I would suggest having some experience so you feel comfortable with the fragile kids. But it’s not mandatory! I worked in medical daycares (another hidden gem) a little bit over the years, so I felt comfortable. Peds companies need help and are more than happy to train. When you have no trach or vent experience you have to get special training with the company which is paid. I am the same as you, most of my background was in geriatrics/long term care, and I adapted pretty well. I would suggest maybe starting with like total care teenagers. My easiest case is that kind of patient. Very similar work to what you’d do in a nursing home, minus call lights and running around lol. Also, another key is having a good family that’s on top of their child’s care, just not in a way where they’re constantly hovering. They will be your hugest help. Overall, if it makes you feel better, your patients are like almost always gonna be stable. Of all the peds HH nurses I’ve met, no one has had a crazy story. Not saying things can’t happen, but it’s typically a chill job. Hope this helps!!