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Career Story: Pediatric Home Care Nurse

Pediatric Home Care Nurse

Job Title: Pediatric Home Care Nurse

Type of Company: Health maintenance for children with complex medical issues needing skilled nursing care to remain safely in their homes.

Education: BSN University of Massachusetts

Previous Experience: I worked as a staff nurse on the bone marrow transplant unit after college in a major children's' hospital for 2 years. I also worked as a clinical research nurse at the same hospital for an additional year.

Job Tasks: Assist the family with the complex medical care of their child, I am contracted to fill skilled nursing hours for one child at at time in their home. The child will have complex, ongoing, medical needs. I communicate with the child's doctor for the medical orders, and carry out the plan of care with the help of the family and other nurses. I may develop the plan of care too.

For example: A child leaves the hospital with a gastrostomy tube for feeding and a J-tube for medications. The family has been allotted 24 hours of nursing care per week. I fill the hours that work into my schedule. I meet with the family, review medical orders, develop a care plan for treatments and medications in an easy to read format. I will get a report to begin. How long ago was the last gastrostomy feed? How did they tolerate the last medication by J tube? After report- I assess the child- taking the vital signs (temp/ blood pressure/ heart rate/ respiration's) look at the skin for signs of infection at J tube and G tube, I fit into the plan of care developed previously - caregiving and providing skilled interventions as needed. I document my findings. I continue to provide care, assess, and document my finding during my hours of work. I play in developmentally appropriate ways with my client. Then I report to the next nurse (or family). Periodically, I update the plan of care and contact the doctor for new orders.

Best and Worst Parts of the Job: Best: It's rewarding to get to know children and their families on on intimate level (while in their home environment). There's ample time to spend between skilled duties "playing" with the child to foster their development. In previous hospital setting, nurses did not have time due to the juggling of multiple patients and they even had separate jobs: Child life specialists. There's an pportunity to treat the whole child, more holistically. Also, you can pick your hours making for great flexibility!

Worst: It can be lonely if you work nights while the child is sleeping. No colleagues to get second opinions, etc. if I'm feeling unsure about what action to take.

Job Tips:
1. Get a BSN degree and become an RN - you will earn more money and have more job opportunities

2. Get at least one year of hospital experience first, two is better- so you have experience to draw from. You will need to know the basics before you are without colleagues to bounce ideas off.

3. Take child development classes - they will prove invaluable.

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