At the home health I work for it is mostly in a rural area. Many nights we have scheduled PM visits or PM admissions.
Our nurses have been voicing concern about the danger of PM visits, especially admissions, when no one has ever been to the home before and a PI team has been put in place to investigate the concerns.
Does anyone have any insight to any verification of the danger of PM visits, such as crimes or problems that have occured toward home health nurses and night time visits?
Does you HH have a policy that ensures the safety of it's nurses in these situations?
Also we take call after working all day and are expected to be there on time the next AM? Is it the same a your HH? Example: After working all day the the other night the on call LPN had to go out and see a patient that had back to back 90 minute IVs that started at 9 PM, so at best they would complete at Midnight, plus she had to draw blood cultures and other labs and deliver them to the hospital, then drive the 45 minutes home and be back to work at 8 AM.
Any insight would be helpful.
Nov 12, '06
basically what we do, is if the nurse feels uncomfortable with the area (and we usually know what areas to stay away from at night) we voice concern to the administrator and if it is justifyable (she is very reasonable) we call the MD, tell him/her the situation and ask if the pt can be started in the morning, have yet had a MD say no., we have asked the hospital to give that dose...you can go out and do the visit get the forms signed and go back the next day to do the admission that way you are not out quite as long, but 2-- 90 min IV meds is bad, that's enough time to complete the soc...don't know if any of this helps or not
Nov 13, '06
I am an LPN so I don't do admissions so I usually go into homes that have already been checked out. But I am oncall 1 night a week and have to make PM visits. None of this really bothered me years ago, but I am getting a older and wiser. Sometimes the directions are wrong, it will say 4th house on the left and it will be the 4th house on the right. What if you went into the one on the left and it was a meth lab or whatever?
Nov 14, '06
when it comes to directions I try to make it a habit to call the home before going out and verifying address and directions - these days very few folks do not have a phone and most agencies require a phone to provide service.....I never take someone elses directions for fact....
Nov 14, '06
We do openings in the evening - the nurse on call for that night begins work around 2 pm until 10. We have never had a problem with safety in the home at night - we are also rural. We do have a supervisor on call and we have created a code word that if a staff member feels threatened and cannot walk out of the home, we have them call the supervisor and use the code word. The supervisor will ask yes and no questions and call 911. The first rule is if you don't feel comfortable, don't go into the situation or leave the home.
Nov 14, '06
one agency i worked for (in the city) has a part time guard service we could call. they would meet us at the office and follow or drive us to the house and wait outside. If we had an issue we could alert them. I do have to say that i only had a few very scary moments in almost 20 yrs as a VN, and those were in the daylight!
Nov 14, '06
I've worked for 2 different HHA and we don't do late visits. If its an IV patient and they need to get a 9pm or 10pm we let the hospitals know we don't do visits that last but we open them the following morning so usually the hospital gives them the late dose and d/cs the pt the next am. Occasionally we make exceptions and the nurse on call that day see's that admission but usually anything after 5pm they get admitted the next day. The LPN's never took call unless they were backing up a RN on a holiday.
Dec 19, '06
I am the unfortunate example of one working for an agency that does not care about the physical safety of the employees. I typically have worked night shift and have been the victim of stalking, threats, assault and battery. Some of the details are elsewhere, I do not want to divulge any more than I already have. But to this day, the same person and his associates continue to interfere with my existence. The agency terminated my employment and I am encountering hell every time I go for a new job. I find it ironic that an employer can go to such lengths to deal in a people-oriented business, yet treat the lowly employee as so much disposable garbage. Needless, to say, while I must be careful when I seek employment, (of course, I can't even hint at the truth), I no longer hand out the business cards for this employer. You have to watch out for your own safety and well being. Expect nothing from any employer. If you want the name of the employer, please PM me. I will be most willing to warn you.
Dec 21, '06
Thats why I love long term! We very rarely do any PM visits. We have one nurse that does call and it's mostly phone triage . If necessary she arranges for pt. to be transported to ER or if something minor, primary RN will visit in am. As far as safety, we can request an escort if we feel the area or building is unsafe. I have never done so and have been in some pretty shady buildings. Most of the residents there are very nice though, they know you are there to help someone in the bldg. and won't ever bother you. It also helps to make friends with security staff and bldg. superintendents.This only helps in urban areas I know
hey, what do you guys do in snowy states when it storms? Do you have to go out and do you get any help?
Dec 23, '06
My sister used to do HHNursing in a rotten part of town. Somehow, a few of the drug dealers found out who she was. They knew she was usually going to see someone's sick grandmother or grandfather so they made it their business to keep an eye on her and escort her up and down the stairs of scary apartment buildings! What ever works. I work in LTC and you'd think it'd be safe with all those little old ladies. Well, the little old ladies are now sometimes 50 year old men who are bigger than I am. We had one guy come in the building after he had been discharged --he demanded we give him some narcotics because he had used all his. Luckily the local police come quickly if we need them.
Dec 23, '06
My home care only does admissions up to 9 o'clock at night. Anything after that needs to have a good reason why we are sending a nurse out. I am the charge nurse every other week and I won't go out if I can handle it over the phone. I can't say that for all the charge nurses I work with. I am organizing inservices with our security dept to inservice the nurses I work with on safety and personal awareness.
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