Cat Heaven, Nurse H..l!

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Just finished taking and shower and changing my clothes. My first patient had a multitude of cats. It's a place where you have to hold your nose and your throat burns or you gag - constantly. I did my work, waited until I got to the street to breathe through my nose and started to gag again. I sat with my door open so I could gag some more. Febreezed myself, the car, cleaned the equipment which I had not returned to my bag. I could not take the chance that the next patient would smell that on me or my equipment. The nurse who went on the visit before me was urinated on by one of the cats.

Before I share my plan, I am wondering what your input will be. How would you proceed with this case? Patient is competent, stable (chf) and has 2 equally competent family members who care for her. This was her 3rd visit. 7 weeks to go.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I love cats but that's gross! I wouldn't go back.

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Specializes in Complex pedi to LTC/SA & now a manager.

Consider discharge due to unsanitary home environment?

I'm guessing strong cat waste smell? How is that safe for a CHF patient?

Why skilled HH if stable and competent family care givers?

Referral to APS if safety, health or mental health is a concern.

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Specializes in Oncology; medical specialty website.

My best friend in nursing school turned into a crazy cat lady...and before anyone jumps on me, I love cats. Just not 30+ of them in one house. The last time I visited her (she had moved away), the stench in the house was awful.

I agree that this may not be a safe environment for delivering home care. Were you told there were that many cats in the home prior to visiting? What if you were allergic/asthmatic?

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If she is competent and stable, how are you justifying 7 more weeks of visits? Sounds like you could discharge.

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I am case managing the cat ladies (as many as there are) for the cm allergic to cats. I have done this before. One patient's girl friend had over 30 cats. My eyes and throat burned but I didn't gag and I did not feel like I had to change after leaving. I knew but I couldn't believe someone didn't make a decision before I went in. The first cm probably talked to the supervisor as I did and the nurse before me. They don't intervene. That's just the way it is. Ever nurse that goes in will have to make a decision. It should be handled as an agency, IMO.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I am case managing the cat ladies (as many as there are) for the cm allergic to cats. I have done this before. One patient's girl friend had over 30 cats. My eyes and throat burned but I didn't gag and I did not feel like I had to change after leaving. I knew but I couldn't believe someone didn't make a decision before I went in. The first cm probably talked to the supervisor as I did and the nurse before me. They don't intervene. That's just the way it is. Ever nurse that goes in will have to make a decision. It should be handled as an agency, IMO.

Obviously it won't. So if they won't I would report it to adult protective services. Because if they are living in any state of neglect (if the house smells live ammonia d/t the 30+ cats) then APS needs to be involved. Maybe the agency will do something once APS starts calling them. Don't forget, you are a mandated reporter. Good luck with all of this.

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What are you doing for her for 7 weeks?

3 weeks here with follow up by phone until total of 30 days and discharged if no significant changes in condition.

ETA Cats aside, doesn't sound medically necessary nor skilled..

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I tried to find support in the literature for cat waste being a health concern but could not (except for toxoplasmosis.)

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Specializes in Complex pedi to LTC/SA & now a manager.

Look towards animal control or local health department. They may have the guidelines you need

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Having a stable patient for homecare is another thread. It's not uncommon for us. Until you asked it didn't occur to me that she wasn't appropriate. For teaching, vs monitoring, medication monitoring? I used to think patients were not appropriate but you can describe almost any homebound patient as appropriate. That's all I know. I did call protective services, arranged a telephone dc. My supervisor is insisting I go in now to do bloodwork. The patient needs assistance to get to a lab, but she can. The PCP was notified this past week that an outpatient lab needed to be arranged after yesterday. I was off an the office moved the dc to tomorrow.

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We do 8 weeks. For CHF DX 3xwx2, 2xwx2, 1xwx4. If they are high risk for hospitalization, we do phone calls for the first two weeks on non visit days.

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