Hi all. I have an elderly patient who recently had a stroke, lives in a mouse and roach infested house, lives alone with no family able or willing to help out, is weak and confused, can't keep self clean, can't remember to take meds, very unsteady on feet, can't remember to use oxygen or walker. Patient was at a long term care facility, but was discharged back to that house. According to the powers that be, patient didn't want to stay at the facility, so they had no option other than to let patient go back. Facility never performed a psychiatric evaluation or competency evaluation on patient. I made a report to APS. I called my boss to report that I'd made a report and got an earful. According to the boss, I had no right to do that, it was a social worker issue. When I made the report, the intake worker couldn't find patient in the system, though I'd been told repeatedly that the social worker has filed reports prior to mine. Boss was very upset with me. I said, "I'm sorry that you're upset with me, but I feel that I have to file a report to cover myself should anything come up legally." Was I wrong to do this? I suppose boss is peeved because my filing a report makes our agency look bad, but what choice did I have???? It is MY license. Any feedback would be appreciated.
My state is a mandatory reporting state and I have called Elderly Protective Services twice in the past year. The only times I have lost sleep with the two cases I have reported are the nights before I knew these two people were safe and being taken care of. I get rather worked up over stuff like this and I don't hesitate to call the authorities. So far, administration has backed me and if they ever decide not to, I will find another job.
Bottom line, you as a healthcare professional have an obligation and right to report something like this, you shouldn't need to clear it with your manager or anyone else, in my opinion.
this is the bottom line.
yrs ago, i would announce who i was reporting to aps/cps.
i was stunned to learn of the resistance i met.
since then, i do what i'm supposed to do, and don't share it with anyone.
next time tencat, just do what you need to do....privately.
it's truly scary, the lack of concern and advocacy out there.
When I worked in home care, and witnessed poor living and physical conditions, I would always discuss the case with my manager and request a social work consult.....unless it was a life compromising event.
You did what you felt was best for the patient. Others may not agree, but so be it.
Is there a policy in place at the home care company you work for that outlines what to do in this situation? Maybe your supervisor feels you went over her head.
Either way, you can feel confident that you were advocating for the patient. You were doing your job.
yrs ago, i would announce who i was reporting to aps/cps.
i was stunned to learn of the resistance i met.
since then, i do what i'm supposed to do, and don't share it with anyone.
next time tencat, just do what you need to do....privately.
it's truly scary, the lack of concern and advocacy out there.
leslie
I reported a patient to CPS years ago when a pt's husband brought in her new baby to visit, and it had what looked like a burn on it's face, and the husband was really evasive when I asked him about it. I discussed it with the charge nurse who was very against it, and was really down on me for doing so, inspite of the fact that the patient's other children had already been removed from the home. Turns out she (the charge nurse) had been reported by a church Sunday school teacher after her bratty pre-teen daughter had complained to the teacher about her mean, abusive mother.
I really felt obligated because I had strong suspicion, so I wrote down the name and reported it from home the next day.
In CA nurses are mandated reporters. I'm assuming it's the same in all states. Nurses do not have to confer with anyone else if abuse or neglect is suspected. If abuse/neglect is proven later on and it comes out that a nurse knew/suspected and did nothing----regardless of WHY s/he did nothing----that nurse is in deep doo-doo.
If APS deems everything is AOK once they investigate and that the woman is competent and this is her choice then no harm is done. On the other hand if they decide that is not the case then your boss is wrong.
It is never wrong to report something you suspect it is always wrong not to report when you suspect something. It is the law you are a mandated reporter.
If your boss is angry then more is going on here than meets the eye. In other words she is more concerned over $$ than the patient's welfare.
The laws in each state are very clear on mandated reporting. None of them say to "have a meeting and decid" or to "get a supervisor's approval". No they say report it if you suspect it.
At work today something along this line came up in discussion, and I was discouraged from taking action, to include notifying the social worker, by my boss. Know that when the time comes, will have to make that anonymous report. Never ceases to amaze me how mgmt will tell us what our legal and ethical responsibilities are from one side of their mouth, while simultaneously telling us not to ever rock their world, out of the other side of their mouth. Hypocrites, every one.
Thanks for all your support and insight. I know I did what I should have done (legally, morally, etc), and I am not sorry I did it. HOW I went about it was not the best way, but I'm still learning to negotiate the world of nursing politics. I learned a lot from the experience, and if I have to do it again, I'll be better prepared. I DO really care about the patient, and I want the patient to be in the best and safest environment. I guess I'm a little jaded from working out in the real world (years as a public school teacher), so I realize that CYA is very, very important......So am I 'self serving'? Maybe. If I don't look out for myself and my license, who will? But that doesn't mean I don't care about the patient and the situation that the patient is in. Truth be told, it breaks my heart that patient may have to be removed from the home. Patient lives with pets who are very dear to the patient. But patient can't take care of self or take care of them adequately due to illness. No one 'wins' in this situation, I can tell you.
Thanks for all your support and insight. I know I did what I should have done (legally, morally, etc), and I am not sorry I did it. HOW I went about it was not the best way, but I'm still learning to negotiate the world of nursing politics. I learned a lot from the experience, and if I have to do it again, I'll be better prepared. I DO really care about the patient, and I want the patient to be in the best and safest environment. I guess I'm a little jaded from working out in the real world (years as a public school teacher), so I realize that CYA is very, very important......So am I 'self serving'? Maybe. If I don't look out for myself and my license, who will? But that doesn't mean I don't care about the patient and the situation that the patient is in. Truth be told, it breaks my heart that patient may have to be removed from the home. Patient lives with pets who are very dear to the patient. But patient can't take care of self or take care of them adequately due to illness. No one 'wins' in this situation, I can tell you.
Just an idea that may be of some comfort to this patient. Some pet rescue agencies or SPCA's have volunteers who will "foster" pets until a new home can be found. A phone call or two might find some info on this.
grammyr
321 Posts
My state is a mandatory reporting state and I have called Elderly Protective Services twice in the past year. The only times I have lost sleep with the two cases I have reported are the nights before I knew these two people were safe and being taken care of. I get rather worked up over stuff like this and I don't hesitate to call the authorities. So far, administration has backed me and if they ever decide not to, I will find another job.