Feeling Concerned for my safety.

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Long story short one of the case managers who is an RN went to the home of a patient to do a supervisory visit. Pt's grandson who is supposed to be taking care of the patient claims he did not know who the nurse was after she knocked a few times despite her name tag being on and her verbally identityfying herself. He then proceeds to come back to the door with a knife and waving it at the nurse. She gets concerned and goes out to the car to call the Daugther who then apologizes for the grandson's behavior who is her son. So the nurse proceeds to go back to the home to knock on the door to gain entry to the home. He opens the door and then slams the door back in her face as she is trying to walk through it. She feels unsafe and leaves. What is the proper protocol for this situation? My issue is if somone waved a knife in my face they could very well use it.Under no circumstances would I have gone back into the home a second time.

Now this person is also getting out of pocket with me and displaying very threatening behaviors. I sent an email and called my supervisor to tell him of th situation and I do not feel comfortable going into the home any longer. I have not yet heard back on what they plan to do.

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Are these mandatory visits (as in required by insurance or another governing body) or did the family sign up for these?

If mandatory, I'd say you have 2 options.

1) Call for a police escort.

2) Call adult protective services--they can go out with a police escort to investigate.

Otherwise, if this is something the family has requested, it sounds like time for a meeting with the daughter. I don't know how old the grandson is, but unless he's hiding something or mentally ill, pulling a knife on someone is not what I'd consider normal.

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The patient has a MD orderd therapies and nursing visits. This person appears to be in their 20's. He's off which I would agree with and probably may even be on something. His behavior is very off. The patient is also neglected as far as care being provided by grandson.

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The story is odd to me. Why would her reaction to a man waving a knife at her "get concerned"? That seems like quite the under reaction.

I can't imagine my company not taking some kind of legal action including immediate call to LE for the patient's protection.

I also can't imagine calling the family versus my director over the incident.

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I don't understand it either. It baffles me why she entered the home a second time. I have never met this nurse but her behavior struck me as odd as well. I would have called the policce.

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Specializes in NICU, PICU, Transport, L&D, Hospice.
Long story short one of the case managers who is an RN went to the home of a patient to do a supervisory visit. Pt's grandson who is supposed to be taking care of the patient claims he did not know who the nurse was after she knocked a few times despite her name tag being on and her verbally identityfying herself. He then proceeds to come back to the door with a knife and waving it at the nurse. She gets concerned and goes out to the car to call the Daugther who then apologizes for the grandson's behavior who is her son. So the nurse proceeds to go back to the home to knock on the door to gain entry to the home. He opens the door and then slams the door back in her face as she is trying to walk through it. She feels unsafe and leaves. What is the proper protocol for this situation? My issue is if somone waved a knife in my face they could very well use it.Under no circumstances would I have gone back into the home a second time.

Now this person is also getting out of pocket with me and displaying very threatening behaviors. I sent an email and called my supervisor to tell him of th situation and I do not feel comfortable going into the home any longer. I have not yet heard back on what they plan to do.

I found it reasonably common, in both hospice and home care, to encounter families who had an adult family member with mental illness residing in the home of the person receiving the care. Sometimes the family has engaged that person to provide some of the care as they are often available during the day when employed adults are not available.

In any event, your agency should have a policy and a plan for staff safety in these type of situations. In my experience I have worked with employers who;

-paid a security company a stipend to be available for staff escorts in the more dangerous urban areas or into homes considered unsafe.

-requested that staff contact police when they feel threatened.

-made arrangements for a minimum of 2 staff members to make each and every visit...no solo professionals in the home.

Personally, if I feel unsafe I leave and immediately notify the employer of the situation while documenting every detail of why I was uncomfortable.

I also carry a weapon in my vehicle and have been known to conceal carry when on the job when working in a majory urban setting.

I have a friend who was assigned the care of a DM/cardiac patient in her VERY rural home. When she arrived she realized that the woman was poorly compliant, agitated, mentally ill, AND lived with her mentally ill adult daughter who was violent having recently drowned her mother's cat because she didn't want to empty the cat box any longer. She had no cell coverage at the home and the house/parking area were not visible from the road. She refused to continue to go to the home alone when the agency refused to send another staff person with her. The agency ultimately fired her for that...right to work and all that.

Good luck, be safe, the world is full of crazy people

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Yes, encountering someone waving a knife at me from the door would be my cue to leave and not go back until there was a plan in place to ensure my safety, I don't care how sick the patient in there is. The area we cover is very, very urban so we don't have the problem of homes being isolated, but we do sometimes have problems with very sweet and safe patients living in very unsafe buildings (ie. lots of folks selling lots of drugs; large vicious dogs who may be leashed or unleashed to protect those drugs; neighbours with unstable mental illness who might find us threatening). Usually our first response is to send two people in. If that won't do it, we have a security company who can travel with us to those visits, or in worst case scenarios, police can go in and check things out before we go in. We have also met with folks in their building's hallway, or lobby, or their building manager's office, or the drop-in centre next door, etc if we just absolutely cannot wrangle a safe home situation.

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Specializes in hospice.

I'd say the nurse in this situation needs some intervention as well as the family. Waving a knife at me is a ONE STRIKE offense. No one gets offered a second chance to kill me. And yes, I'd be on the phone to the police because threatening me with a knife is a criminal act. If my employer fired me, well hallelujah, because I found out they don't give a crap about my safety before it's too late and I can move on. You better believe I'd fight tooth and nail for unemployment benefits, too, and I'd win.

I think the daughter should be informed that as long as her son is there none of our employees will be making visits.

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The patient has a MD orderd therapies and nursing visits. This person appears to be in their 20's. He's off which I would agree with and probably may even be on something. His behavior is very off. The patient is also neglected as far as care being provided by grandson.

First, don't even go to the house, it's not worth the risk to your safety. We have a discharge option "discharged due to unsafe environment or safety of staff". My agency first and foremost stresses that we should not enter (or re enter) an unsafe situation. No ifs ands or buts. If there is an immediate danger for the patient, call 911, report the situation to the police, and ask the patient be transported to hospital for evaluation. If there is no immediate danger to the patient, but neglect is present, call whomever is your local organization for preventing elder abuse, usually found on your states health and human services website (your agency hopefully can help you locate the right place). You are a mandated reported of suspected or witnessed abuse, including elder abuse.

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Specializes in Pedi.

If someone came to the door waving a knife at me, I would leave and make a call... but that call would be to the police, not to the patient's daughter. I also would not approach the house again with a known violent person inside.

I actually did once have a patient's mother come to the door with a knife in her hand... and of course it's the one patient who's in state custody because of a report of neglect that I filed... but she went right back to peeling potatoes as soon as she let me in and certainly never waved it at me or threatened me with it.

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I told my supervisor under no circumstances would I set foot back in the home. It's not worth the risk. Will they fire me? Probably not as they can't find reliable staff as it is. He told me they were still investigating the incident. Personally they should have dealt with the situation properly a month back when the nurse was threataenend with a knife. He's a nutcase waiting to explode.

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That is my next step to report the neglect. I have not witnessed abuse at this time but who knows. The crazy grandson then said the reason why he had a knife in his hand was to protect his grandmother. From what? A nurse who identified herself? His crazy story makes zero sense. If he was that worried about her safety why not call 911 if you want the agency off the property? Bottom line he's shady and doesn't want us to see what is reaally not going on in the home. He has expressed he doesn't want us there. I think he is in way over his head and needs to relinquish his responsibilities. This pt has advanced dementia and lives with her grandson in her own home. I'm like sell the patients home and put her in an alzheimer's facility or memory care assisted living.

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