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Author Topic: Asking a nurse to watch your child when your child is the patient.  (Read 14562 times)

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Momsalwaysright!

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #30 on: September 17, 2010, 01:34:31 PM »
I've never heard of a rule that parents had to stay with their children.  My "baby" is 22, so I guess I'm just out of touch.  When my son was hospitalized at age 5, I wasn't able to stay with him all day, but I did sleep in his room at night and spent as much time with him as I could around my job and three other kids.  My son was blessed to have lots of visitors, great nurses, and a phone right by his bed that I could call to talk to him while I was at work.

My favorite story from the week he spent there was the day I called to check on him and he cheerfully told me that he was doing fine.  He said the nice lady doctor had come and made pictures with him that day.  He was being seen by three or four doctors, all specialists, so I was trying to figure out what specialist would have time to sit and draw pictures with my son.  Then he said, "You know, Mom, the doctor in the red and white striped dress!"  (For those who may not be familiar, in our area that's the uniform of a "candystriper," a teenaged volunteer.)

I can't imagine how I would have handled it if I'd been expected to be there all the time, and I'm very thankful for people like the lovely "doctor" in the red and while striped dress!

camlan

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #31 on: September 17, 2010, 01:36:24 PM »


Our pediatric unit requires that all children younger than 13 have someone with them, but it doesn't have to be a parent.  They will look the other way if the person sitting with a school age child steps out to go to the restroom/vending machines.  But if the child is younger than that (but not newborn/nursery) if the child is left alone the riot act will be read.  This is for the child's safety and security. 

If hospitalizations are fairly routine or lengthy, the expectation is that the parents will have a network of friends/family to help them either with the hospitalized child or other children at home.  But when it comes down to brass tacks, nursing is staffed so that each pedi nurse generally has 3 patients.  They can't ignore the others to watch yours.  You are responsible for tending to your child at home and ensuring their safety at the hospital as well.  Nurses are medical caregivers not babysitters.  If you need a babysitter, then you need to hire one.



So if, say, a single parent with three kids couldn't commit to being with the hospitalized child all day and all night, the child would be refused medical care?

I understand that nurses are not babysitters. But couldn't other staff be hired to watch the children of parents who can't be at the hospital? For a week or so, I think most families could manage. But after that, the needs of the other children may not be able to be met by babysitters. And if you've had to take unpaid medical leave in order to be at the hospital as much as your hospital demands, the money may simply not be there to hire a babysitter. In a perfect world, everyone would have a network of family and friends who could look after the children at home. But in reality, most people don't. They have one or two people who can help out, in between taking care of their own families.

I can understand why a hospital would want parents there as much as possible. But demanding their presence is putting a lot of pressure on an already stressful situation.
Nothing is impossible, the word itself says, “I’m possible!” –Audrey Hepburn


hot_shaker

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #32 on: September 17, 2010, 01:50:39 PM »
If hospitalizations are fairly routine or lengthy, the expectation is that the parents will have a network of friends/family to help them either with the hospitalized child or other children at home.  But when it comes down to brass tacks, nursing is staffed so that each pedi nurse generally has 3 patients.  They can't ignore the others to watch yours.  You are responsible for tending to your child at home and ensuring their safety at the hospital as well.  Nurses are medical caregivers not babysitters.  If you need a babysitter, then you need to hire one.

I don't know if this is your personal belief or if you're just explaining the logic behind the policy, but I disagree with this.  If an adult is in the hospital, then the hospital is responsible for whatever needs s/he may have.  For example, care for a patient with dementia is the duty of the hospital, not the person's children, family members, friends, etc, even though they can need as much supervision as a child.  I think the same logic applies to the other, young, end of the spectrum; the hospital is responsible for that child.  Not everyone has the flexibility and/or a social network that can come and sit around a hospital bed all day.  I worked with an older woman who had a young adopted daughter.  At some point she was discussing how, while she was very competent to care for her child, it really was just her.  No spouse, no nearby siblings, no grandparents to help out in a pinch. 

I would say that babysitting is a duty of pediatric nurses.

