PDA

View Full Version : New Nurse - How Much Training Do You Give?


Ainsley's Mom
05-01-2009, 01:03 PM
Our two day a week day nurse gave notice (only 1 week). This was okay with me since I'd been having some issues with her anyway. To my surprise they found someone to fill her shift and she's coming to meet us today. I don't have the liberty of the old nurse training her. Last time it was summer so I stayed home to train the nurse myself and had her do a trach change before I left her alone. I'm feeling a little uncertain about leaving this new nurse alone with Ainsley. Her first shift would be this Monday so I can drive carpool in the morning. That would allow for zero training unless I do it today somehow but this is supposed to be a meet-and-greet not a shift. In this situation how much training do you think I should give her before leaving?

Ainsley's Mom
05-01-2009, 01:06 PM
Oh wait. Duh! The kids's school is closed due to a swine flu scare. I guess I don't have to worry about that then. Still I'm interested in what people do. I'm sure it depends on personality, both ours and the nurse's.

suzanne2545
05-01-2009, 01:10 PM
For me, I'd want to know what kind of training she already has. Our nursing agency all required their nurses to do trach training at our hospital.

Ann
05-01-2009, 02:48 PM
In our case, the new nurse comes to the house and spends the day with Jack's primary nurse (Kristi) just observing. Then, we require the new nurse to come another day and do all of Jack's care with Kristi watching. Kristi and I talk and if Kristi is comfortable with the nurse, she can do a shift on her own. If Kristi isn't comfortable, we require more training or say "thanks, but no thanks". My situation is a little different because (1) I'm not home during the day with Jack and; (2) I have a nurse who has been caring for Jack for 7 years and she knows him and his care as well as I do (perhaps better) and I trust her opinion implicitly.

Garrett
05-01-2009, 02:48 PM
Even though our agency sends the new nurses to orientate with current nurses (depending on the new nurses' experience the orientation can be a few hours to a couple of shifts), I spend at least a few hours with each nurse to make sure that I'm comfortable leaving our son, Garrett, with them. It gives me time to watch them do the cares needed as well as get to know them a little. If I was in your situation, I would ask the agency and the nurse about his/her experience and then spend some time with him/her - I've found that with the nurses I've been uncomfortable with, it doesn't take long to figure out that they aren't quite sure of what they're doing when it comes to Garrett's cares.

Good luck!

Melissa -- mom to Garrett (Spina Bifida, trach and vent dependent)

llwilliams8
05-01-2009, 02:58 PM
Well, I've decided after having nurses here that I THOUGHT were trained and then realized they really weren't I've changed my training routine. I don't even ask anymore what they know. I treat them all like they know nothing and show them step by step how I do everything. I even go over emergency protocol with them. I show them a trach change but honestly I've never trusted any of my nurses to actually do one. I guess I should let them to make sure they can do it but since we do all the trach care and changes anyways they would only have to do it in an emergency situation. The first day I go over everything and let them observe me--the second time I let them do it all and I observe them and then when I feel comfortable enough with them I will leave them alone with Autumn. I'm a stay at home mom though so most of the time I am home with the nurses because I mainly only have evening/night nursing.

kadiera
05-01-2009, 03:09 PM
We didn't have much option for new nurses when we first came home, but our agency requires all nurses to be trained to their specifications before they ever work.

We had a couple hours of orientation in the hospital before Alexander came home. 3 of the 4 day nurses, we stayed home with them the first day; the 4th was on vacation when he came home, but also only called me once the first day she stayed with him by herself, so I think she's probably fine.

The two midnight nurses...one didn't make the hospital training, and the other this is her first home health assignment (but she's actually working on a masters degree as an NP, so she's very knowledgable). There's a backup midnight nurse who came and did half a shift with one of the other nurses too.

We both work full time days, so we're rarely home when the day shift is there. We have a housekeeper who comes in 3 afternoons a week and it's been interesting hearing her take on what they do with Alexander during the day while we're out - not interesting enough to make us worry, but we do know who we need to be a little more specific with at times...

