I see this thread from time to time in the general nursing or student sections, but since PDN is a different situation from floor/facility nursing (no locker to stash stuff in, no cafeteria or vending machines, no coworkers to borrow from), I wondered what all everyone carries with them to work?
What do you have in your bag for every shift?
What do you keep in your car for "just-in-case"?
What did you use to carry with you that you realized was a waste of energy so you stopped bringing it?
Since insurance doesnt cover otc meds i think thats why parents do nit buy them.
It doesn't matter if its otc or not. Its still a drug. Its still risky. Its still boiling hot in a car in the summer and too cold in the winter to keep drugs that way. I bet melted glycerine enemas are difficult to get out of the carpet in the car too!
I take all my own vital sign equipment as I've found the patients are usually missing or broken. So Stethoscope, BP cuff, thermometer, pulse ox.
For the patients:
Soap, hand sanitizer, baby wipes, towel and washcloth (sometimes the mother gets really behind on laundry and I'm not about to start doing it for her), burp clothes (for my drooling kids), toothpaste and toothbrush (each kid has their own), scissors, lotion.
For me:
laptop, phone, ipad, chargers and multi-port extension cord, headphones, DVDs, magazines, few snacks, a ton of drinks, toilet paper, bag of pens, medication (like tums or headache meds), and a heating blanket (one of my clients doesn't have heat). I use to carry a lamp in my car because the father would take the one out of our room to use in his room, but I ended up just leaving it there with the understanding it would not leave. haha
I travel pretty light! I only do one client (I have another job) and his family allows me to use utensils from their kitchen as long as I clean up. The family also provides a coffeemaker and coffee for nurses.
Specializes in Complex pedi to LTC/SA & now a manager.
Nurses should NOT be providing their own OTC drugs for patients. They are drugs. It's is a parent or insurance responsibility. If a parent isn't supplying notify your clinical manager. Medicaid will often cover OTC with a physician script.
Nurses should NOT be providing their own OTC drugs for patients. They are drugs. It's is a parent or insurance responsibility. If a parent isn't supplying notify your clinical manager. Medicaid will often cover OTC with a physician script.
When nurses buy Ibuprofen for some of the kids are you saying that is a liability issue,even though Ibuprofen is a prescribed med?
If the MAR says Pediatric ibuprofen 100mg/5 ml and i buy the Ibuprofen from the pharm with the exact same 100mg/5ml that is a liability issue?
My old agency used to have bottles of Ibuprofen and acetaminophen in the office and the supervisor would give to the parents if they could not afford it,but only if it was in the MAR and the same dosage type ex Pediatric Ibuprofen or Infant acetaminophen.
My current supervisor says when parents refuse to buy Otc meds and the kid needs it all we can do is chart it. i have had a kid go 2 months without mineral oil(it was not even a prn med but given hs daily )because parents didnt get it for whatever reason. She was frequently constipated of course and i could tell extremely painful for her.
Most insurance companies will not pay for Otc meds,even with a script.
I have only seen Medicaid pts get Otc meds paid for.
In NJ most kids have Medicaid HMo's which basically are Hmo's.
Specializes in Complex pedi to LTC/SA & now a manager.
Exactly. You are accepting responsibility and liability for providing a medication. If the medication is tainted and you provided it (and there have been several cases of contaminated pediatric OTC meds being contaminated in the past couple of years) YOU are liable. You are dispensing/providing medication ( not just administering) which is out of the scope of a nurse in any state. You are accepting responsibility for safe storage and handling which is a pharmacist responsibility. Temperature extremes (that can occur in a vehicle especially) can turn an OTC medication toxic.
The agency is correct that if a parent doesn't supply an ordered medication, whether Rx or OTC, the nurse responsibility is to document the family refusal or inability to follow the plan of care & physician orders NOT to supply. & dispense the medication. If the family fails to provide an Rx med would you pay the copay & pick it up? If OTC (many are very low cost like mineral oil) is not covered then an Rx version may be covered. Several respiratory & GI meds have gone OTC but there are Rx versions are available. Such as Prevacid/lansoprazole & Prevacid SoluTabs or Nasonex (Rx) vs. Nasacort (OTC).
Medicaid A HMOs in NJ cover unlimited OTC drugs with a physician prescription. Medicaid B/C/D cover a certain amount of OTC meds with physician order. If a family is in dire straights financially or noncompliant there can be exceptions made by a social worker or the case manager at the county special child health department. Nearly children in NJ receiving PDN qualify for special child health case management.
Worst case if a parent consistently refuses to follow a plan of care or MD orders without good reason, a call to child protective services may be in order to investigate medical neglect.
Specializes in Complex pedi to LTC/SA & now a manager.
When nurses buy Ibuprofen for some of the kids are you saying that is a liability issue,even though Ibuprofen is a prescribed med?
If the MAR says Pediatric ibuprofen 100mg/5 ml and i buy the Ibuprofen from the pharm with the exact same 100mg/5ml that is a liability issue?