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Danismom

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #33 on: September 17, 2010, 01:52:04 PM »
The hospital won't refuse care.  They also will insist that someone be with the child for the child's own safety and security.  Young children typically need someone nearby to make sure they don't pull out their IV, try to climb out of bed, etc.  It is not appropriate to expect the hospital to provide someone to be at your child's side every minute.  That is the parent's responsibility.  While I understand that there are extenuating circumstances for virtually every family, that still doesn't make this the hospital's responsibility -- and certainly not an expense that the hospital will absorb since NO insurance (private or state) will cover that cost.  If the parents refuse to be there or have someone there with the child then you can bet a CPS referral will be made for abandonment/neglect.

Now to assist families in difficult situations, we do have volunteers that can be arranged for.  These are trained volunteers who can sit with a child for a couple of hours.  It generally takes several hours lead time to get them set up.  It also is not meant for more than a few hours each day.

Danismom

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #34 on: September 17, 2010, 01:55:39 PM »
If hospitalizations are fairly routine or lengthy, the expectation is that the parents will have a network of friends/family to help them either with the hospitalized child or other children at home.  But when it comes down to brass tacks, nursing is staffed so that each pedi nurse generally has 3 patients.  They can't ignore the others to watch yours.  You are responsible for tending to your child at home and ensuring their safety at the hospital as well.  Nurses are medical caregivers not babysitters.  If you need a babysitter, then you need to hire one.

I don't know if this is your personal belief or if you're just explaining the logic behind the policy, but I disagree with this.  If an adult is in the hospital, then the hospital is responsible for whatever needs s/he may have.  For example, care for a patient with dementia is the duty of the hospital, not the person's children, family members, friends, etc, even though they can need as much supervision as a child.  I think the same logic applies to the other, young, end of the spectrum; the hospital is responsible for that child.  Not everyone has the flexibility and/or a social network that can come and sit around a hospital bed all day.  I worked with an older woman who had a young adopted daughter.  At some point she was discussing how, while she was very competent to care for her child, it really was just her.  No spouse, no nearby siblings, no grandparents to help out in a pinch. 

I would say that babysitting is a duty of pediatric nurses.

so are you saying that either children should be in shared areas so that they have a nurse with them constantly?   Or do you think it is okay to leave a young child alone for 40 minutes/hour where you can't see them and don't know if they are doing something dangerous?  Or are you saying that there should be a 1-1 ratio so that the nurse is constantly in the room with the patient -- and are willing to pay for the extra level of care at the tune of ~$30/hr?

camlan

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #35 on: September 17, 2010, 02:02:17 PM »
 If the parents refuse to be there or have someone there with the child then you can bet a CPS referral will be made for abandonment/neglect.



So a single parent has the choice of "abandoning" the kids at home, thus possibly leading to a CPS referral, or "abandoning" the kid in the hospital?

It's not that I don't understand your hospital's position, but it's a pretty draconian policy. I know several families with good, loving parents, who would be completely unable to provide for an adult to be at the hospital 24/7. If only because someone has to go to work to provide the insurance to pay for the kid's hospital stay.

When my cousin's youngest ended up in intensive care at the age of two weeks, Cousin had two other children at home under the age of 5. And her husband was deployed in Iraq. There was simply no way Cousin could be at the hospital all day and all night--if nothing else, her other children were scared and frightened and needed to see a parent--not grandparents, aunts or cousins; they needed their mom or their dad, and they were not allowed in the ICU. The baby was in a room right by the nurses' desk and someone was able to watch her whenever Cousin couldn't be there. This was not a problem; the hospital was clearly set up to handle this.
Nothing is impossible, the word itself says, “I’m possible!” –Audrey Hepburn


qestia

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #36 on: September 17, 2010, 02:12:38 PM »
When we came back the nurse said "you guys must have really wanted a babysitter" or something like that.

I don't understand this part.  They were unhappy you left and are saying that's why your child was in the hospital -- so you'd have a break from parenting?

Five years later I don't understand it either. And he was an immobile, basically unconscious newborn in a fully contained isolette--not a rowdy two-year-old running around pulling out people's IVs. And we'd been parents for less than 3 days--we weren't exactly dying to go out on a date or anything. For me, a new parent, going from the post-birth hospital stay--where he was not allowed to stay in my room with me but rather the nursery so he could be monitored 24 hours (he was 5 weeks early), to go to the opposite where I was criticized for leaving him for 30 min when I was told I could... well, I'm hoping this thread will shed some light on why the nurse felt compelled to talk to me that way.

