Transition from Pediatric to Adult Care

fightcfjb · Jun 2, 2008

I'm interested in learning how your CF center is handling the transition from pediatric to adult CF care. We are served by a clinic that has a very small CF population. The number of patients becoming adults can be counted on one and a half hands.

There are 3 doctors involved in the clinic, the director (peds), a doc who sees adults, and a new doc who refuses to see patients over 18 because she feels that they belong in the "adult" program. [Whatever the heck that is!]

Another factor effecting this is that the adult program will admit to the adult hospital rather that the children's hospital. One of the problems I see with this is that the CF nursing expertise is deep and extraordinarily competent and caring on the peds side. Can you imagine the adult nursing staff dealing with just a few adult CF patients showing up periodically? The peds nurses know every CFer by name, condition, medical needs, etc.

The new "adult" program was instituted without a single word of input from the CFers transitioning to adult care.

Remember this is a program that has produced a handful of adult CFers. It does not have an adult population of dozens.

I'm tempted to write to the center director to express my displeasure on how the how division of care was artificially created, the complete lack of patient input, and the potential for substandard care under the new arrangement.

I would be very interested in learning about the pedi to adult transition in centers with a population less than 200 or so.

I would also welcome your thoughts in general on this topic.

fightcfjb · Jun 2, 2008

I'm interested in learning how your CF center is handling the transition from pediatric to adult CF care. We are served by a clinic that has a very small CF population. The number of patients becoming adults can be counted on one and a half hands.

There are 3 doctors involved in the clinic, the director (peds), a doc who sees adults, and a new doc who refuses to see patients over 18 because she feels that they belong in the "adult" program. [Whatever the heck that is!]

Another factor effecting this is that the adult program will admit to the adult hospital rather that the children's hospital. One of the problems I see with this is that the CF nursing expertise is deep and extraordinarily competent and caring on the peds side. Can you imagine the adult nursing staff dealing with just a few adult CF patients showing up periodically? The peds nurses know every CFer by name, condition, medical needs, etc.

The new "adult" program was instituted without a single word of input from the CFers transitioning to adult care.

Remember this is a program that has produced a handful of adult CFers. It does not have an adult population of dozens.

I'm tempted to write to the center director to express my displeasure on how the how division of care was artificially created, the complete lack of patient input, and the potential for substandard care under the new arrangement.

I would be very interested in learning about the pedi to adult transition in centers with a population less than 200 or so.

I would also welcome your thoughts in general on this topic.

fightcfjb · Jun 2, 2008

I'm interested in learning how your CF center is handling the transition from pediatric to adult CF care. We are served by a clinic that has a very small CF population. The number of patients becoming adults can be counted on one and a half hands.

There are 3 doctors involved in the clinic, the director (peds), a doc who sees adults, and a new doc who refuses to see patients over 18 because she feels that they belong in the "adult" program. [Whatever the heck that is!]

Another factor effecting this is that the adult program will admit to the adult hospital rather that the children's hospital. One of the problems I see with this is that the CF nursing expertise is deep and extraordinarily competent and caring on the peds side. Can you imagine the adult nursing staff dealing with just a few adult CF patients showing up periodically? The peds nurses know every CFer by name, condition, medical needs, etc.

The new "adult" program was instituted without a single word of input from the CFers transitioning to adult care.

Remember this is a program that has produced a handful of adult CFers. It does not have an adult population of dozens.

I'm tempted to write to the center director to express my displeasure on how the how division of care was artificially created, the complete lack of patient input, and the potential for substandard care under the new arrangement.

I would be very interested in learning about the pedi to adult transition in centers with a population less than 200 or so.

I would also welcome your thoughts in general on this topic.

fightcfjb · Jun 2, 2008

I'm interested in learning how your CF center is handling the transition from pediatric to adult CF care. We are served by a clinic that has a very small CF population. The number of patients becoming adults can be counted on one and a half hands.

