When patients aren't home

[KelRN215, BSN, RN]

I can deal if they have a legit excuse. If a parent took their child to the hospital in the middle of the night, I totally get that calling the VNA isn't their top priority. BUT, I am so annoyed about something that happened yesterday.

One of my primary patients... I've had her on my caseload for 10 months... and I see her every other week. Her parents KNOW that she needs to be seen on these days and know the general time that I come. I called her mother yesterday morning and said "I'll be there between 4:30-5:00." Mother called back several hours later to say that the child didn't go to school and would be home all day. (Had she answered the phone when I called or called me back sooner, I could have done the visit in the morning before I went into the office.) She confirmed that the time I gave her was fine. Then she called me back at 2:30pm saying that she needed to go pick up her other daughter and wouldn't be home in time. She asked me to come at 6pm. I told her that this was too late and that she needed to be home for the visit. (It does not take 2 hours to pick up her other child.) She promised to be home by 5:30 pm. I arrived to the house at 5:25 pm (stopped to do errands on the way there because I knew she wouldn't be home) and got no answer. I called the mother's cell phone and she said "I'll be home in 10 minutes" so I agreed to wait. Twenty minutes later she still hadn't arrived. I called her again and she said "I'm in traffic, I'll be there in 5 minutes" (She told me what street she was on and I had come from that street... there is never any traffic on that street and if she was really there, it wouldn't take five minutes even with traffic to get to her house.) She finally arrived home twenty minutes later... with GROCERIES. So she wasn't out doing anything important nor did she spend the entire afternoon picking up her other child... she decided that grocery shopping was more important than her child's care.

I realize that by waiting for her I didn't really do anything to discourage this kind of behavior but the child needed to be seen and I didn't want to go out there again today. /End rant.

What do you all do when patients aren't home? If this happens with this kid again (this was the 2nd time), I'm going to tell the mother "I can't wait" and move on.

[tktjRN]

I usually do a missed visit. I'm not waiting around for these people. I have a life too!

[suanniam4]

This is the bad part of hh. Try to claim an attempted visit to at least get gas money in the future. If pts screw with

my time like that I usually try to discharge or give away the assignment.

[LadyFree28, BSN, LPN, RN]

I usually do a missed visit. I'm not waiting around for these people. I have a life too!

^^^^Write a missed visit and move on...pt not home, no answer, etc. document, then move to the next one.

[Mom2boysRN]

I agree with what others have said. If pt isn't home I do a missed visit report and move on. I will also leave a message on the patients voicemail to let them know I stopped and I will call them to schedule another visit. At the next visit I will ask them to make sure and call if they will not be able to keep our appointment.

[WeirdNurseKelly, BSN, RN]

For my agency and state we only need to wait 15 minutes, but sometimes if I have a light day I will give the benefit of the doubt to the patient and wait a little bit longer. If I can and have time I will reschedule the patient for the next day or see if an LPN can see the patient. If not I miss the visit and notify the doctor as to the reason why. I also document why the visit was missed, what happened (your many contacts with the patient during the day) and how long you waited. CYA. When it comes time for surevey and this note has been seen you cover all your basis.