Common Myths About the Role of Your Nurse

With all of the changes you and your family are adjusting to, you might not have had the time to think about what your child’s nurse can and can’t do beyond taking care of your son or daughter.

While nurses will become an important part of your family, they and their agencies still have rules and laws to follow while they’re caring for your child.

Myth: My child will have a nurse with him 24/7.
Fact: Your insurance company or MCO will authorize your child to receive a certain number of hours of care depending on his or her unique needs. This likely will not be around-the-clock nursing services. Instead, insurers consider the schedule of other household members who could provide help. These include parents, adult siblings and other family members who live with you.

Myth: Parents can change their scheduled shift nursing hours when they choose.
Fact: Scheduled hours can be changed only with a physician order and an authorization from the child’s insurance provider. Nurses do not have the discretion to stay late or arrive at a different time. All of these changes have to be approved by the home health agency and the insurer.

Myth: If I need to run errands, the nurse in my home can care for all of my children.
Fact: By law, home health nurses are not permitted to oversee or care for other children in the home. They can provide care only for the shift nursing patient.

Myth: The nurse can clean up the house for us.
Fact: Nurses are not permitted to perform housekeeping for the family. Their responsibility is to care for the patient, which might include incidental cleaning. It is important to remember that the nurses are medical professionals and, as much as they may become part of your family routine, they are not able to help with typical household chores.

Myth: My family should avoid speaking to the nurse while he or she is on duty in the home.
Fact: While the nurse’s first priority is the health and safety of your child, it is fine and even encouraged for all of your family to get to know the child’s nurses. Pediatric shift nursing care is intimate and personal, not just for the patient but for the whole family who has invited this person into their home and given him or her their trust. Nurses welcome the opportunity to bond with the whole family when appropriate.

Myth: If you don't like the nurse the agency sends, it can send more until I find someone I like.
Fact: This is true to some extent. However, the home health industry is facing a crippling shortage of nurses. Agencies will do everything they can to match families with nurses who fit their needs and preferences, but the agency and the child’s MCO will not be able to accommodate all requests for new nursing staff. It is best to communicate your preferences or issues with staff to the home health agency as soon as possible.

It's the Law: State and Federal Restrictions on a Nurse's Work

State and federal laws prohibit the nurse from taking on certain tasks or roles while caring for your child. Restrictions in place in Pennsylvania and across the country:

• Agencies cannot communicate with you about your child’s care through text message. Some agencies might offer a HIPAA-compliant messaging service or online portal for families to keep track of care, but standard text messages do not meet federal privacy law requirements.

• Nurses cannot physically restrain your child if he or she is misbehaving or acting out. Your home health agency will discuss appropriate interventions with you if your child has behavioral issues. This might include strategies to avoid tantrum triggers or using approaches you have taken as a parent to soothe a misbehaving child.

• Nurses cannot remove their shoes completely while working in your home. They can change into indoor-only shoes or place shoe covers over their street shoes if you prefer.

• Nurses cannot provide care to other siblings in the home, although they can talk and interact with them while working with the patient.

• Nurses do not have flexibility to change your child’s care plan or medications without your doctor’s approval. They have very little flexibility to change the schedule of their visits without approval from your child’s health insurance provider.

Home Health Aide Services Differ From Nursing Care

Your child also might receive services from a home health aide. Aides are not licensed nurses but have training in how to meet your child’s everyday needs such as bathing, dressing and moving around the house. Home health aides often can stay with your child for hours at a time, to help with these kinds of tasks or provide socialization when nursing care is not needed. Your family might receive home health aide services as part of your pediatric home health care, which is a great way for your child to gain more independence and fully participate in family activities.