There are 3 doctors involved in the clinic, the director (peds), a doc who sees adults, and a new doc who refuses to see patients over 18 because she feels that they belong in the "adult" program. [Whatever the heck that is!]

Another factor effecting this is that the adult program will admit to the adult hospital rather that the children's hospital. One of the problems I see with this is that the CF nursing expertise is deep and extraordinarily competent and caring on the peds side. Can you imagine the adult nursing staff dealing with just a few adult CF patients showing up periodically? The peds nurses know every CFer by name, condition, medical needs, etc.

The new "adult" program was instituted without a single word of input from the CFers transitioning to adult care.

Remember this is a program that has produced a handful of adult CFers. It does not have an adult population of dozens.

I'm tempted to write to the center director to express my displeasure on how the how division of care was artificially created, the complete lack of patient input, and the potential for substandard care under the new arrangement.

I would be very interested in learning about the pedi to adult transition in centers with a population less than 200 or so.

I would also welcome your thoughts in general on this topic.

fightcfjb · Jun 2, 2008

I'm interested in learning how your CF center is handling the transition from pediatric to adult CF care. We are served by a clinic that has a very small CF population. The number of patients becoming adults can be counted on one and a half hands.
 
 There are 3 doctors involved in the clinic, the director (peds), a doc who sees adults, and a new doc who refuses to see patients over 18 because she feels that they belong in the "adult" program. [Whatever the heck that is!]
 
 Another factor effecting this is that the adult program will admit to the adult hospital rather that the children's hospital. One of the problems I see with this is that the CF nursing expertise is deep and extraordinarily competent and caring on the peds side. Can you imagine the adult nursing staff dealing with just a few adult CF patients showing up periodically? The peds nurses know every CFer by name, condition, medical needs, etc.
 
 The new "adult" program was instituted without a single word of input from the CFers transitioning to adult care.
 
 Remember this is a program that has produced a handful of adult CFers. It does not have an adult population of dozens.
 
 I'm tempted to write to the center director to express my displeasure on how the how division of care was artificially created, the complete lack of patient input, and the potential for substandard care under the new arrangement.
 
 I would be very interested in learning about the pedi to adult transition in centers with a population less than 200 or so.
 
 I would also welcome your thoughts in general on this topic.

NoExcuses · Jun 2, 2008

I was just given a name and an address. Perhaps there was some doctor talking behind the scenes that I didn't know, but my peds clinic was slightly chaotic at the time so I doubt it.

I introduced myself - it was about an hour clinic appointment of taking my history.

I don't really see what else they could have done. I mean more hand holding would seem only time consuming I would think.....

NoExcuses · Jun 2, 2008

I was just given a name and an address. Perhaps there was some doctor talking behind the scenes that I didn't know, but my peds clinic was slightly chaotic at the time so I doubt it.

I introduced myself - it was about an hour clinic appointment of taking my history.

I don't really see what else they could have done. I mean more hand holding would seem only time consuming I would think.....

NoExcuses · Jun 2, 2008

I was just given a name and an address. Perhaps there was some doctor talking behind the scenes that I didn't know, but my peds clinic was slightly chaotic at the time so I doubt it.

I introduced myself - it was about an hour clinic appointment of taking my history.

I don't really see what else they could have done. I mean more hand holding would seem only time consuming I would think.....

NoExcuses · Jun 2, 2008

I was just given a name and an address. Perhaps there was some doctor talking behind the scenes that I didn't know, but my peds clinic was slightly chaotic at the time so I doubt it.

I introduced myself - it was about an hour clinic appointment of taking my history.

I don't really see what else they could have done. I mean more hand holding would seem only time consuming I would think.....

NoExcuses · Jun 2, 2008

I was just given a name and an address. Perhaps there was some doctor talking behind the scenes that I didn't know, but my peds clinic was slightly chaotic at the time so I doubt it.
 
 I introduced myself - it was about an hour clinic appointment of taking my history.
 
 I don't really see what else they could have done. I mean more hand holding would seem only time consuming I would think.....

