Published Feb 24, 2014
So, this weekend I've been filling in for a patient new to the agency while my main patient is undergoing surgery. I was warned the location was small, cramped, dirty with an inexperienced mom and another young child who likes to unplug vent circuits. No worries, I can charm the pants off even the grumpiest, most neurotic parents, and thanks to many years spent in hospitality, I've learned to navigate around rambunctious little kids.
What I wasn't okay with was the filth and roaches. They are everywhere, big fat roaches and the skinny little German cockroaches, I've counted at least four different species, and I'm pretty sure this is either roach Woodstock/hippy drum circle or an attempt at building an advanced civilization to take over the world.
The patient is a sweet little premature baby, vent-dependent, post-pneumectomy, major respiratory issues and still recovering from neglect suffered by either mom or another agency (severe skin breakdown to the point of scarring on buttocks and infection of GT/Trach and eyes). She gets 24 hour nursing, but there was a 12 hour lapse. I left her at 7am, was back at 7pm, walked in the house and found roaches ON the patient, inside the suction equipment and running up and down the pole with her feed. Mom completely ignored the situation, flounced back into her room and hasn't been out since. She has openly stated that she will not be making any efforts to clean the place up.
I've chased off the bugs from the pt/equipment, sanitized everything to the best of my abilities, and taken pics (not of the patient or of any identifiers), but of the filth, congealing food on every surface, and the bugs. I'll be calling the caseworker and agency when my relief gets here (hopefully soon, because I can't use the bathroom with roaches skittering across the seat). I'm also contemplating an anonymous call to CPS.
Anyone ever been in a similar situation? How did you handle it?
meanmaryjean, DNP, RN
Does the agency KNOW about this issue? If not- they should be notified first. But if nothing is happening there, CPS needs to be involved for the child's sake.
Sounds like the kid maybe needs to be admitted while the home is cleaned and fumigated. The other child is in danger as well.
They know the place is filthy, and the way they warned me in advance makes me suspect they are aware of the roaches. But I'm going to bring it to their attention nonetheless. It's crappy government apartment housing and the building is old, but filth is filth. If it were a stand-alone house, it would be a simpler matter to deal with, but it's an apartment.
I really hope my agency steps up and does something. I can't in good conscience leave a patient in this situation. It's a case I'm only on for a few days, so I may not know if the problem is corrected.
Let me tell you, when I read your vivid description of the surroundings I was thinking two things, one, boy she must be great at documentation, and second, that is scarier then watching american horror story in a strange house with moaning from the grandmother in the next room. What did you do with your things? Make sure you go thru your bag outside of your car and home, you only need one "follower" to bring home. But back to the patient, what a heartbreak! I don't have any advise as private duty is new to me and I am just getting my feet wet with it. I have only had one patient and reading the posts here, have come to recognize my blessings. Kuddos to you for going back and staying the course.
uRNmyway, ASN, RN
Omg...I agree, I think this needs to be reported to CPS. The conditions you described sound unsafe and unsanitary even for a healthy child, but a preemie on a vent with trach?
I'm just...flabbergasted that this person hasn't been reported. I mean, I'm no Holly Housewife myself, but I'd definitely make the effort if I had a sick immunocompromised child at home! I'm so sad for those poor babies...
Advocate for the patient.... Who obviously can't do it for themself!!! Those conditions sound abhorrent and you don't want that on your conscience.... Wondering if there was more you should've done. Def let the agency know but don't let them just brush it under the rug. CPS exists for this very reason.... I think they're a resource you should definitely refer to.
Advocate for the patient.... Who obviously can't do it for themself!!! Those conditions sound abhorrent and you don't want that on your conscience.... Wondering if there was more you should've done. Def let the agency know but don't let them just sweep it under the rug. CPS exists for this very reason.... I think they're a resource you should definitely refer to.
I actually haven't left yet, still a couple more hours to go.
If I'm completely honest with myself, I don't think the agency will do anything unless I'm adamant about follow up. We'll see how that goes. In any case, it will be a first for me to document: "pt received laying supine, roach on pt's right arm laying prone"
I've only been in PDN for 6 months but OMG, I think I would do everything possible to rectify that situation, including calling CPS. That's not just dirty but completely unsafe and even life-threatening for the child.
What did you do with your things? Make sure you go thru your bag outside of your car and home, you only need one "follower" to bring home. But back to the patient, what a heartbreak!
I brought no food, just a few sealed snacks and a few cans of soda, all stored in the fridge triple bagged in ziplock, because even the fridge is disgusting. I was too leery of all the dishes shoved uncovered into the fridge after watching them languish at room temp for a disturbingly long time. Thanks for the reminder about checking my bag! I will look for hitchhikers!
Also kudos to you for even sticking it out at your shift. I can handle a lot of things with a straight face, but roaches is the one thing that gets to me (shivers)
Retired APRN, MSN, RN, APRN
What is your status as a mandated reporter and an agency employee? Do you need to report only to your agency or to CPS as well?
If your description is accurate, and I have no reason to think that it is not, that child is in a clear state of neglect and the mother may not be competent to care for a child. Please let us know how this plays out.
Poor little mite...
Esme12, ASN, BSN, RN
I think a report as a mandated reporter is in order. The whole thing has made my skin crawl. Keep everything off the floor....although by your description they are everywhere...yuck
That poor baby
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