Parent Insists Nurse Brings Pt to the BR When SHE Uses It!

Specialties Private Duty

Published

Wow. I just talked to another nurse from our agency who said she had oriented with a peds patient in the home. Apparently the child has to be constantly monitored because he/she puts stuff in his/her mouth and has elopement precautions. I don't know the dx, but the nurse said the parent was there, and instructed the nurse that she would have to take the child to the bathroom with her when she went because of all the precautions. I found that ludicrous, way past crossing the line, and a very easy set-up for accusations down the road.

The nurse said she didn't mention this to management, but didn't intend on going back to the assignment. I thought she should definitely mention it, because another nurse will be sent there and have to deal with those expectations.

If the child cannot be left alone for the few minutes that a nurse is in the bathroom, what are the alternatives? To me it sounds like they need a sitter AND a nurse.

Specializes in Oncology.
What if you have to poop?

I save that for home. Hopefully these are 8 hour shifts :rolleyes:

If the parent is home, is there a reason why the parent can't step in for 5 minutes while you use the bathroom?

Or, in the case of a day shift (to your manager): "The parent has asked that the child not be left alone for a moment and is unable and unwilling to even stay with the child should I need to use the restroom. The parent has asked me to bring the child in the restroom with me. I am unable and unwilling to do that. Perhaps there needs to be a CNA in house during the day to assist with the care of this child."

Specializes in Flight Nursing, Emergency, Forensics, SANE, Trauma.
Would the patient happen to be a teenage girl with an eating disorder? You've got to watch those anarexics and bulemics. Turn your back even for a second and they are up to no good.

Or PICA?

Specializes in Pedi.

The agency needs to be notified so they can set appropriate limits/expectations with the parent. It is possible that other nurses in the home are doing it and not informing the agency since some people working in PDN have, shall we say, boundary issues. When I was a manager in pediatric home care (not PDN), my colleague who managed our PDN population often found out that similar things had been going on for a long time when a new nurse went into a home and reported it. The parent then would come back and say "well all our other nurses do it." This needs to stop and is not appropriate. A parent bringing the child with her to the bathroom is one thing. A nurse doing it is something completely different.

​I would be interested to know...thanks.
Okay, I asked, and she said she never asked her aides what they did (I probably wouldn't have either, as it never would have occurred to me, to be honest). She suggested leaving the door open to the bathroom. I think NOADLs has the best solution: find a place to confine the child for a brief period of time, run and go, and then come back. Also strictly limit coffee consumption...diuretic and all.
Specializes in CNA 8 yrs LPN 6 geri, chemical dependency.

OP-REALLY sorry you're in this crappy situation, no pun intended. I've never worked in home care - barely anywhere -as an LPN, just as an STNA. That said, some options:

1-Ask your agency . At best, someone has worked with this family before and have found ways around this. Keep in mind, if none of them said anything, you may be getting a co-worker in hot water, though you certainly can't be blamed for their lapse in judgement. At worst, at least the situation will be out in the open and you'll become known as someone who's not scared to bring up potentially iffy situations vs. just wing it. Maybe there are loopholes in company policy and BON rules, though I can't imagine what. Earmuffs and a blindfold for the kid? Have them stand outside the bathroom door and humming? Have a set of walkie talkies-mute from your side, of course, and have them tell you about their day, medication side effects, etc. while they're out of sight for any reason, NOT telling them you're in the washroom? Those sound dumb, no? And that's me REALLY trying lol. I really can't wait to see what your employer thinks of as a non-worthy of its' own sitcom resolution if they won't bend on the most unique request I've ever heard of in the home care sector . Ooooo, thought of another -if any of the meds your patient is on can cause dizziness or have a potential for internal bleeding, you can do the walkie talkie thing, mute again, you in the bathroom-secretly-simultaneously -but with them talking, so if there's melena or dizziness, they can report it asap. This way, it feels like it's more of an effort towards maintaining constant safety for them. One more unreasonable but workable suggestion, unless you have gi issues or a small bladder. It may or may not work, depending on how long your shifts are. Go when you first get there, when a caregiver or relative is there to keep and eye on the patientand, do the same when leaving. I'm sure this didn't help whatsoever, but I'm just speechless when it comes to such a....... "unique" situation.

Specializes in Private Duty Pediatrics.
OK, the child has elopement issues. If he/she should decide to make a run for it while the nurse is caught with her pants down, that would make an interesting chase ...

I was being facetious, of course. No way would I take a child in while I used the bathroom, unless he was less than a year old, and secure in his stroller or wheelchair.

I had a baby once who had no gag reflex and who would forget to breathe. He had an apnea monitor on at all times unless an adult was holding him and looking at him. The apnea monitor would go off, and I would immediately stimulate him and he would start breathing again. Yeah, I brought that baby in with me. (His brain matured, and he grew up normally. :))

Specializes in Private Duty Pediatrics.

Pro-Care Craig Bed

Here is a link to a possible solution.

Disaster waiting to happen. Tell your agency that a plan needs to be made where the child is safe and you are not endangering your license, reputation, basically life as you know it. We all know it can happen in an instant when working with kids (I'm a former teacher.)

What is the parent doing at home that they can't watch their child for a few minutes?

YOU deserve to do your ADL's in private wherever you are!!

Posey also has a pediatric canopy bed enclosed on 4 sides. I can't add image!

Specializes in LTC & Private Duty Pediatrics.

What happens if the nurse happens to be a male? I'm a 52 year old male RN. Do I take your 8 year old daughter/client into the restroom with me while I tinkle? Of course not. So why should this issue be forced on the female nursing staff? Conversely, why should it be permissible for a female nurse to take a young male client into the restroom?

The whole concept of taking any patient, any age, any sex, into the bathroom with me (while I am doing my business) is completely absurd, and not happening. I drink a 2 liter bottle of diet soda at night, and pee three times during my 8 hour shift. There's no way some kid is going into the restroom with me.

In fact, I won't even take female pediatric clients over the age of 6 or 7 yrs of age simply due to the risk of potential abuse allegations. Furthermore, none of the three agencies I work with (private duty pediatric care), will assign a male nurse to any pediatric female client over the age 6 or 7.

Specializes in retired LTC.

to SirJohnny - wise precautions.

to others - don't you just LOOOOOOve it when some member posts a response that catches you totally off kilter. Like PP who's a guy bringing up various situations that just make you stop and think! Like we all kind of become a bit complacent.... TY Sir

+ Add a Comment