing this.

This was a horrible day And I feel so bad for this child. I'm actually nervous to go back there Monday since I had the nursing sup. out there as well as talking with the drs office, as well as her setting the parents straight.

But I will not be defeated! This child needs some good care and I swear I'm going to give it.

I feel much better after venting....wow..I just needed to release all that frustration.

I guess to that I should make another CYS referral...in addition to the others made. *sigh*

Thanks for listening...

[TexasPediRN]

Heres my update:

Called my supervisor at 10am this morning, and go figure, they went and got the medication that NIGHT. Apparently a kick in the you know where is enough to make people get in gear.

I cant wait til CYS investigates..and for this childs sake I hope he is moved to a better place. A place that has an interest in potty training him and brushing his teeth. Not to mention will take excellent care of him.

My supervisor says I dont have to file my own complaint since I reported it to them and they will handle it- but do you guys think I should also do my own? I mean its annonoymous right? I would think 2 is better then 1..

[hipab4hands]

Heres my update:

My supervisor says I dont have to file my own complaint since I reported it to them and they will handle it- but do you guys think I should also do my own? I mean its annonoymous right? I would think 2 is better then 1..

It depends on whether your state has mandatory reporting laws for healthcare. In our state, I have to report all suspected abuse or neglect cases. Just to CYA myself, I always call and make the report, even if a supervisor says they'll take care of it ( because sometimes they don't do it).

If you can confirmed that a report has already been made by your supervisor to Child Protective Services, then your covered. If your supervisor has not done it by now- then go ahead and make the call.

[TexasPediRN]

It depends on whether your state has mandatory reporting laws for healthcare. In our state, I have to report all suspected abuse or neglect cases. Just to CYA myself, I always call and make the report, even if a supervisor says they'll take care of it ( because sometimes they don't do it).

If you can confirmed that a report has already been made by your supervisor to Child Protective Services, then your covered. If your supervisor has not done it by now- then go ahead and make the call.

Thanks for the advice-

CYS was already notified in December, before these new issues arose. I spoke with my supervisor today, who said its up to the head supervisor to decide if she wants to make a follow up complaint with CYS.

I've never had to call before..I really dont know how to go about it..

But you are right, to Cover my ***, I should call..

Thanks again for the advice- I will look into what to do and how to go about reporting it...