Discharging PTs to an Unsafe Environment??

  1. I already posted this as a follow up to a different thread...but so far I have not had replies to this question, so I am posting it here.

    As it turns out, I had to do an abuse report today. A visitor yanked her grandchild by the hood of her coat backwards, choking her for a moment and then the child who is one year old, fell backwards. The grandmother threatened to 'rip her tongue out by the root' if she didn't be quiet.

    Then I had to discharge the patient (a minor)...right back with the family. DCF was already involved with the parents suspected abuse, but not the grandmother. I truly felt that the children were at BEST neglected, but they both had marks and bruises on them, so I think it is worse than that. I conveyed my concerns to the charge nurse, the doctor and another RN. I don't understand why I had to send my patient home with those people! My patient, who was 4, has already been sexually abused, according to DCF, and it is not even clear if the abuser is in the house or not. The children could have been in imminent danger...why did I have to send them home?
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  2. 9 Comments

  3. by   GooeyRN
    Im so sorry you had to witness this. It is a horrible situation for the kiddo's. Poor kids.
  4. by   teeituptom
    Mostly CPS is highly ineffective, they care greatly but are hamstrung by laws and policies that prevent them from doing their jobs. Also there are not that many places to send them too. Shelters overfull, those people that do foster children are overwhelmed. Where else can you send them.

    Sad but true
  5. by   Indy
    I don't know the answer, but that is why I don't feel like I can work in pediatrics. I don't tolerate abusive personalities and would have all sorts of nightmares trying to treat abused kids.
  6. by   Bipley
    Quote from teeituptom
    Mostly CPS is highly ineffective, they care greatly but are hamstrung by laws and policies that prevent them from doing their jobs. Also there are not that many places to send them too. Shelters overfull, those people that do foster children are overwhelmed. Where else can you send them.

    Sad but true
    I'm quite sure most do sincerely care a great deal but it doesn't make the problems any less frustrating.

    Many many years ago (20?) I had a peds patients that tested postive for STDs and it took CPS three weeks to determine if he was making up the abusive situations or if it was for real.

    I couldn't handle peds anymore. Never did well with it, I really enjoy old people the best. If I was in Peds today I'd likely strangle many of the parents and CPS staff and abduct the kids to hide them out in my home until they were 18 and able to fend for themselves.
  7. by   bethin
    Quote from Bipley
    Many many years ago (20?) I had a peds patients that tested postive for STDs and it took CPS three weeks to determine if he was making up the abusive situations or if it was for real.
    If the peds pt. ended up with an STD it's quite obvious (to me anyways) that the pt. has been sexually abused. You don't give yourself STD's. Three weeks seems like a long time to detemine if the pt. is telling the truth or not. Again, you cannot give yourself a STD.

    To the OP, I have unfortunately had a few cases where I wheeled or walked a pt. out and didn't feel right about it. I'm a CNA and I report bruises, burns, etc to the nurse but there's not a whole lot I can do except let the nurse know. I don't have patience with parents who hit their kids or verbally abuse their children. Once, I was in Wal Mart and in the same aisle as me was a woman with a child that looked to be about 18 months old. This cutie was singing the alphabet and when she got to the end she asked her mom if "next time won't you sing with me" and the mother started screaming at her child, yelling obscenties. It infuriated me and I told the child that next time I would sing with her. This may sound cruel, but some people shouldn't have kids. There are plenty of people out there who jump through hoops to adopt a child, waiting years and years. But yet a parent can abuse a child more than once and still keep him or her. I don't understand that. Kids sitting in crack houses vs. going to a healthy home with caring parents? Not hard to decide.
  8. by   NurseCard
    I can't imagine why anyone would ever want to harm a child. The last post about the mom yelling obsenities at her little girl just because she was singing the alphabet song? What is wrong with people??? I'm at work right now and I just want to go home and hug my little 3 year old angel (actually I call her my "little goddess" ) over and over again. I'm constantly telling her that I love her; I wonder if she ever gets sick of it?

    Anyway, though... I work in Med/Surge but take care of some peds. I've actually never been unfortunate enough to have to care for a child who has obviously been abused; however I was working one night and one of the other nurses working had an abuse case on her hands.
  9. by   VeryPlainJane
    In my state CPS can not take the child out of the home they must have a court order, which sadly may take a few weeks. But if you make a call to the police and they can take custody on the spot. Police and Firefighters are the only ones that can do it.
  10. by   Bipley
    Quote from VeryPlainJane
    In my state CPS can not take the child out of the home they must have a court order, which sadly may take a few weeks. But if you make a call to the police and they can take custody on the spot. Police and Firefighters are the only ones that can do it.
    :::: beating head on desk ::::

    How does this make sense? Clearly I am NOT blaming you, I am merely frustrated. What are medical PROFESSIONALS to do? Call the FD because OUR patient is a victim of abuse??

    Gahhhh...
  11. by   Aneroo
    Quote from bethin
    Again, you cannot give yourself a STD.

    .
    Totally away from the OP, but you can. Say the child has been kissed on the face by a loving aunt with a cold sore (HSV type one). Child touches sore, doesn't wash hands, child can self-introduce herpes into eyes, genitals or any other mucous membrance. Although I highly doubt that was the case, it is possible.

    To the OP- I'm sorry you had to witness this, but you got your charge RN and the doc involved. I'm assuming a case manager, pt rep or a social worker was also involved since you knew about DCF being involved (unless the family disclosed that with you).

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