Published Sep 17, 2004
You are reading page 2 of Home Health Nurse Safety
renerian, BSN, RN
Your post was very kind. I can tell you really care for your patient's.
How timely I found you!--I have worked since 1988 visiting patients in the home--both daytime-and night call. This past week, I received an assignment to case manage a patient living in a apartment complex where 2 homocides occurred 2 weeks prior. Per the local police, there is not escort availability and they cannot advise safety guidelines;there are 8 pages of reported crimes in this complex since jan 08--even after all this safety risk info, our manager wanted to offer a scaled back plan for one RN visit per week (throw me under the bus). It is high time we respect our nurses by providing a look at safety and crime. I recently participated in a new study assessing safety risks for nurses visiting in to home. It assessed some but not all potential risks. It did not even ask if the management supported or practiced assessing area safety...but it is a beginning
how nice of your manager to pick the one day of the week for that RN visit when she knew there would be no crime!!!!!!!!!!! i know there has to be some agencies that take staff safety into consideration, we just need to find it!!!
What are our right regarding safety and refusal of visiting in an unsafe area and what it the suggested procedure...so as not to 'abandon' the patient. Are managers supporting this right of individual nurses to decline an unsafe visit area? Does anyone have stories on this? My direct manager was very glib about the issue of my safety--with the "...we can't abandon her...she needs us..." comment first and foremost. I love my work, but I am not prepared to face this risk. Our safety must come first or our ranks will dwindle or be filled with martyres
Just started a new case at new agency, and had an incident with a son of the patient I care for throwing a fit and breaking their door while I was there. A lot of yelling and stomping. Luckily this happened at the end of my shift. I called my agency next day and explained situation. I was a little scared to go back and Im a tough girl. Basically, all they did was notify some people in the office, were going to send out RN supervisor 2 days after incident, and talked to wife of resident. That didnt make me feel any safer! The agency said, if anything happens walk out of the house and call us from your car. AND dont hesitate to call the police. My feelings: should I be even going to a house where this is a possibility? The wife was mad too after the agency's talk with her, which made my situation even more uncomfortable. Not even much of an apology from the previous day. AND the son was back at the house the following day after the incident! Luckily, he didnt get angry. All weekend I was very depressed and upset, and dreading going back. I went back today and wife talked about the situation with me more and I feel better. Im still debating about this agency...is there an agency that actually cares about their nurses' safety?
Rachel--We are in the same process right now at my agency. Though our managers did look into safety considerations by going to the local police to look up the crime history of the building where my assigned patient lived (prior post---2 homacides in the same complex 2 weeks prior my patient admission.) They were still insisting we needed to offer a scaled back plan which was directed at 1 RN visit per week. I declined the assignment as still too unsafe given the several pages of crimes at this complex. I am being called in to talk with my manager this week about "some of her concerns..." I know what is coming.
Still, we have the right to decline an assignment--then it is not abandonment if we did not accept it--and we also have the right to not visit when there is significant safety risk.
This is new territory---staff safety. It will only change if we field nurses insist our safety is paramount.
Advice--contact your Employee Assistance program coordinator and verbally document all your perceived threat and safety risk, lost sleep depression, each conversation you have to address all with your managers and their responses. You have the right to have your MSW manager address things with the patient and son before going back. Insist they make policies--beginning with this case. We had one similar to this one--except it was the husband--and the s---hit the fan eventually and all was investigated...you know who they blamed for not enough reporting the problems??? you guessed it--the nurse.
We all can address this with the American Nurses Association, the Board of Regisiotered Nursing and whoever else has the power. If we don't, you can bet, they won't---it is a tight budget! Good luck
I know its years later, but I don't think this is a confidentiality issue, since the patients name, DOB, SSN, DX, TX, MEDS are not being given to the police. The house owners name is not protected (and truly doesn't have to be provided to the police.) The address is only protected when connected with the name of the patient. Your thoughts?
i am a new HH rn and i was opening a case in an abandoned building and the drug landlord and his croonies were outside "dealing" in front of the building i was going to walk in.my patient got hit by a bb gun on the left arm a couple of years ago...i told my agency and they said they will cancel rn visits and just send PT there....but wanting me to stop by to "talk" to me....
my agency are all GREED...the owners are not even licensed MD OR RN...and they are billionaires...for 45 dollars a visit and a 5 dollar mileage and get hit by a STRAY BULLET ...i dont think so....
Missouri has the answer...THE RIGHT TO CARRY an CONCEALED WEAPON. Only kidding..... :) Can you see that headline? "Local Hospice Nurse Shoots Mugger on Way to Patient." LOL!
years ago when i did skilled visits in an urban area we were allowed to not visit if the area appeared unsafe.. we simply needed to document such and inform the ordering physician . walked into more than one drug deal in a hallway...most of them just nodded and said "hi nurse" as i quickly walked by!! we eventually either doubled up or called an on call security guard. they werent much help so we usually just did the scary visits together as a co visit.
I am managing home health care in Jeddah, Saudi Arabia. Our nurses go out to some very dangerous places, where there is no security, no running water or sanitation. Recently, two of our staff had stones thrown at them when entering a home. The persons throwing the stones were neighbourhood boys. I would be interested in hearing whether others have experiences anything like this.
In Northern Ireland the ambulances have grills on the window due to foreign missiles frequently coming their way. These are not military ambulances - normal everyday community ones.
Some places are just more risky than others and it has to be judged whether the risk of attending known trouble spots is worth it with the level of security that is available.
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