Unique nursing oppertunity

roser13, ASN, RN · Mar 15, 2016

*opportunity

Alex Egan, LPN, EMT-B · Mar 15, 2016

Ok so I have been doing PDN for about eight years now, in every setting and shift imaginable. So I'm speaking from expearence, I just want to bring up some points that jump out at me.

1. Taking a case with a diagnosis that is ''special" to you will make you more likely to not maintain good professional barriers, I cannot stress how important these are and how easy it is to find yourself being taken advantage of.

2. Bus cases are the pits. Firstly the bus is never on time and I would bet you a hundred bucks you get stuck waiting outside the kids house because the parent "just ran out for a second"

3. A forty mile drive is at least an hour commute, to and from twice a day. That's four hours in the car...per day. There is no way the pay is gonna make up for gas, mileage, and wear and tear to your car.

4. Did you get cold called for this case or aggressively recruited? Be extra careful if so... If they are spending lots of time and money to find new nurses, that means all of the experienced ones are done with the case.

LeChien, BSN, RN · Mar 16, 2016

The child will most likely have a "to-go" bag with PRN seizure meds, suctioning equipment, etc. or it may be kept at the school.

Usually the company will tell you if you should wear scrubs or street clothes.

A lot of schools are "normal" and have wings/wards for "special" kids.

I would weigh the pros and cons heavily, as 40min is quite a drive.

I would also ask about behavioral issues, a list of meds, home life (not all homes are clean/parents' personalities may not mesh with yours).

Good luck!

dishes, BSN, RN · Mar 16, 2016

Split shifts are horrible for work life balance, just ask public transit drivers.

JustBeachyNurse, LPN · Mar 16, 2016

I do bus runs. But the furthest is 15 min. The go bag would have a face mask plus chart, gloves, care plan and meds (often DiaStat but may be klonopin wafers or Ativan SL etc) . You do NOT bring your own pulse ox. You do not assess pulse ox unless it's in the plan of care. You do NOT being bacitracin as you do not bring personal medications and cannot apply without an order. You are strictly there if the child has a seizure nothing more nothing less. If the child complains of pain you tell the parent or school nurse. You bring pen, penlight, and stethoscope. You rarely check vitals on bus runs but need to if the child as a seizure. You meet at the designated location (may or may not be the child's home). Pick up student get brief report from parent, accept the go bag containing minimal supplies, chart, emergency seizure medication. You may sit across from the child you may sit next to the child. Child must be within your view. The child may use a wheelchair for transport.

You are not there to enhance the child's life or make it more normal. Your job is to monitor for seizure activity and follow the seizure action plan if a seizure occurs (most often alert aid/driver to pull over bus, have driver radio for EMS, administer antiseizure medication, watch the airway (put in recovery position. You likely won't have suction, oxygen, blankets or any first aid kit but you cannot use anything other than the blanket without physician order). Monitor HR & respirations then report off to EMA.

Honestly, you sound like you would have a hard time maintaining professional boundaries. And not project your past/expectations onto the child.

You almost never enter the parent home on bus runs. You meet the child/parent in front of the house, assist if needed to get child on the bus (only bus personnel can secure/tie down wheelchairs), monitor for seizures, assist student off bus and follow policy. It may be give go bag/meds to paraprofessional, it may be leave student with teacher/aid then being go bag and medication to school nurse. You follow school/agency policy.

The only time I travel to bus runs is for STAT pay, I get reimbursed by my agency for cases >20 miles from home and get up to double my base hourly rate for covering a case last minute.

Taking a case 40 minutes away (more likely an hour with traffic) but risk being called off if Mom decides at 5:55am child not going to school.

As far as

I float, sometimes I have had up to 3 jobs at once, so I have a my nursing bag with most of the things I think I would need in an emergency, is there anything that I may want to consider brining along that could be helpful in the event of a seizure? I have a CPR pocket mask, pulse ox, thermometer.... lots of bandaids, bacitracin even normal saline. Suggestions are helpful..

thermometer not needed (VS are most often only PRN if seizure and often no T only pulse & respirations) pocket mask is up to you but likely provided by agency. No personal pulse oximiter in pediatrics. ever they rarely work and are only if there is an O2 order, the pulse ox is provided by & maintained by DME. In five years I needed one bandaid. That was for the driver. No bacitracin (physician order only). No normal saline (for what? But again needs MD order).

The bus often has a blanket of needed to put child on floor for DiaStat administration.

If this condition is "close to you" DO NOT TAKE THE CASE.

JustBeachyNurse, LPN · Mar 16, 2016

I do split bus runs but they are 10 minutes from home. I do a second or third set of runs in between and run errands when not working.