Caring for the Ventilator Dependent Child by Laura M. Sterni & John L. Carroll

Author:Laura M. Sterni & John L. Carroll
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

The Human Factor

A vigilant, well-trained caregiver is the best prevention for pediatric tracheostomy and ventilator emergencies in the home. This is equally true for both professional home nurses and family caregivers [14].

Nurses

The nursing profession and the public are concerned with the capacity for nurses to be consistent, vigilant caregivers. Families report that a primary frustration of homecare is a lack of vigilance by the nurses who monitor their children, especially when nurses sleep on the job. It is difficult for families to develop trust, confidence, and rapport with a nurse who has been found asleep. In its extreme, a lack of vigilance due to sleeping by a nurse can lead to the preventable death of a patient [15]. Nursing agencies are responsible for ensuring that work schedules for nurses allow for proper rest between shifts. Agencies are accountable for taking corrective action after families report a nurse sleeping on the job. For the nurse who commits a serious nursing error or is found asleep on the job we recommend reassessment of skill levels, followed by remedial instruction and documentation of completed remedial training by the nursing agency supervisor or clinical educator prior to the nurse returning to the child’s home.

Family caregivers assume most of the responsibility of caring for their medically complex child. Home nursing support, especially night nursing, is vital for the health and well-being of family caregivers of ventilator-dependent children. Studies since the late 1980s have regularly reported sleep disturbances in parental caregivers of technology-dependent children [16–18]. A more recent study found a distinct relationship between home nursing coverage, sleep, and daytime functioning in parents of ventilator-assisted children. In the study, parents with clinically significant symptoms of depression and sleepiness received significantly fewer hours of night nursing [19]. Families rely on nursing agencies to provide enough qualified nurses to fill the number of approved nursing shifts for the child, especially during the night.

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