How do I know if I am ready to cut back my nursing?

Johblues · #1 01-26-2011, 08:04 AM

Sorry - Rant and long

We currently have 16 hours a day nursing coverage. Amirah has been home for 4 months now. And after our first trip back to the hospital after she first came home she has been completely stable. We have begun weaning her from the vent and we are no 02 for most of the daytime hours, and at night we are at about .5 liters. She needs very little suctioning (maybe 6 times a day), sleeps the whole night, is over 20lbs and in general is doing extremely well.

My question is how do I know if I should cut back on my nursing? The only thing we really need them for during the day is to go do doctors appointments so I have someone in the back seat with her. And the only reason we have them at night is so me and DH get a full nights sleep. But at this point it seems like even that is more about us than about Amirah.

The other problem is that we live in a pretty small 2 bedroom apartment. We have moved all of Amirah's stuff, including her crib, into the living room. So, when the nurse is here if me and my DH want to get away from the nurse we have to be in our bedroom. And most of the time we want to be hanging out with Amirah so we never want to have them in her room.

I am a little apprehensive to cut back on nursing hours....what if next month she gets sick and I need more help? I think because Amirah is still on the vent 24/7 we aren't being pushed to cut our nursing hours.

I just don't know what to do.

jarner79 · #2 01-26-2011, 08:26 AM

I currently have 96 hours per week and I will have more if he is home sickfrom school so I can still work. Sometimes I love it when they call out due to snow storms or whatever because it is nice to have our house to ourselves! Why not try a trial run for a couple weeks. Explain to them that you are not letting them go but you just want to see if you need them as much as you currently do? Maybe cut back a couple days or so? It is all how you will feel when you don't have them there for a certain amount of time that I think will determine how much you do need their help.

suzanne2545 · #3 01-26-2011, 09:10 AM

First of all, I feel strongly that it doesn't matter if night nursing is about YOU! You have to be alert and aware and all that at other times. If you have nursing for night I would keep it unless there is a real reason not to.

A compromise would be to cut back a few nights and see how it goes.

In our case, we were approved for 80 hours a week but never used all of that ever. We were allowed to add hours as needed. So, for example, if Ian and I wanted to go on a date night, we would have a nurse come at 6 p.m. instead of 10 p.m. or something.

We were allowed to keep some extra hours in our back pocket for stuff like that as long as we planned ahead.

rosi's mom · #4 01-26-2011, 10:23 AM

Night nursing isn't really about you. It's about getting sleep so you are awake and able to care for your daughter during the day. Yes, 'normal' babies get up at night and so do their moms, but I've had both and with a so called 'normal' baby you are less likely to have emergent situations during the day that you need to be awake for.
We actually gave up weekend day hours first. We decided that since both dh and I were home on weekends we didn't need nurses then. After a couple months like that we gave up a couple nights a week because Rosi didn't need much care at night. Then we gave up the rest of the nights because we liked not having another person in the house when we went to bed and when we got up in the morning. But we also knew we were heading for decannulation soon.
It's really up to you. We didn't start getting rid of hours until we had been home for almost a year and we started being tired of extra people in our house all the time. I do know there are people who have never had nursing help. You know what you are comfortable with and what you aren't. If you are going to get rid of them do it slowly, maybe drop a day at a time.

KJKK8437 · #5 01-26-2011, 10:29 AM

This is such a personal question, and there is a different answer for every family. My personal theory is that it's time to start trialing without nurses when you look forward to them calling out. It's definitely time, when you hope they call out, and you are long over due when you realize it's harder to function with them there then when they are not.

Of course, if and when you ever reach these stages depends on you, your family, your house, your kid, and your nurses.

twintotwin · #6 01-26-2011, 12:45 PM

Yes, what Karin just said!

You can just tell them you're going away for a few days- and take those days to see how you do. If your child is on a vent you should be very, very sure you don't want nursing because once you ditch it it's very hard to get back- if you can at all! In fact, I personally don't recommend stopping it while the vent is around at all. You would hate yourself if anything went wrong because you didn't wake up.

That said, living in a 2 bedroom apt it must be awful to have a nurse in your space. But that can't be the deciding factor in discontinuing nursing. It's risky to take on this life full-time.

lynn · #7 01-26-2011, 01:20 PM

Quote:

Originally Posted by KJKK8437

This is such a personal question, and there is a different answer for every family. My personal theory is that it's time to start trialing without nurses when you look forward to them calling out. It's definitely time, when you hope they call out, and you are long over due when you realize it's harder to function with them there then when they are not.

Of course, if and when you ever reach these stages depends on you, your family, your house, your kid, and your nurses.

Very well put Karin!!

We started with non scheduled weekends since DH and I were both home and wanted to be able to have family time without others around. It also helped me to make my decision about discontinuing nursing when I used to get so anxious and actually made myself sick every night right before they were to show up for their shift. I actually used to get giddy with relief when we had call outs (which became very frequent), and realized I actually functioned better as a mom and caregiver without nurses present.

RylanDakota · #8 01-26-2011, 01:22 PM

We currently have 12hrs/day and I HATE having the nurse with me during the day. I rather just be on my own, but it is nice to have her around when I need to run errands. She's kinda like an over qualified babysitter for Rylan.

Johblues · #9 01-26-2011, 01:34 PM

Thanks for all the great advice. It really helps to know what others do/did.

I think I am going to start by cutting nursing for all of Sunday (including the night shift). Both me and DH are at the point that we are very happy when the nurse calls out for what every reason.

I am going to go slowly with the cutting back, but really feel we are ready to start trimming back some.

Ainsley's Mom · #10 01-26-2011, 02:54 PM

Quote:

Originally Posted by Johblues

Thanks for all the great advice. It really helps to know what others do/did.

I think I am going to start by cutting nursing for all of Sunday (including the night shift). Both me and DH are at the point that we are very happy when the nurse calls out for what every reason.

I am going to go slowly with the cutting back, but really feel we are ready to start trimming back some.

It sounds like you have a good starting point. My child isn't on a vent, so it's different, but we ended up deciding to do two day shifts a week. I schedule my dr appts on those days. Just to let you know that EVENTUALLY when you are ready, you don't have to accept an excess of nursing if you don't want to. Because of the vent I would be much more cautious in your situation. Good luck!