Scope of practice for pediatrics and delegation in home health

Home Forums Nurse to Nurse Advice Scope of practice for pediatrics and delegation in home health

This topic contains 3 replies, has 3 voices, and was last updated by Profile photo of JessinPA JessinPA 2 years, 4 months ago.

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    Hi all, hoping you can offer some advice/direction. I am posting this on behalf of a friend who is a Registered Nurse.

    My friend has a child under the age of two with special needs. He is cared for at home by my friend, and among other issues, he is at risk for seizure and bleeding on the brain/stroke. He attends PT on a regular basis due to long term effects of past hemorrhages. Neurological assessments are required, as well. My friend has had a visiting nurse for some time to monitor and assess her son due to the medications he must take for his conditions, as well as the multitude of side effects they can cause. Also, the doses must be closely monitored and adjusted. The visiting nurse has both enabled my friend to spend more time at home, rather than in a hospital, as well as being a direct line of communication/care with his physician.

    Recently, she was informed that she would no longer have a visiting nurse, and instead, a nurse’s aide would be taking the place of the RN. Needless to say, being a registered nurse herself, my friend is not very happy about this change, and has appealed this decision with her carrier.

    In the meantime, aside from basing her appeal on the state’s nurse practice act, what are some things she can do to ensure her son continues to receive an appropriate level of care and assessment at home? She doesn’t feel an aide is appropriate, since they cannot perform an appropriate neurological assessment, administer meds, or assess for side-effects.

    Thanks in advance! I know there are some really kind, caring, smart, and compassionate nurses here, so I was hoping you guys could offer some advice/ideas to her.


    Hey Melissa: I got nothing for you … but it is GREAT to see you back on MN 🙂 Hopefully people smarter than I will help you out soon. Good luck!


    Hi Jason – this is a tough one for me, too. I know nothing about pediatrics in home health. I’m hoping there are some “smahties” out there who may have something to offer, too! 🙂

    Profile photo of JessinPA

    It depends what state she lives in and the kind of coverage that her insurance provides. Contact a nursing agency in her area they should be able to guide her with the letters of medical necessities and all the other paperwork. Good luck to her

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