Pt's home infested with bed bugs, fleas, etc..

[RN-DC]

It's long, I apologize in advance

Went to do a SOC today and the patient's house was not only a home that was tough to walk in due to the hoarding (which doesn't bother me. I've been in several hoarders homes), and realized within a minute that the place was infested. Every chair I tried to find to sit on had multiple bugs ( bed bugs, fleas, etc...) crawling on them. The floors had bugs on them. The walls, bed, everything. I was there to do a wound dressing change and noted a dead bed bug on the abdominal dressing. I was, to say the least, disgusted.

I completed the SOC, left, and called my company immediately to alert them of the situation. I said I didn't feel comfortable going back to do the daily wound changes unless they take care of the infestation ( I did try offer to call pest control and the pt refused. I offered to get them numbers of different pest places and the pt refused stating he sprays) . At first my director stated we still needed to provide the dressing changes. I called the LPN who would be splitting the days with me and she is justifiably refusing. I alerted the DON and she said she'll put the pt on hold. Which is good, but now I'm concerned. The pt does actually need someone to do his dressing changes.

QUESTIONS:

1-Is it right of me to refuse to go until the situation has been resolved, or is this what I should expect doing Home visits? (I'm new at the home visits) If I should still go, has anyone dealt with this and what precautions did you take?

2-Should I call the department of health? If I do that, will they assess and fumigate for free or will the pt be charged? I want to get the okay from the pt first, but doubt that will happen if he has to pay. (he'll probably refuse either way) If they won't fumigate for free, is there a way to get it done without the pt having to pay?

The house is probably going to be condemned if the DOH goes out there. The pt lives with 2 brothers. I would undoubtedly be ruining their lives. However, the Bedbugs ARE TRYING TO GET INTO HIS WOUND. (a very large abdominal (dehisced) wound).

ANY info, suggestions, opinions will be appreciated.

[Libby1987]

We would though make sure we check all equipment and ourselves to make sure we don't have any "hitchhikers". We've put ambulances out of service to allow crews to shower and change after exiting certain residences.

Yeah, Paramedics and EMT's are further up the food chain than RN's,(LOL) It would be a cold day in hell before a Home Health manager allowed the RN to "go out of service" to clean up equipment, car, go for a shower, change clothes. Pity the next patient when the hitchhikers find themselves a new home.

BTW, the night I was mugged in a drug infested project building, and it was at night, my manager said that if I didnt go see the next 2 psych patients on my schedule that I would be fired for "abandonment". I took a good punch to the side of my face which broke my glasses and knocked my jaw out of alignment but I kept working. Had rent to pay, food for my child.

What??! I can't imagine my manager treating me like that. Or it even being legal.

Not all employers are like that, it would be a cold day in hell before I wouldn't be encouraged to go home and change my clothes.

[CecileSF]

After reading these comments, I'm worried about my home health job. My future client is going through bed bug treatments and I'm told to start work after 2 weeks when all the treatments will be over. 2 weeks doesn't seem like enough time to get rid of the bed bugs. But the authorities were notified so I'm hoping they have good pest control. There is so much to think about, like re infection and the clients confirmed unwillingness to throw away items in the house. You can never be too careful. My thoughts are with all the people in occupations where they have to go to other's homes

[AtlantaRn1]

Never again will I ever kneel next to a pts bed without a barrier. I know better. Myself n 5 other caregivers got scabies. I, however, am the only one that brought a bed bug hitchhiker home. Pest control quote is $900 for heating my home to 130 degrees to kill the critters (I'm the only one getting bit-thank goodness)-pest inspector said this was caught early 🙌🏻

[msteeleart]

I just quit as an RN home health case manager in June to go work at an office at an insurance company. I will not miss going into filthy, insect infested homes. There were many nights when I was wondering if I brought bed bugs home and what I would do if I did. I did this job for 2 years and never got a raise, just a pay cut, I enjoyed the freedom and flexibility but it just go to be too much especially when they expanded my area and increased documentation requirements. I feel bad for the patients that need the care because with the decrease in pay, the care will just get worse and there will be increased turnover.

[AtlantaRn1]

Bless you. You've gotta do what you e gotta do. At the end of the day-if we don't care for ourselves we really cannot give to others. After 21yrs I've considered other settings to hang my shingle. I'm ultra conscious now-this weekend every time I was able to return home-scrubs were washed on hottest setting n I showered. I eventually I'm hoping I will be an educator with my company. Until then I've gotta be diligent w standard precautions.