(It was a terrible hospital visit for many reasons--don't get me started on the Lactation consultant who criticized me for nursing my jaundiced son "too long" -- yes, totally setting us up to fail completely at nursing later)

FauxFoodist

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #37 on: September 17, 2010, 02:36:26 PM »
But couldn't other staff be hired to watch the children of parents who can't be at the hospital?

I know at my hospital that wouldn't be possible.  We are a government facility and are already cutting back for regular staff.

hot_shaker

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #38 on: September 17, 2010, 02:53:29 PM »
So are you saying that either children should be in shared areas so that they have a nurse with them constantly?   Or do you think it is okay to leave a young child alone for 40 minutes/hour where you can't see them and don't know if they are doing something dangerous?  Or are you saying that there should be a 1-1 ratio so that the nurse is constantly in the room with the patient -- and are willing to pay for the extra level of care at the tune of ~$30/hr?

Aren't the parents (or their employers) already paying thousands of dollars for treatment and care?

I'm not a hospital administrator but why can't they have group areas as long as the disease isn't contagious?  Or, like, 3 kids in a room with a nurse?  (Someone said upthread that it was a 3:1 ratio at her hiospital, I think.)   The kids would probably love it and the parents wouldn't have their lives come to screeching halt because of an extreme policy. 

I think parents should be encouraged to stay but if someone has to work to pay for those pricey insurance premiums, well, they have to work.  I'm sure most parents don't want to leave their sick child alone but sometimes it can't be helped.

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Danismom

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #39 on: September 17, 2010, 02:54:06 PM »
 If the parents refuse to be there or have someone there with the child then you can bet a CPS referral will be made for abandonment/neglect.



So a single parent has the choice of "abandoning" the kids at home, thus possibly leading to a CPS referral, or "abandoning" the kid in the hospital?

It's not that I don't understand your hospital's position, but it's a pretty draconian policy. I know several families with good, loving parents, who would be completely unable to provide for an adult to be at the hospital 24/7. If only because someone has to go to work to provide the insurance to pay for the kid's hospital stay.

When my cousin's youngest ended up in intensive care at the age of two weeks, Cousin had two other children at home under the age of 5. And her husband was deployed in Iraq. There was simply no way Cousin could be at the hospital all day and all night--if nothing else, her other children were scared and frightened and needed to see a parent--not grandparents, aunts or cousins; they needed their mom or their dad, and they were not allowed in the ICU. The baby was in a room right by the nurses' desk and someone was able to watch her whenever Cousin couldn't be there. This was not a problem; the hospital was clearly set up to handle this.

ICU is a whole different ball of wax.  Due to the acuity, there is a lower patient-nurse ratio.  There, one can expect 1RN-1or2 patients.  Also, I specifically said that the hospital expected a parent OR other adult at the bedside.  Of course the other children needed to see their parents also.  The aunts, uncles, grandparents, friends, etc can take turns sitting with the hospitalized child too.

Momsalwaysright!

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #40 on: September 17, 2010, 02:58:32 PM »
Do they really expect parents of babies to be there 24/7?  My first baby stayed in the hospital nursery for 17 days after her birth.  My doctor sent me home with instructions to get lots of rest.  I returned to the hospital every 3 hours to feed her (except at night, because my doctor insisted that I needed to sleep).  I pumped breast milk for her for those night feedings and the nurses took care of that.  When baby girl wasn't eating, she was sleeping.  (In fact, we usually had to wake her up to eat.)  I can't imagine that the hospital would have expected me to be there to watch her sleep all day.  There certainly wouldn't have been room for every baby in that nursery to have a parent present.  Granted, this was almost 30 years ago.  

I'm afraid I'm confused... do hospitals really insist that parents be there constantly?  I can understand why they'd want a familiar person to be with a toddler or preschooler, but does a newborn really need mom or dad to watch him sleep all day?  Or have I completely misunderstood previous posts?

hot_shaker

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #41 on: September 17, 2010, 02:58:55 PM »
ICU is a whole different ball of wax.  Due to the acuity, there is a lower patient-nurse ratio.  There, one can expect 1RN-1or2 patients.  Also, I specifically said that the hospital expected a parent OR other adult at the bedside.  Of course the other children needed to see their parents also.  The aunts, uncles, grandparents, friends, etc can take turns sitting with the hospitalized child too.