Yes it is. Contact your professional liability/malpractice carrier if you want confirmation. This is dispensing medication and out of the nursing scope of practice.
My current supervisor says when parents refuse to buy Otc meds and the kid needs it all we can do is chart it. i have had a kid go 2 months without mineral oil(it was not even a prn med but given hs daily )because parents didnt get it for whatever reason. She was frequently constipated of course and i could tell extremely painful for her. [\QUOTE]
Your supervisor is correct.
Most insurance companies will not pay for Otc meds,even with a script.
I have only seen Medicaid pts get Otc meds paid for.
In NJ most kids have Medicaid HMo's which basically are Hmos.
In NJ, Medicaid HMOs cover OTC meds with physician prescription. Not all families are aware of this.
Specializes in Complex pedi to LTC/SA & now a manager.
To answer the OP, I have a spare pulse ox, stethoscope, baby wipes, soap, paper towels, sani-wipes, antibacterial wipes, pens, stapler, drug book, paperwork, clip board, nook, personal (sanitary products, inhaler, glucometer, epi pen, Tylenol, emergency meds) first aid kit, index cards, sticky notes, scissors, stickers, gloves, masks, shoe covers, zipper bags, plastic bags, extra diapers & wipes for my primary toddler patients, mini shampoo, soap, toiletries ( one patient swims. & I have to be in pool within arms reach), id badges, clip boards, bulb syringe, forceps, tweezers, plus a lunch box.
In my car gloves, bags, kitty litter, shovel, scrapers, paperwork, extra clothes/scrubs, water, non-perishables, seat cushion.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Just realized I didn't answer my own thread! DOH! Sorry about that!
Backpack Main Compartment:
Clipboard (repurposing my old nursing school clipboard with the paperwork compartment behind the writing area and pen compartment at the bottom -- comes in handy for keeping the various forms accessible without getting bleed-through on the carbonless copies. I also keep a cheap pair of reading glasses ("cheaters") and two pens in the clipboard.)
Tablet
Kindle
Stethoscope (my patient has his own steth, BP cuff, pulse ox, and thermometers, but I prefer my own steth)
Flushable wipes (small packet -- toilet paper is provided, but not really suitable for anything but urine, and sometimes you just can't hold it for twelve hours!)
Backpack Side Pocket 1 (mesh):
Plastic grocery bags for carting home empty pop cans/bottles (we have a 10-cent deposit on cans/bottles in Michigan)
Backpack Side Pocket 2 (zippered):
Ziplock baggie with Pup-peroni dog treats for my client's family dog (with prior permission from the family, of course)
Backpack Top Front Pocket (zippered):
Hair elastics
Hairsticks (I have butt-length hair, usually bunned and held with a hairstick)
Napkins and/or tissues (none available in the home)
Backpack Bottom Front Pocket (zippered):
Extra pens
Extra "cheater" reading glasses
Sticky notes
ID badge
Nail file
Cuticle trimmer
Small hard-plastic compartmented container with Q-tips, spare contact lenses, ibuprofen, decongestant, caffeine pills (it's about the size of a bar of soap)
Lip balm
Cell phone (reception there is about zero-to-none, but my kid can at least text me in case of emergency at home)
Tote Bag (not very big -- it's one of those reusable grocery bags):
Newspaper, magazines, catalogs, or any other paper-based reading material that I haven't had time to catch up on at home.
FOOD!
Dishware if necessary for food (like a plastic bowl for a can of soup, etc.)
Food accessories ziploc baggie 1: plastic cutlery from the dollar store
At least three cans or bottles of caffeinated diet pop (preferably Pepsi Max, or second choice Diet Mt. Dew) -- I don't like coffee
At least three water bottles (I like a version by Aladdin that is similar to this one only larger -- the whole lid comes off for easy washing, it's dishwasher safe, and the best part is that my fingers never touch the drinking spout part. I hate the kind with a straw or spout that you have to touch in order to open it. Even store-bought disposable bottles of water are hard to open without touching the threads, b/c they've gone to using smaller/shorter lids for "less trash in the landfill". These Aladdin bottles have the big cap and the inner spout, so I never have to worry about washing up before I can take a sip.)
Mesh Bag:
Slip-on "indoor only" shoes (I leave this bag at the front door with my outdoor shoes)
Car:
Change of clothes
Store-bought water bottles
Wallet (I never carry a purse)
Pump-bottle of hand sanitizer (I was very happy for this one day when the client's electricity went out due to an ice/snow storm before my shift was over... no power = no water pump = no running water to wash my hands!)
Phew, I think that's it!
I'm fortunate that my client's room is very well-stocked with everything he needs, and my agency doesn't have to supply things like suction catheters or vitals equipment. If that were the case, I'd probably switch from a backpack to a small rolling suitcase, rather than adding on another entire bag to carry around just for supplies.
smartnurse1982
1,775 Posts
Fleet enemas and the other stuff are Otc drugs.
Since insurance doesnt cover otc meds i think thats why parents do nit buy them.