Home nursing is beneficial, and in some cases, necessary for families with medically complex children. It can be very difficult to find quality home nurses, especially when there is a shortage.

Here are some tips for finding and working with home nursing:

Reach Out to Several Nursing Agencies

With a shortage of nurses, there is likely to be a waiting list for some agencies. Call around to agencies to express interest. Let your insurance case manager know you need nursing – They can also reach out to agencies on your behalf. You may need to work with several nurses across several agencies to get all shifts covered.

Information to share when you reach out:

  • Days and hours that nursing is required
  • Your location
  • A brief overview of your child’s needs (trach, feeding tube, ambulatory needs, etc.)
  • Pets in the home

Set Up a Meet and Greet

If the agency has a nurse that fits your family’s needs, they will work with you to set up a meet and greet. During the meet and greet it is important to touch on the following topics:

  • Confirm that the nurse’s availability meets your needs
  • Ask about their experience as a nurse and how they got into pediatrics and home nursing
  • Ask what they know about your child and fill in any gaps
  • Review your child’s specific needs and ask about their capability to carry out necessary medical interventions and/or their willingness to learn
    • Ask specific questions to gauge their knowledge
    • You may want to give a brief demonstration of some medical interventions so they understand exactly what is expected
    • Will you ask them to do your child’s laundry, clean equipment, etc.?
  • Review your child’s daily schedule
  • Let the nurse know if you plan to have cameras on in the home – check your state’s law for exactly what is required to be disclosed, but letting them know ahead of time regardless of the law can help establish trust
  • Review your expectations regarding smoking
    • No smoking should occur during their shift!
    • Should they bring a change of clothes if they do smoke?
    • Do you prefer non-smoking nurses in general?
  • Tell the nurse about your family so they can get a feel for your family and if they think it will be a good fit
  • Review house basics and accommodations
    • No shoes in the house – Some nurses prefer to wear shoes and will bring a clean pair to wear so it’s good for them to know this ahead of time
    • Use of refrigerator/microwave
    • Access to water – Can they refill water bottle/get water for tea
    • Phone use – Are you comfortable with personal phone use during down time?
  • Let the nurse know they should contact the agency to let them know if they are interested in taking on your child’s case. You should also reach out to the agency to let them know if you are interested in having the nurse work with you

Working With Nurses in Your Home

Home nursing can be a big adjustment. Many families are not used to opening their house up to someone else and it can be awkward at first. After some time, having a nurse at home will become part of your regular routine, and in some cases, nurses often become unofficial members of the family. Once you have a home nurse, there are several things you can do to establish a good working relationship to ensure that your child receives the best possible care.

  • Stay close by on the nurse’s first day with your child to help address any questions or concerns that might arise.
  • Verify your list of medications, dosing instructions, and timing against the nurse’s information from their agency. If there any discrepancies, verify which information is correct and then reach out to their nurse manager to have any errors corrected.
  • Write out a schedule for your child including medication and any treatments or interventions that occur daily. This will help keep things organized and help to make sure that nothing is missed.
  • Leave a list of activities your child enjoys, especially if they are non verbal and/or non ambulatory.
  • Keep medical supplies as organized as possible and consider adding labels for easy identification. In the of an emergency, every moment counts and the quicker your nurse can find supplies, the quicker they can tend to your child.
  • Clear a small area near your child’s supplies for the nurse to store their charting binder and/or tablet.
  • Most of the time, you will have access to your child’s binder or tablet. Make sure you are familiar with it in case you need to verify that a medication or intervention was given after the nurse’s shift ends.
  • If your nurse will be spending a lot of time in your child’s bedroom, consider adding a comfortable chair and possibly a tray table that can be easily broken down. When not tending to your child, they will need to spend time charting. A comfortable, efficient place to do this when they can still monitor your child will be much appreciated.