March 15, 2011


I take care of children and babies (and a few young adults) with varying degrees of health problems. Some of these children have disabilities that makes them dependant on others to provide the most basic of care. Someone to feed them, someone to bathe them, someone to turn and reposition them. Daycare centers won’t accept these kids into their programs because of the level of assistance they require. Therefore, these kids often rely on a home health aide to provide this care so the family can maintain their employment. I also care for children who have greater needs. Kids that are dependant on receiving their nutrition through a feeding tube. Kids that are dependant on the patency of a tube that is inserted into their neck to enable them to breath. Kids that are dependant on a ventilator to do the work of breathing for them. These children (and their parents) rely on the assistance of a nurse to assist them with their care needs.

There are various waiver programs and state assistance to help with the costs of caring for these children. It’s a wonderful, good thing. These kids are given the opportunity to stay in familiar environments, to remain at home with their families where they can grow and thrive. Otherwise, many of these children would end up in institutions. In addition to this, it costs FAR less to provide this care in the home versus in a long term care setting.

Now please forgive me for a moment. I LOVE what I do. I love helping families and I love helping my patients. But I need to rant for a moment.

I’ve had quite a few experiences now where these families have taken advantage of the system. It’s frustrating. There’s the Mom who I suspect of Munchausen’s by proxy. Who has first one child that gets nursing services, then all of a sudden, whose other child begins mysteriously having “health problems”. Somehow she manages to defraud the system to gain nursing for BOTH children so she can go tanning. Yes, tanning. She WAS supposed to be working, but she used her time more wisely. Not. She didn’t last long before she was caught committing fraud.

Then I have the mom who becomes angry when her very healthy daughter is denied continued nursing coverage. This child does have a feeding tube in place, but has NOT used the tube in quite some time (seriously, why don‘t they just remove it already?) I’m quite sure the mother is somehow deceiving the child’s physicians to believe that she still needs the feeding tube. She has had services for most of her life, but this child has overcome her feeding difficulties, and is completely independent for all of her activities of daily living…as much as any other preschooler. She can feed herself, she can use the bathroom independently, she can tie her shoes. Why the hell does she need a nurse?!? She wouldn’t even qualify for a home health aide!

This mother should be ashamed of herself. Yes, I know her child had a difficult start. Yes, I know that can be a difficult thing for a parent to deal with. there are tons of children that are FAR worse off. Children who are terminal. Children who will never get better. Children who will never *not* need the assistance of another person for their most basic care. If this mother gets her way, it will cost taxpayers approximately $9,000 per month. You read that right. $9,000 per month to provide approximately 200 hours of skilled nursing care. $9,000 per month, when these parents can spend $50 to $80 per week to put their child in daycare just like all the rest of us working parents.

I’m all for state assistance for children with chronic health problems. Those that manipulate the system and twist facts to get their way? When….. and note, I say when, not if….. When they get caught, they should have to pay back every penny plus interest.

March 14, 2011

I'll Never Understand

A pediatric patient of mine refuses to eat. She is fed mostly through a feeding tube because of this. The goal is to attempt to get her to take as much of her feeding by mouth, then give whatever she doesn't eat through the feeding tube. So I'm talking to her mom about this and notice a small piece of a baby carrot on the child's bouncy chair tray. I pick it up and take it from her and explain the choking hazards to the mom. She just laughs while saying her son must have given it to her. Then she turns around and hands her daughter a BBQ chip. This patient is around 6 months old so I suggest to the mom that she feed her daughter either stage 1 baby foods or pureed table foods if she wants to give solids. The mom's reply? "But she'll lose weight! We want her to drink from her bottle!"


No matter how hard I tried to explain, I just couldn't get through. Instead, the child will be fed chips and have twice the amount of formula prescribed dumped down her tube "so she doesn't lose weight". No wonder she wont drink it from a bottle. Her poor little belly is stuffed.

March 13, 2011

Pediatric Home Care Nurse

I currently have another blog that pretty much encompasses the many different facets of my life. However, as I am in the midst of a job change, I'm finding that I'm wanting to post more on the aspects of my life that pertain to my career. I'm also beginning to see how it may be preferable to both myself and my readers to separate the nursing stuff from the rest of my ramblings. So here we have it: The Random Ramblings of a Critical Care Nurse.

I'm currently making the transition from pediatric home care to critical care. Until that transition is complete, expect that the topic of most of my posts will pertain to pediatric home care.