How would your unit handle this?

[Kim44]

I work on an in patient oncology unit. When our census is down, we take overflow medical admissions. Recently, we had a 30 year old female admitted with pneumonia for IV antibiotics. After the ambulance dropped her off, we went in to assess her. We could see something moving under her blanket. We were thinking that she brought her cat or dog. It wasnt, it was her 6 month old son!! It turns out that her and her husband live about an hour away and he dropped his wife and the baby off in Emerg and went back home to care for the other kids. Now, its 0230, this woman is febrile and SOB. She has been started on antibiotics that arent safe for breastfeeding and she brought no diapers for this baby. We call Admin and they tell us to do the best we can, call peds for a crib and some formula etc...She was with us for 5 days!! Her hubby picked her up when she was discharged. We were expected to care for the patient and help her with the baby prn. No this is not a joke. Any thoughts??

[SmilingBluEyes]

i am stupid of course, but isn't taking med patients on oncology a dangerous practice, where immune systems maybe severly compromised? please, educate me. this is an earnest question from an OB nurse, not a med/surg nurse. thanks!

[dawngloves, BSN, RN]

Wawawawhat!!!!! No Social Services involved??? Subjecting this kid to intitutional buggies??? The liability???? Oh brother!!!

[Mattigan, RN]

Do you have a Social Work Dept. I would have called ours (on call 24/7) and they would ahve helped arrange for child care through DHS or something. It is not safe care for oncology patients to be around kids. Even if he wasn't sick, I almost guarentee he was carrying some germ around. This hapens alot around here- lots of single moms- no family , college students with kids and just dead beats wanting babysitters so our Social Work Dept. pretty much has this one worked out. On Peds if we aren't having a bed crunch we'll let them keep an extra kid until morning to give them a chance to work something out. Oncology is quite a different situation and the mother was the patient so I think you needed someone to help with that one.

So.. what has Adm/Nurse Mgr. done to develop a procedure to keep you from being put in that situation again?

[Kim44]

We have been arguing this for years. We are told that a bed is a bed and a nurse is a nurse. Wash your hands and everything will be fine. I was actually able to refuse a patient once. I was supposed to admit a patient with head lice, body lice and open wounds all over his body. He also had maggots in several of these wounds. He was to be admitted to the room beside my stem cell transplant. I was the talk of the unit for refusing this patient. He went to medical and I was told that I was "dumping" the pt.

[Kim44]

We do have a social worker on the unit. We were encouraged to keep the family together. Administration has done nothing with this situation as of yet, its not over.

[nell]

What acuity did you assign this extra patient?

This is outrageous! Nurses are not babysitters!

I would have called child protective services if the father didn't come and get the kid immediately.

Your administration sucks. This situation was not good for the baby, the mom the nurses or any of the other patients on the floor.

[P_RN, ADN, RN]

If something HAD happened to the baby while there I bet administration would be singing a different tune....."Oh WE were never informed of the situation...."

What do the oncologists say about germie patients being around THEIR patients? Most oncologists I know would have raised the roof!!!! Y'all need to get them on your side.

[JailRN]

Liability, liability, liability. Your admin are a$$e$. You would have been hung out to dry if anything had happened to the mom, baby or another patient because of extra time spent with your "second pt". What in the h#%% are they thinking?? I wouold have called DCS and had the father jailed for neglect. How was his wife supposed to care for the baby??

[Kim44]

The oncologists arent happy about the situation. We are trying to be designated as a closed unit so that we dont take overflow patients. The Docs only get really upset if our beds are used up with overflow when they have to admit an oncology patient. We do what we can and try to assign certain nurses to care for these patients and not the oncology patients. Its very challenging at times!

[fedupnurse]

P_RN is so right. Had something happened to that kid their tune would be Hang those nurses out to dry STAT!! I'd have called Child services immediately or handed the baby to a suit and say, here you have plenty of assistants who can handle this little project.

What idiots. Sounds like the same mindset in suitland where I work.

[ChemoRN]

This is CRAZY on so many levels!!

First of all the fact that you are not their babysitter!! Tell them teenagers are available for that job - NOT RN's!!

We don't allow children under 3 on my oncology unit. They don't get past the front desk, period. We have a special family room where patients who have young children can spend time with their children if they choose to take the risk. This room is before you actually enter the unit and is not on our airflow system. Under no circumstances are other immunocompromised patients put at risk without their knowledge. Our docs are pretty laid back but I can only imagine the h*ll raising that would have happened in our medical directors office.

And you mean to tell me the ambulance drivers didn't know their was a baby under there?!?!?! Geez, come on!!

Besides all that (which is plenty)... A community acquired pneumonia next door to a stem cell patient? Holy cow if I were that SCT patient

We also have to take "off service" patients at times. I know, I know, empty beds don't generate money. However we are able to limit the types of patients we get to minimize risk to our patients.

thanks, I used to think my adminsitration just didn't get it when it came to oncology and stem cell patients. Boy, I have no problems compared to what you are dealing with. Your docs need to start squealing!!!