I'm a private-duty home care nurse working for a small agency. My patient is a six y.o. boy on a ventilator, an adverted SIDS pt. who is quadraplegic and gets tube-feedings. He is unable to move at all, except his fingers a little and stretching.
At first, the family (Dad and Mom), seemed nice. They do live in a poor, dangerous part of town. She works, he is around the house, mostly drinking and playing poker on-line. They were somewhat critical of me, "we don't put the blanket on like that", or the window, door, or "leave him alone, let him rest!" when I would do even what I needed to, (pulse ox readings, assessments).
After a few months, I found I was getting yelled at almost everytime I was there, by the Dad. I also smelled pot occas. I saw arguments between the parents. And I came to realize when the evening nurse left at night, the parents didn't do anything and the pt. didn't get care 'til the nurse in morning arrived, (other than, hopefully, they were listening for alarms from the ventilator).
I talked to my supervisor about the Dad being angry with me, and especially smelling pot. She callled him to address the pot issue, he denied all. She was subsequently not supportive with me. Next day, I got yelled at, "this is our house, maybe we have pot, heroin, coke, it's none of your business."
I was there 4days/wk, went down to 2/wk. (for other reasons, but thought things might improve,too.)
Not so, still anger toward me and in general. I witnessed Dad and Mom at pt.'s bedside having a argument. Dad said, "mama better behave or I'll wrap this around..." & he wrapped the pt's ventilator tubing around his neck. She said, "stop it!". I was still smelling pot each time I was there. Mom was sometimes passed-out sleeping.
Last week, the pt. didn't void the whole shift, (usually has no problem voiding). The room had been very cold. He started to vocalize as if crying. I called the office for advice (should I get an cath. order), to report no void/crying and was referred to calling another nurse who works with him more. She is kinda an enabler with the family, but sadly, though, provides more care for the pt. than his parents. She said he's done this a few times before, (but hasn't for 6 mo.). When leaving, I gave report to Dad, told him pt. hadn't voided/was crying. I was trying to be reasuring and said I had called the other nurse and agency, if they need anything during the night, they could call them. Well, I got my daily verbal lashing- "Don't call them, Don't tell on us.. you think you know my son better than me... he's fine.." Shaken, I left the house with echos of the pt.'s crys/whimpers in my head, regretfully. I worried all wk. Today, the agency called me off. My pt. has been in the hospital since the morning after that eve I left last wk. He has pancreatitus. Who knows if he suffered all night, (he had finally voided, though), but when the other nurse came on, he was getting unresponsive. She told the parents, something's wrong, and said he had to go to the hospital. They nearly lost him and have had him on Dilaudid for pain, with other tx, too.
I think the pt. is fully alert, which makes all this worse. He reliably answers questions with thumb movements.
I afraid for my pt. that his parents don't really care if he suffers. He is a pay-check to them (Fed SS money). They don't seem to want him to get better, very resistant to any therapies, like they just want him to lie there. Due to drug usage or up-bringing, they seem unable or unwilling to care if he's in pain. And they should have taken him to the hospital that night, based on that they nearly lost him.
He is scheduled to go home tomorrow. I feel like calling the hospital and telling them about his parent's drug usage and lack of giving care. Is he safe there with them high? My supervisor has already dismissed this, so she is no help.
These people are the kind that would probably come after me, (there are guns in the house).
If I quit all together, I will feel like I'm abandoning my pt.
