Being directed to get a patients son a ride home

[unappreciatedrn]

Hello

I work on a 39 med/surg unit in the inter-city. I recently had a 26 year old patient who needed an I/D of her hand. Her 13 year old son was at her bedside and had been since the previous night when she was admitted. During my clinical coordinator making rounds, she came out of my patients room and told me that I had to find this patients child a ride home. I responded that I had asked the patient if someone could come pick him up and she said no. Due to budget cuts our hospital has stopped giving cab vouchers so what was I to to? The clinical coordinator continued to tell me that it was my job to find the patients child a ride home I had explained to her that I just did not have a way of doing that and she said we are trying to make our hospital more family oriented and we need to raise our scores so I needed to figure something out.

What was I to do in this situation?

[TheCommuter, BSN, RN]

What was I to do in this situation?

If your clinical coordinator was dead-set on getting this kid home, she should have coughed up the money, cab fare or bus tokens that would enable him to get home. Better yet, she could have personally given him a ride home if the issue was so important to her.

Coordinating transportation for visitors, guests, family members and other non-patients should not be the floor nurse's responsibility IMHO.

[brownbook]

I am not sure what a clinical coordinator is? The clinical coordinator asked you, the patients floor/staff nurse, to find a ride home for a 13 year old boy?

So much is wrong about this post I don't know where to start. But.....you could politely tell her you are uncomfortable doing that. Politely tell her to do it herself, or politely tell her to contact social services or discharge planning to get the boy home.

[elkpark]

Anywhere I've ever worked, transportation for clients or family members is a social work issue ...

[Anna Flaxis, BSN, RN]

Does your hospital have social workers on staff?

While I agree that it's not technically your job to actually find transportation for the family member, I don't think it's okay to just say "It's not my job" and then do nothing. I think it should be at least addressed by contacting social work, discharge planning, or at least your charge nurse. Some form of effort to at the very least contact the appropriate resource is not at all unreasonable to expect.

[SaoirseRN]

If mom doesn't have money for bus fare, then social work would be your best bet. The CC really should have taken that on herself though.

[caroladybelle, BSN, RN]

Explain to the care coordinator, that you have neither money, cab voucher nor bus passes to give, thus (the HELL!) are you supposed to do this. And refer him/her to social work.

Then call their supervisor, let them know the above. Explain that are not educated, do not have the time, the power, nor the training that social work has to perform this task. Does this child anyone at home to care for them? If not, by sending this child away, and the nurse not having adequately checked out the safety/supervision of the home environment, the facility (and the nurse) could be held liable. Explain that the next time this care coordinator acts this way, you will call DFACS ( or whatever state appropriate agency) to handle it. Grant you, the PR involved may not be pretty, but the safety of the child is the major concern.

After discussing this, explain to this supervisor that s/he may wish to have a class discussing the roles of nurses, doctors and social workers, and explain their appropriate duties.

(And bluntly, why the HELL did this person not do it themselves? And where the parents in this situation?)

Placing on the flame retardant scrubs.

[brownbook]

How can it be legal or ethical to send a 13 year old home alone in a bus or cab? I am the least paranoid person in the world but I can come up with many scenarios where this 13 year old could end up intentionally or by accident in a dangerous situation.

[dansamy]

Page the social worker. Your job/duty is to your patient. The social worker is there to deal with these sorts of things.

[Altra, BSN, RN]

I totally agree that the patient's 13-year old son needs to go home. How is he eating, bathing, etc. during his mother's multi-day hospital stay?

I also agree that it would be totally inappropriate to give a 13-year old a bus pass or cab voucher and say, "here ya go, kid".

It's almost unbelievable to me that the nurse who admitted this patient didn't address it immediately. If the patient stated there was "no one" to take him home, I would have pursued the conversation a little more firmly, making the point that we need to find a solution. On that patient's chart is someone who is listed as an emergency contact -- I would have called that person. And if that didn't work, then I would have bounced it to the social worker immediately. If your hospital doesn't have24-hour social worker coverage, there is still a nursing supervisor or someone who handles those tasks during off-hours.

[applewhitern, BSN, RN]

There is no way I would be responsible for this. Anything could happen to the child. If there are no family members who care enough to provide transportation, then who would care enough to see after the kid at home?

[Morainey, BSN, RN]

As a fellow floor nurse, I would describe this issue as Not Your Problem.

Sounds like a case management thing, though.