Sevenstars · Jun 2, 2008

It's definitely hard to make the transition, even with a big center like mine. I believe we have over 400 adult patients at my clinic.

How transitioning is done depends mainly on the patient. Some start very early and move quickly to adult care, and others (generally sicker kids) transition much more slowly, sometimes staying with the peds docs until they are 21-22. Personally I stayed with my ped doc and hospital until I was 21, then reluctantly switched over to adult care. The nurses there also know me now, and I trust them just as I did with my peds nurses. To be honest, it starts to get very awkward going to a children's hopsital when you are over 21. Yes, the familiar faces are nice, but you just aren't a kid anymore.

I think even in a small center, you have to give them the benefit of the doubt. Sure, they may not be used to treating droves of CF patients like the peds nurses (I'm just referring to inpatient care here) but you should give them the chance to learn and get to know you - because afterall, hopefully they will be dealing with more and more adult patients as the CF community as a whole gets healthier and lives longer! <img src="i/expressions/face-icon-small-smile.gif" border="0">

It sounds like you want to get involved with making this transition smoother for everyone all around. Is your center involved with LLC? (Learning and leadership committee) It would give you a voice and help you help them smooth out the process. One big thing I found that helps a lot with "getting things right" in the hospital is having certain standing orders for every CF patient. This is a form that gets faxed right to the hospital when you get admitted, from your doctor, that includes important things for every CFer: diet, meal passes, CPT, inhaled meds, antibiotic regimen, etc. Things like this are the result of LLC and doctors, nurses and patients all communicating about what is important to them, and about what goes on in the hospitals.

Sorry, got a little ahead of myself here... how the actual transition is done at my center is basically you see two doctors while you are transitioning. You meet your usual ped doc on a special clinic day, then an adult doc will come in and meet with you AND your ped doc for part of your visit. It allows you the comfort of still seeing your ped doc, while getting to know your doc-to-be.

Hope this helped you. Give your adult center a chance, you can teach them a lot if they're willing to listen.

Sevenstars · Jun 2, 2008

It's definitely hard to make the transition, even with a big center like mine. I believe we have over 400 adult patients at my clinic.

How transitioning is done depends mainly on the patient. Some start very early and move quickly to adult care, and others (generally sicker kids) transition much more slowly, sometimes staying with the peds docs until they are 21-22. Personally I stayed with my ped doc and hospital until I was 21, then reluctantly switched over to adult care. The nurses there also know me now, and I trust them just as I did with my peds nurses. To be honest, it starts to get very awkward going to a children's hopsital when you are over 21. Yes, the familiar faces are nice, but you just aren't a kid anymore.

I think even in a small center, you have to give them the benefit of the doubt. Sure, they may not be used to treating droves of CF patients like the peds nurses (I'm just referring to inpatient care here) but you should give them the chance to learn and get to know you - because afterall, hopefully they will be dealing with more and more adult patients as the CF community as a whole gets healthier and lives longer! <img src="i/expressions/face-icon-small-smile.gif" border="0">

It sounds like you want to get involved with making this transition smoother for everyone all around. Is your center involved with LLC? (Learning and leadership committee) It would give you a voice and help you help them smooth out the process. One big thing I found that helps a lot with "getting things right" in the hospital is having certain standing orders for every CF patient. This is a form that gets faxed right to the hospital when you get admitted, from your doctor, that includes important things for every CFer: diet, meal passes, CPT, inhaled meds, antibiotic regimen, etc. Things like this are the result of LLC and doctors, nurses and patients all communicating about what is important to them, and about what goes on in the hospitals.

Sorry, got a little ahead of myself here... how the actual transition is done at my center is basically you see two doctors while you are transitioning. You meet your usual ped doc on a special clinic day, then an adult doc will come in and meet with you AND your ped doc for part of your visit. It allows you the comfort of still seeing your ped doc, while getting to know your doc-to-be.

Hope this helped you. Give your adult center a chance, you can teach them a lot if they're willing to listen.

Sevenstars · Jun 2, 2008

It's definitely hard to make the transition, even with a big center like mine. I believe we have over 400 adult patients at my clinic.

