Filthy Home with Pet Rodents

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Luckily, this is not my case but before this patient was opened for services, I told the primary nurse that I'd substitute for her if needed. She saw the patient today for the first time. Upon entering the home, she was faced with several cages full of pet rats, 30 of them. The house was very unsanitary and rat droppings were dropping onto the floor out of the cages. The patient has open wounds. This is a nurse who is new to home health.

My opinion: I would have called my supervisor and reported the rat problem and that the case should not have been opened for services for the safety of the nurse (not to mention the gross out factor of dealing with all those rats, who are situated in the same room with the patient). The primary nurse plans to call the office tomorrow and report the home conditions. My question: should this patient have been taken under care? What would you have done?

I've been in home health for many years and have only refused to go back to a patient's home on two occasions. One was a mentally ill person with a gun in one hand and a bottle of booze in the other and the other was a cockroach infested home that was so full of cockroaches that the wood paneled walls appeared to be in motion with them. So my tolerance for filth is pretty high. But I'm not going to help her out with this patient!

I would have phoned my supervisor from outside the front door of the home and reported the situation when I told her I would no longer be working with the case. The agency could have stipulated to the patient and family a minimal standard for cleanliness of the patient's immediate area for them to service the case or offered assistance with finding another agency. As a minimum, the animals should have been removed from the patient's immediate area. We can't force the family to maintain a clean home, but we can inform them what the minimum standards are to receive nursing services. One of my former employers actually had a statement in the contract that stated the client's living area (to be more precise, the contract actually said "home") had to be clean and sanitary to receive services. I think that is a reasonable request.

a call to the health department or human services.

Specializes in Hemodialysis, Home Health.
One of my former employers actually had a statement in the contract that stated the client's living area (to be more precise, the contract actually said "home") had to be clean and sanitary to receive services. I think that is a reasonable request.

Wow... don't know that I could agree with that..speaking "as a nurse".

People deserve to get the care they need... and it is often those with homes like these who need it most. I know several yrs ago in my area there was a LOL waaaaaaaaay on top of the mountain ridge (you had to walk forever through the snowdrifts to even get to her) who was found by one of our nurses to be lying inside her home with rat bites all over her...pitiful circumstances.. lived alone, quite elderly. She was not responding to the nurse's knocks at the door.. she peered through the window and saw her lying there. The nurse crawled through the window to get to her... and had to beat off the rats to tend to her while she waited for 911 to respond.

I know this is extreme, but is anyone really "not deserving" of care? We just don't know what their circumstances or their life story is. And in different parts of the country there are most certainly geographical/cultural differences in what is considered "normal". We have one LOL who keeps a pet rooster in a cage in her little shack... not to mention the multiple dogs, cats, etc. (and their waste) These "pets" are all she has. She is considered mentally competent and refuses to go to a NH, although her living conditions are deplorable. But she deserves our care. If we don't, who will?

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