Oh, I didn't realize that was an ICU situation that I referenced with the 3:1 ratio.

But like I said above, not everyone has a social network.  The woman I referred to lived alone with her daughter, had no local family (I don't think she was close to her family regardless), and didn't have close enough friends to lean upon.  And even if they do, those people have to work as well; many people don't have job flexibility.

This can't be a rare situation where a parent/adult can't be there all day for multiple days.

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Danismom

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #42 on: September 17, 2010, 02:59:56 PM »
So are you saying that either children should be in shared areas so that they have a nurse with them constantly?   Or do you think it is okay to leave a young child alone for 40 minutes/hour where you can't see them and don't know if they are doing something dangerous?  Or are you saying that there should be a 1-1 ratio so that the nurse is constantly in the room with the patient -- and are willing to pay for the extra level of care at the tune of ~$30/hr?

Aren't the parents (or their employers) already paying thousands of dollars for treatment and care?

I'm not a hospital administrator but why can't they have group areas as long as the disease isn't contagious?  Or, like, 3 kids in a room with a nurse?  (Someone said upthread that it was a 3:1 ratio at her hiospital, I think.)   The kids would probably love it and the parents wouldn't have their lives come to screeching halt because of an extreme policy. 

I think parents should be encouraged to stay but if someone has to work to pay for those pricey insurance premiums, well, they have to work.  I'm sure most parents don't want to leave their sick child alone but sometimes it can't be helped.

Parents are paying for approx 1:3 care.  If they want 1:1 care and their child's medical needs do not dictate that this is necessary (ICU) then the parents should expect to pay for the extra services.  Not to be totally crude, but you don't expect to fly first class when you pay coach prices.

Danismom

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #43 on: September 17, 2010, 03:01:44 PM »
ICU is a whole different ball of wax.  Due to the acuity, there is a lower patient-nurse ratio.  There, one can expect 1RN-1or2 patients.  Also, I specifically said that the hospital expected a parent OR other adult at the bedside.  Of course the other children needed to see their parents also.  The aunts, uncles, grandparents, friends, etc can take turns sitting with the hospitalized child too.

Oh, I didn't realize that was an ICU situation that I referenced with the 3:1 ratio.

But like I said above, not everyone has a social network.  The woman I referred to lived alone with her daughter, had no local family (I don't think she was close to her family regardless), and didn't have close enough friends to lean upon.  And even if they do, those people have to work as well; many people don't have job flexibility.

This can't be a rare situation where a parent/adult can't be there all day for multiple days.

The poster I was responding to was in an ICU situation.  That is usually 1:1 or 2:1.  A regular pediatric unit will be 3 or 4:1.  Keep in mind also a typical patient stay is generally less than 3 days for a normal pediatric admission.

Danismom

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Re: Asking a nurse to watch your child when your child is the patient.
« Reply #44 on: September 17, 2010, 03:05:15 PM »
Do they really expect parents of babies to be there 24/7?  My first baby stayed in the hospital nursery for 17 days after her birth.  My doctor sent me home with instructions to get lots of rest.  I returned to the hospital every 3 hours to feed her (except at night, because my doctor insisted that I needed to sleep).  I pumped breast milk for her for those night feedings and the nurses took care of that.  When baby girl wasn't eating, she was sleeping.  (In fact, we usually had to wake her up to eat.)  I can't imagine that the hospital would have expected me to be there to watch her sleep all day.  There certainly wouldn't have been room for every baby in that nursery to have a parent present.  Granted, this was almost 30 years ago.  

I'm afraid I'm confused... do hospitals really insist that parents be there constantly?  I can understand why they'd want a familiar person to be with a toddler or preschooler, but does a newborn really need mom or dad to watch him sleep all day?  Or have I completely misunderstood previous posts?

It sounds like your baby was in the NICU.  My hospital does not expect parents of NICU babies to be there 24/7 as the NICU is an open room with multiple babies and staff right there.  I'm referring to a pediatric unit.  Babies who have been discharged from the hospital almost never go back into the NICU.  They may go into a pediatric ICU (PICU) if they need ICU care.  But I only know of 1 hospital that let a baby who had discharged from a hospital go into the NICU (for bili lights).