How transitioning is done depends mainly on the patient. Some start very early and move quickly to adult care, and others (generally sicker kids) transition much more slowly, sometimes staying with the peds docs until they are 21-22. Personally I stayed with my ped doc and hospital until I was 21, then reluctantly switched over to adult care. The nurses there also know me now, and I trust them just as I did with my peds nurses. To be honest, it starts to get very awkward going to a children's hopsital when you are over 21. Yes, the familiar faces are nice, but you just aren't a kid anymore.

I think even in a small center, you have to give them the benefit of the doubt. Sure, they may not be used to treating droves of CF patients like the peds nurses (I'm just referring to inpatient care here) but you should give them the chance to learn and get to know you - because afterall, hopefully they will be dealing with more and more adult patients as the CF community as a whole gets healthier and lives longer! <img src="i/expressions/face-icon-small-smile.gif" border="0">

It sounds like you want to get involved with making this transition smoother for everyone all around. Is your center involved with LLC? (Learning and leadership committee) It would give you a voice and help you help them smooth out the process. One big thing I found that helps a lot with "getting things right" in the hospital is having certain standing orders for every CF patient. This is a form that gets faxed right to the hospital when you get admitted, from your doctor, that includes important things for every CFer: diet, meal passes, CPT, inhaled meds, antibiotic regimen, etc. Things like this are the result of LLC and doctors, nurses and patients all communicating about what is important to them, and about what goes on in the hospitals.

Sorry, got a little ahead of myself here... how the actual transition is done at my center is basically you see two doctors while you are transitioning. You meet your usual ped doc on a special clinic day, then an adult doc will come in and meet with you AND your ped doc for part of your visit. It allows you the comfort of still seeing your ped doc, while getting to know your doc-to-be.

Hope this helped you. Give your adult center a chance, you can teach them a lot if they're willing to listen.

Sevenstars · Jun 2, 2008

It's definitely hard to make the transition, even with a big center like mine. I believe we have over 400 adult patients at my clinic.

How transitioning is done depends mainly on the patient. Some start very early and move quickly to adult care, and others (generally sicker kids) transition much more slowly, sometimes staying with the peds docs until they are 21-22. Personally I stayed with my ped doc and hospital until I was 21, then reluctantly switched over to adult care. The nurses there also know me now, and I trust them just as I did with my peds nurses. To be honest, it starts to get very awkward going to a children's hopsital when you are over 21. Yes, the familiar faces are nice, but you just aren't a kid anymore.

I think even in a small center, you have to give them the benefit of the doubt. Sure, they may not be used to treating droves of CF patients like the peds nurses (I'm just referring to inpatient care here) but you should give them the chance to learn and get to know you - because afterall, hopefully they will be dealing with more and more adult patients as the CF community as a whole gets healthier and lives longer! <img src="i/expressions/face-icon-small-smile.gif" border="0">

It sounds like you want to get involved with making this transition smoother for everyone all around. Is your center involved with LLC? (Learning and leadership committee) It would give you a voice and help you help them smooth out the process. One big thing I found that helps a lot with "getting things right" in the hospital is having certain standing orders for every CF patient. This is a form that gets faxed right to the hospital when you get admitted, from your doctor, that includes important things for every CFer: diet, meal passes, CPT, inhaled meds, antibiotic regimen, etc. Things like this are the result of LLC and doctors, nurses and patients all communicating about what is important to them, and about what goes on in the hospitals.

Sorry, got a little ahead of myself here... how the actual transition is done at my center is basically you see two doctors while you are transitioning. You meet your usual ped doc on a special clinic day, then an adult doc will come in and meet with you AND your ped doc for part of your visit. It allows you the comfort of still seeing your ped doc, while getting to know your doc-to-be.

Hope this helped you. Give your adult center a chance, you can teach them a lot if they're willing to listen.

Sevenstars · Jun 2, 2008

It's definitely hard to make the transition, even with a big center like mine. I believe we have over 400 adult patients at my clinic.
 
