Private Duty Nursing: What Is It? Why You Need It? And How to Get It

Private Duty Nursing

I am a mom of a special needs child that is medically complex. For the first 2 years of his life, my husband and I did everything for him. We now, finally, have help. So how did we finally get help? What kind of help did we get? And how do you get help? Sadly, if your child has 40 medications, but they are all on a schedule, you will not qualify. Just because you are feeling overwhelmed, you will not qualify. If your child seems to be going backwards because you just can’t do it all, you will not qualify. I have felt, and still do feel, all of your pain. I was telling everyone I could for 2 years about our daily struggles. I cried to everyone. I told our doctors, case managers, and therapists. It seemed as though no one was really listening. We were told our son was “not bad enough” to get any kind of help. We didn’t even get respite care. We had to do it all the time …everyday … and every night.  The thing that changed everything, you ask? I finally cried to the right person. Our son was ready to add more therapy… one…more…therapy. He was ready. It was time. But it was going to be one more thing that I would feel guilty about if it didn’t get done; one more person coming into our home; one more thing that I didn’t know if I could do. I cried to that therapist the first time that we met. I am not sure if she thought I was crazy, or if she felt sorry for me, but either way, she got the ball rolling to get us help. Our son is also on a bi-pap machine at night and occasionally stops breathing. He is really quiet and quick about it. Even with monitors on him, I can’t get to him fast enough. It helps to have someone awake while he is sleeping in order to get him breathing again.

What is private duty nursing?

Private Duty Nursing (PDN) is comprised of nurses, either a Registered Nurse (RN) or a Licensed Practitioner Nurse (LPN), who want to work as a nurse but prefer the one-to-one hands-on care they can provide in the home environment. They can be from an agency or independent contractors. All of ours are independent (NIP/ Nurse in Independent Practice contracted with Wisconsin Medicaid). Our nurses pay for their own insurance and taxes. They get a National Provider Identifier number and apply to be an NIP through the state Medicaid program allowing them to bill the state for the time they work. They also have to keep a HIPAA compliant file on our son, at their home, for 7 years that the state can audit. They can work more than one case and make their own schedule. We currently have 3 full time people that are only working our case and 3 fill-ins that pick up a few hours a month. The full timers are each in our home for 10-12 hours a day and work, on average, 5 days a week. PDN hours are based on medical need and caregiver availability. The maximum number of hours for children is 20 hours per day and for adults it is 24 hours per day, 7 days per week in Wisconsin (there are always exceptions to every rule). They come into our home for a maximum of 20 hours a day and help with therapies, perform all skilled nursing procedures and treatments, personal cares, and everyday basic needs that our child has. They can come to doctor appointments, outings to the store, and ours have even gone with us on vacation. They are there to help you keep track of everything and keep your child on a regular schedule. They are also there to give medication and help coordinate care with the doctors.

Why do you need this?

• Does your child need any oxygen?
• Does your child need any intervention care? (Ours child would aspirate and turn blue if not suctioned out)
• Does your child have medications that need to be given only in certain situations (i.e., seizures, or pain)?
• Has your child been in the hospital for unplanned medical reasons?
• Is your child on a ventilator?
• Does your child have respiratory issues?
• Does your child have a feeding tube that requires venting regularly?
• Does your child have a tracheostomy to help them breathe?
• Do they need something to assess the situation on any given day?
• Do they have seizures that are not controlled by medication and have several every week?
• Do they have a catheter or automatic dysreflexia (when the bladder is full their blood pressure rises)?

If you said YES to any one of these you may be able to get private duty nursing. Your child needs to have some kind of situation, in their daily life, which needs to be assessed by a skilled nurse, in order to qualify. You will need to contact a social worker in your area to see if you qualify. We used our local clinic’s case manager to find out more and help fill out the paperwork.

So, what is it REALLY like to have nurses in your home? Click here to read more >>

Tracy Felix Tracy blogs about her life and challenges as a mom to a son with special needs. Her blog has provided a forum for parents to get support, share ideas, and learn. You can connect with her at www.facebook.com/xlinked1

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This post originally appeared on our November/December 2014 Magazine