Dangerous home, what to do?

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Hi all-

i am in quite a situation with my current patient's home. I absolutely love taking care of my patient. The problem lies with the patient's family member who has a serious mental disorder which I have just really started realizing is manifesting or getting worse. Without revealing to many details, some of the concerns i have surroung the new appearance of guns and bullets around the home combined with a plethera of anti-psychotic medications and verbal abuse. What do I do? I do feel somewhat unsure about being in the home with this person but im not sure if i am jumping the gun or not and since it is my first case i dont want to seem ungrateful or like a complainer by my agency? Im contemplating even going in tomorrow as i found out there was a major incident that occured last night which no one alerted me to today, which resulted in someone being taken away on a restraining order but not jailed and able to come home at will???

Advise please, i really dont know who I could talk to about this without HIPPA coming into play or facing a raised eyebrow from my employer.:confused:

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Do not waste any more time before you inform the employer that you will not be going back to that case. If you want to "preserve" your standing with them, do not say anything about your personal safety issues. I can assure you that they do not want to hear that and if you say anything about the lack of safety at that house, you will be the one who suffers the consequences. If you are wise, you will come up with a very plausible "reason".

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WOW, now im even more confused??? Are PDN agencies that desperate for cases that they would allow the safety of their nurses to be at risk? I can understand if I just didnt like the individual, but this person is definately suicidal potentially homicidal and I could potentially face retaliation for being reasonably afraid?

Caliotter, I am glad that you weighed in, I would have never thought about it from that perspective. Needless to say my husband is in an uproar and absolutely does not want me in that home again, even if it means I loose my job, but i dont want to quit, I just dont want to be the dead nurse that was there at the wrong time when Mr. Crazy comes to finish everyone else off...

Now as for plausable reasons, is there such a thing if fearing for your life wouldnt cut the mustard? I have nothing negative to say about the patient or the condition of the home or really anything else. Im stumpped... :uhoh3:

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Well, come out and tell them the truth, and too bad if they don't like it. I warned you about a negative attitude from the agency because it is apparently quite common for employers to blame and punish the victim. Most nurses always come up with some reason to tell the agency that will not cause them to have to go into details. They do this to keep from getting on the bad side of the agency and rightly so. The agency personnel are looking at the dollar signs and do not care about their nurses (for the most part).

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Specializes in home health & nonprofit management.

I had a pd case where the pcg started throwing equipment at me (tpn bags and tubing, soft stuff). When I mentioned this to the agency they gave me a blank look. I learned its ok to be "sick", have child care issues or even be "moving" out of that pts range....make something up or you'll be nice and dead. The warning signs are there.....

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Specializes in med-surg, teaching, cardiac, priv. duty.

Agencies often just want to turn a blind eye to "problems" in a home...Money is often the bottom line, and they want to keep the case and keep nurses on the case. They don't like nurses complaining or bringing up issues, because that just makes their job harder. Just go to work and make the agency money! Keep the machine running! Some agencies are worse than others. One that starts with "M" is particularly money hungry.

To be more positive...I did work for a mom and pop agency that DID truly care about the nurses, and patients too. Situations were carefully sized up. It was great to have a supervisor who you knew would back you up, and take your concerns seriously, whatever they might be. I was so sad when they retired and sold to a national chain...everything changed then.

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You have developed a "personality conflict" with the patient/family that is getting worse by the day and you have started to get physical symptoms. (Your doctor recommends a change away from your "stressor".) Be prepared to follow up with this one.

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When I read your post, I just had to respond to this. I have worked in home healthcare for over 30 years as an RN and have dealt with many dysfunctional family situations. If you tell the agency about your concerns with an unstable family member, make sure you tell it to the case manager or supervisor for that agency. The office help has no backround to help you on this. Also, you are mandated by law to report this to DCFS or whatever agency in your state handles possible safety issues for a child or adult. Your agency is also mandated to report this, but unfortunately, they usually won't because all they want is to make money from these cases. They will not protect your nursing license. Only you can protect your license and you are an advocate for your patient. If you are caring for an elderly person, you can call the elder abuse hotline and they will investigate. You can do this anonymously also. If you don't feel safe in this home, then I would suggest you call in sick, car breakdown, etc for an excuse and find another case. Or you could ask the agency if they have any other cases available. If they don't have any other cases, then I would sign up with a different agency. No job is worth putting your life in danger and there will always be other cases where this situation will not occur. If the family member in question has a restraining order against him, I don't understand how he could be allowed to return to the home if the restraining order was processed by another family member who lives there also. If he is violating the restraining order by returning to the home, all you have to do is contact the county sheriff's department. They have the records of the recent restraining orders. They can easily pay a visit to the home and the person violating the order is arrested for violation. Either way, I would report all of this to the local police, the sheriff's office, and DCFS whether you decide to stay on the case or not. You and your patient are in danger. You will find out that most of these agencies are in this business for the money and the caregivers do not matter to them at all. For every hour you work, they are charging at least twice that amount that they pay you. This is one of the many reasons why nurses are leaving the profession. We are not valued, we are exploited as a cash cow to make money from our services, and we are left to resolve difficult situations without any assistance from these agencies. That is the sad reality with nursing today. But you MUST report this regardless of the agency's response.

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I have been reading quickly and am very tired; but are many of you really not telling your agency the dangers you sometimes face?

I had a guy pull a sword-like knife out of his pants, wink at me as if to say "don't tell". He put the knife under the chair cushion where his girlfriend (my patient with a 190/128 BP) was sitting. The patient was out of the room washing her face. She had been crying because there was a huge argument involving her, the BF and her adult son. When she can back to the room, I was standing up and told her that I needed to go. We went to the door and I whispered to her that a knife was under the cushion and that she needed to go to ER for follow-up. She said that I didn't need to call the police for her. I called the office, the primary care physician and APS. I documented very carefully on an incident report. I told the DON and the owner that it was not a safe home for ANYONE. The patient was discharged.

I don't understand you guys lying to get yourself out of a situation only to let someone else go blindly into a situation that you know is dangerous. That makes YOU worse than management. The agency can always say that the clinician initially assigned never informed them of any dangers. I am shocked and saddened by the lack of humanity. WOW! Would you not want to know of a problem?

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I am still so mad after re-reading these posts. I have learned over the years that some of us are more employable than others. When you lack competencies, skills and confidence; your choices become few. No you can't bring up issues, because you know you can't pick up and go.Those who are more employable because of strong skills and competencies can report a problem and are usually respected well enough to be heard.

Wow!! I'm still shaking my head in utter disbelief. You're supposed to know better.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

When staff are visiting a home which becomes unsafe we MUST document, notify, and remove ourselves from harm's way.

Some money hungry for profit agencies will ignore you...

but we should never ignore the warning signs of a disaster waiting to happen, and we should never knowingly create unsafe assignments for our co-workers...the issues should be discussed in a team meeting so that every discipline visiting knows the situation in that home.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Don't go back. Do not go back. That going back thing? Don't. As I am always wont to do when people ask questions like this, I post this link:

Nurse Shot & Killed on the Job in Detroit

I think the situation rises to the level of mandatory reporting. Check your state laws on that. I am so sorry-- you like your patient, but you have a family, too. {{hugs}}

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