In just one year, my son, Jacob, was put on Bi-Pap in the PICU on four separate occasions. Only a respiratory therapist was allowed to put the device on him or make adjustments when he was in the hospital.

After a 236-day hospital stay, Jacob was discharged with his own Bi-Pap machine. But without a respiratory therapist to help manage his breathing challenges at home, it was up to me to ensure that Jacob had a clear airway and was hooked up to the ventilator 10-12 hours a day, or more if he was unwell. The home care nurses who were assigned to work with him were also responsible for managing his ventilator needs.

According to the agencies responsible for staffing government funded home care, these nurses had been trained before being dispatched to our home, and were allegedly capable of caring for my medically fragile son. I eventually discovered, however, that the training involved watching an outdated video on how to use a Bi-Pap machine that did not match the specific model Jacob was using.

Home care nurses are paid much less than hospital nurses, often with poor benefits, but their responsibilities are enormous.

Read more on CMAJ Blogs.

H/T Donna Thomson