Trach Suctioning

[luvapug]

Has anyone had to suction a student with a trach regularly? Our school district is needing a nurse that will stay with a 4 yr old student and suction him every 15-30 minutes the whole time he is at school. I don't have hardly any experience in dealing with trachs but they will train the nurse. It's so different from any type of school nursing I've ever done and I'm worried about not only taking care of the suctioning but getting bored just sitting with one student all day long. However, it might be easy and interesting-I just don't know. In the past I've always been intimidated by trachs and hearing the secretions rattle around have made me queezy but I'm hoping that is something easy to over-come. What are some of the challenges I might expect? Do you think I should take this on or pass?

[Jolie, BSN]

Our district requires a 1:1 nurse for students with trachs and/or O2 therapy.

Like any skill, trachs become "no big deal" once you have some experience with them. Remember, this is a student attending school for whom a trach is the norm, not an acutely ill, newly-trached child in the ICU.

Please arrange for a meeting with the student, parents and health care provider to review the student's care and become familiar with equipment, care, maintenance and emergency procedures. Then you can decide whether you are comfortable taking on this challenge.

My guess is that you'll do just fine.

[noreenl]

I would also question suctioning anyone every 15-30 minutes. irritaion to the trach with that much suctioning could cause inflammation or bleeding, both of which would impede the airway. i absolutely agree to meet the child and parents in a safe evironment (usually their home and I ask the parents all about how they care for their child and i aleays ask them to demonstrate any special techniques that they have found work well for their child. You absolutely follow doctor's orders and only doctor's orders but i find my nurses have a better rapport with the parents if we "consult" with them. i would make sure that you had an ambu bag and portable oxygen at the very least!

[geocachingRN]

You're also there in case the trach falls out or gets blocked by food, education and safety. I know because this was my first job in a school district I was in grad school so I had the opportunity to do my homework, which included online lectures. I brought my computer and earphones. I also helped with school nurse reports and researched Ed code issues when they came up. It was a great position for a year, but after that, not so much.

As to queasy, I've been told everyone, including nurses, has an issue with one bodily fluid and it sounds like lung gunk is yours. If you truly have a problem, I wouldn't recommend this as the opportunity to get over it. The 4 year old will pick up on that and may read it as you have a problem with him or her. The nurse they hired to replace me when I took on schools had similar issues and my former charge could tell. She made every excuse to not come to school and her attendance decreased by 30%