 How transitioning is done depends mainly on the patient. Some start very early and move quickly to adult care, and others (generally sicker kids) transition much more slowly, sometimes staying with the peds docs until they are 21-22. Personally I stayed with my ped doc and hospital until I was 21, then reluctantly switched over to adult care. The nurses there also know me now, and I trust them just as I did with my peds nurses. To be honest, it starts to get very awkward going to a children's hopsital when you are over 21. Yes, the familiar faces are nice, but you just aren't a kid anymore.
 
 I think even in a small center, you have to give them the benefit of the doubt. Sure, they may not be used to treating droves of CF patients like the peds nurses (I'm just referring to inpatient care here) but you should give them the chance to learn and get to know you - because afterall, hopefully they will be dealing with more and more adult patients as the CF community as a whole gets healthier and lives longer! <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
 It sounds like you want to get involved with making this transition smoother for everyone all around. Is your center involved with LLC? (Learning and leadership committee) It would give you a voice and help you help them smooth out the process. One big thing I found that helps a lot with "getting things right" in the hospital is having certain standing orders for every CF patient. This is a form that gets faxed right to the hospital when you get admitted, from your doctor, that includes important things for every CFer: diet, meal passes, CPT, inhaled meds, antibiotic regimen, etc. Things like this are the result of LLC and doctors, nurses and patients all communicating about what is important to them, and about what goes on in the hospitals.
 
 Sorry, got a little ahead of myself here... how the actual transition is done at my center is basically you see two doctors while you are transitioning. You meet your usual ped doc on a special clinic day, then an adult doc will come in and meet with you AND your ped doc for part of your visit. It allows you the comfort of still seeing your ped doc, while getting to know your doc-to-be.
 
 Hope this helped you. Give your adult center a chance, you can teach them a lot if they're willing to listen.

JazzysMom · Jun 2, 2008

Our clinic has pediatric & adult care in the same clinic. Although one doc runs the adult program & the other the pediatric, they cover for each other & most if not all patients know both.

If was not a big transition for me except to know the adult doctor would see me in the office instead of just when she covered on the hospital floor.

The last I knew our patient count at the clinic was around 200 total (adults & kids).

The more open minded you are the easier it will be!

HUGS

JazzysMom · Jun 2, 2008

Our clinic has pediatric & adult care in the same clinic. Although one doc runs the adult program & the other the pediatric, they cover for each other & most if not all patients know both.

If was not a big transition for me except to know the adult doctor would see me in the office instead of just when she covered on the hospital floor.

The last I knew our patient count at the clinic was around 200 total (adults & kids).

The more open minded you are the easier it will be!

HUGS

JazzysMom · Jun 2, 2008

Our clinic has pediatric & adult care in the same clinic. Although one doc runs the adult program & the other the pediatric, they cover for each other & most if not all patients know both.

If was not a big transition for me except to know the adult doctor would see me in the office instead of just when she covered on the hospital floor.

The last I knew our patient count at the clinic was around 200 total (adults & kids).

The more open minded you are the easier it will be!

HUGS

JazzysMom · Jun 2, 2008

Our clinic has pediatric & adult care in the same clinic. Although one doc runs the adult program & the other the pediatric, they cover for each other & most if not all patients know both.

If was not a big transition for me except to know the adult doctor would see me in the office instead of just when she covered on the hospital floor.

The last I knew our patient count at the clinic was around 200 total (adults & kids).

The more open minded you are the easier it will be!

HUGS

JazzysMom · Jun 2, 2008

Our clinic has pediatric & adult care in the same clinic. Although one doc runs the adult program & the other the pediatric, they cover for each other & most if not all patients know both.
 
 If was not a big transition for me except to know the adult doctor would see me in the office instead of just when she covered on the hospital floor.
 
 The last I knew our patient count at the clinic was around 200 total (adults & kids).
 
 The more open minded you are the easier it will be!
 
 HUGS

Transition from Pediatric to Adult Care

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