Then again, Alexander is a really easy baby, and they all started when we came home a month ago, so it was all of us getting used to the new routine together. We haven't done an emergency trach change since February (knock on wood). The vent is his only medical concern, and he gets 2 breathing treatments a day and 1 med every 6 hours. He sleeps through the night. He gets part of his feedings by mouth, and the rest via g-tube (only because he isn't efficient enough at eating to actually finish a bottle). If he was more complicated....I think I'd probably worry more and want more training for people.

Kaylie
05-01-2009, 04:44 PM
In our case, the new nurse comes to the house and spends the day with Jack's primary nurse (Kristi) just observing. Then, we require the new nurse to come another day and do all of Jack's care with Kristi watching. Kristi and I talk and if Kristi is comfortable with the nurse, she can do a shift on her own. If Kristi isn't comfortable, we require more training or say "thanks, but no thanks". My situation is a little different because (1) I'm not home during the day with Jack and; (2) I have a nurse who has been caring for Jack for 7 years and she knows him and his care as well as I do (perhaps better) and I trust her opinion implicitly.

We use to do what Ann has said but that was when we had a nurse who had been with Kaylie for several years, although the nurse we have now has been here for almost a year i dont think i would have her do what we use to dowith the other nurse because its just a different thing (i hope that makes sense) what i would do, if u can is train her or him exactly how you would like things to get done, an each day work on a few of those. things. i am pretty picky when it comes to changing the trach, Kaylie has been extremely combative for the last 5 or 6 months due to a incident, that she will not forget, she is so so bad and in can forsure be a ordeal , so i couldnt just let anyone do it.changing the trach can take up to a half and hour or more, its terrible. i dont wanna go into detail on here tho. anyway i also would do what susan said as well. Since we have had many nurses thru out the years i can see rather quickly how things are going to work out, you know its one of those gut feelings. hopefully with the kids off of school you will be able to get some training in. good luck.

Ainsley's Mom
05-01-2009, 07:49 PM
Well she came for a visit. I showed her around, went over the medical history, talked about my schedule and hers, the daily routine. She seemed not too overly eager to please which I hope is a sign that she's a regular person and not covering up odd personality traits IYKWIM. I liked her. She's an RN with 4 kids of her own looking for part-time work. It might just work out great.

The plan is for her to come Monday for a regular shift even though the kids are not going to school due to the swine flu closure and I'll train her on how to do everything. I'm going to also try to put it in writing because I've learned my lesson the hard way that some people are forgetful (myself included but not such a great trait for a nurse). Hopefully all will go well. If they decide to re-open school maybe I can get my husband to drive carpool so I don't have to leave right when she shows up. And then I'll just stay home until I have to take Evie to ballet at 3:00. That should still be enough time to properly train her and know that Ainsley will be safe. And I think I'll have her do a trach change on Wednesday just so I know for sure that she's up to it.

drct1245
05-01-2009, 10:06 PM
Susan,
Depending upon the nurse, some times it would take a few days before I am comfortable and others it would just take a day and of course, some I never got a comfortable with. :) Go with what you feel.... mommy gut is never wrong... sometimes we just need the reminder. :D

FightingForFaith
05-02-2009, 09:25 PM
UGH! New-nurse-anxiety is the WORSE! Last fall we got a new nurse the first week of school (I am a teacher). Even though she was a NICU nurse, I stayed home with her for two weeks (yes, very bad impression was made on my boss) until I felt comfortable. Even then, I went back to work with unease.

But then again, she was a little sketchy, and when she left (three weeks later) and another one came, I had no choice but to go back after one day (upon using up all of my sick days). And I haven't worried since, because she's the best we've ever had. :)

I guess my point to this story is I don't think there is a magic number for being trained- or for how many days it takes until you should feel comfortable. When you know, you know. Trusting strangers with our fragile children is one of the many wrinkle earning facets of our special world.

I hope your nurse leaving is a blessing in disguise (sounds like it is) and this one is better than all of the rest. :)