Reporting Neglect in Home Health

jadelpn, LPN, EMT-B · Mar 22, 2014

I think it is far different if a child is 5 or 6 and is eating cereal watching TV while Mom is laying down. Not ideal, but at that age, they know enough to come get Mom if they need her.

A 2 year old has no such filter. Usually, when a 2 year old wakes up, they immediately go to the parent's room and wake them up. That this child was roaming freely in the house and NOT in Mom's room every 2 seconds is telling.

They can and do find everything in the house that they are curious about, and take it out, turn it on, open it up....and locks are funny to watch a parent open, however, a 2 year old can and does open it without issue.

That the OP is there at all is perhaps due to neglect of the patient--and the Mom was manadated to have 24 hour care perhaps? So Mom apparently "needs a nap" when the nurse arrives? And perhaps a misunderstanding of some sort that the nurse is to watch both kids due to CPS thinking that Mom is "less than ideal" in the parenting department? Lots of huge assumptions, however, when CPS gets involved, parents get very defensive, very quickly. And unfortunetly, the nurse is left in sometimes an uncomfortable situation.

OP, I would have conversation with the agency again in that they need to send the social worker, the case worker, whomever, to state exactly what you are there for. That the 2 year old is NOT part of the care plan. That arrangements need to be made so that the child is properly supervised, and not by you, as your responsibility is the patient. If Mom can not abide by that plan, then a call to CPS is in order.

Sounds to me like Mom is in the room pouting, and its a "I'll show them" situation. As well as taking advantage of the fact there's an adult in the house. And as a complete aside, would you ever just knock on Mom's bedroom door, state that the 2 year old can not roam the house freely while Mom is asleep, and that she needs to care for the child and you are just there for the patient? Sometimes a firm "I am not here to take care of both the children" could serve as sufficient warning.

KelRN215, BSN, RN · Mar 22, 2014

Maybe this is something I'm just missing, but what exactly should the mom have done with the two year old? If all of the outside doors were locked and the house was relatively childproof, is it really a problem that the child is wandering in his own house? Just curious - I'm not a parent so I really don't know the answer. I just wouldn't have thought anything of it if I saw someone free to roam in the place he/she lived in, regardless of age. Are parents supposed to lock children up when they are sleeping?

Parents are supposed to be awake when their 2 year old is. You can't just go leave your 2 year old to fend for himself while you take a nap. I'm having a hard time believing that anyone would think this could be appropriate.

vintagemother, BSN, CNA, LVN, RN · Mar 23, 2014

I'm a pretty relaxed mom but even I think 2 year olds shouldn't wander the house while I sleep. My method was to put them in a child safe room with me while I lightly doze with one ear and eye open, lol!

I think if it were me, I'd firmly and lovingly tell the mom you have to wake up and watch your child. But I have that personality and gift for having difficult conversations with difficult people without exuding fear.

brillohead, ADN, RN · Mar 23, 2014

My husband travels a lot for business, and I don't have any family anymore.

When my son was 2yo, I came down with a nasty virus that left me virtually immobile with fever and chills for a couple days. My solution was to set out a bunch of sippy cups and snacks on the kitchen table and park myself in a recliner in the living room (adjacent to the kitchen -- my house is pretty small).

I had the gate up so he couldn't get into the basement, and I had the doors closed to the master bedroom and bathroom. This left him free to wander in the kitchen, living room, and his bedroom, with food and drink at his disposal. I turned the tv to the Disney Channel and just vegged out until the worst of the illness had passed.

While I was sleeping a lot of the time, I was still present and able to see/hear him almost all the time (the only time he was out of my line of sight was when he was in his bedroom, which was child-friendly by default). There is no way in heck that I would have gone to lie down in my bedroom, unless he was coming in there to nap with me!

As for the concept of "the parent must be awake whenever the child is" --- that is not the case. However, the parent must provide for the child's safety at all times. In your situation, calivianya, your parents made allowances to keep you safe while they slept (by putting you in your bedroom). They did not need to stand watch over you, because you were in a safe situation while they slept.