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Trachs/Vents - How much training?


Specializes in School Nursing. Has 8 years experience.

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Not_A_Hat_Person, RN

Specializes in Geriatrics, Home Health. Has 10 years experience.

I work with adult trach-vent clients. After studying a pretty long book, passing an written test,and completing a skills check in the office, I did 3 orientation shifts with a trach/vent client. With new trach/vent clients, I do 1 or 2 shifts of orientation.

My peds rotation was in LTC for children, so I got some trach/vent experience in school.

I am a new grad and have been offered a private duty case for a 2 1/2 yo girl. I took 2 orientation classes at my agency, one for pediatric assessment and on for vent/trach care. I will also be mentoring with another nurse and will not work alone until I am signed off on skills and I feel comfortable working alone. I'm meeting the mom tomorrow and then I will begin mentoring.

trach/vent kids are very fragile and like previous poster said, things can go wrong very fast. Make sure you are truly comfortable, take trach CPR, practice changing out a trach on a real kid before you are on your own, and know how fast it would take EMS to get to the house if you need to call them. And carry your own malpractice. Not to scare you but it might be that nothing goes wrong or everything does.

tothepointeLVN, LVN

Specializes in Hospice / Ambulatory Clinic. Has 3 years experience.

You can work your way up step by step. I started with a preteen with a G Tube (microcephaly). Stable in the sense that she hadn't been inpatient in years and had reached her maximum potential. All you had to do was maintain her quality of life. Next was GT plus O2 then I tried trach and GT on a toddler who was expected to transition off both pretty soon and probably would have been if mom wasn't delaying it by missing appointments. I didn't really do much complicated than that for more than a few days.

I was with one of my kiddos at school and the nurse of one of the other kids on a vent seemed confident. I pointed out that her vent was silent alarming with low pressure but figure she knew best when she said it was ok. I felt bad when the kid started desating about 1 hour later. Not sure if it was related since I'm not vent savy.

I have been doing adult and child vent/trach for over 6 years. I was fortunate to get a case where they were weaning the child off the vent, which allowed (what I felt) less rush with some things. I agree with the person that said that kids are on different levels of stability. I have had kids that I was concerned all day about their condition, constantly having seizures,etc, to ones where they haven't had to go to the hospital or even had an infection in well over a year and thriving very well. Some even went off vent and trach altogether. But my thought is with every case. I will always be on guard and looking for any (even little) signs of trouble. My hope is to prevent problems before they become a problem. Eventually you learn things and feel more comfortable with your skills. When I first started, I was fortunate to be able to take vent/trach training with a respiratory therapist from the local children's hospital. Sadly my employers don't do that anymore and some nurses concern me when they come for an orientation. My agency usually says the nurse should come for a 4 hour orientation not even a whole shift, but they will allow more if requested (they don't always tell you that). Good luck to you! Btw I am surprised how many RN's here do PDN with trach/vents on here. In my area the RN's are rare and they actually get a reduced salary compared to other jobs.


Specializes in Lvn to RN, new grad med/surg. Has 7 years experience.

My best advice would be to ask for a patient who can sprint off the vent for at least a few minutes at a time to get comfortable with the vent/trach/suction equipment and alarms to learn what they mean. Next I would know at all times where the back up trach tray is, the bvm, the suction machine and anything other essential equipment and keep it within arms reach. On top of that, get a good full report and don't be afraid to ask questions. You already sound like a diligent nurse so that is a plus, and remember to trust your instincts if something doesn't seem right don't second guess yourself. Best of luck!