Roaches ON the patient

Specialties Private Duty

Published

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?

Specializes in Clinical Research, Outpt Women's Health.

Thought about this all day yesterday. Just so horrible for this poor baby. Sheesh.

Specializes in Emergency, ICU.

Wow. I am speechless. Let us know how this turns out but I do hope you call CPS. This is clearly a mandated report scenario. As someone else said, I also feel this baby needs out ASAP. I would have called while still in the home and waited for the response to make sure kids are ok.

I would document everything, including call to CPS and my employing agency in case said agency decided to fire me. I would go to the DA right away to report that agency for client neglect. That's not humane treatment of any person and if the agency was aware... Oh how angry this makes me.

Specializes in Medical Surgical.

Call them. Don't hesitate! Even if nothing ever gets better, at least you did something.

Specializes in LTC Rehab Med/Surg.

Call me naive. An agency would fire you for reporting neglect in a home health setting? I'm almost as outraged about that as I am about the roaches.

Specializes in Gerontology, Med surg, Home Health.

Did you have to use the word mite!?!

Specializes in Med-Surg, Ortho, Subacute, Homecare, LTC.

I heard if you step on a roach the eggs can get stuck to the bottom of your shoe and end up making a second home at your place!!!

:scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying::scrying:

Specializes in Pediatric Private Duty; Camp Nursing.

I find it unbelievable that out of all the people that have dealt w this case, including the medical supply company, nobody stopped this scenario from happening. I have heard of roaches entering trachs, very clear choking hazard. My hubby used to in pest control; the egg-stepping thing is an urban legend. But the risk for spreading the infestation is high nonetheless. Be sure your clothes go straight into a plastic bag at your front door and right into a washing machine! Keep it sealed if you can't do wash right away.

Specializes in Psychiatry, Mental Health.

There is not enough soap and hot water in the world for me right now. :(

Please let us know how things go!

Specializes in Pediatrics.

Thanks for all the replies, folks! Just wanted to update the situation:

I was little (and by little, I mean A LOT) frustrated when the case manager didn't return my calls/messages, so I went down to the office after my shift ended and very sweetly, very conversationally asked HR if there was a particular DCF/CPS number they preferred I call to report. Then, miraculously, the case manager got my number. We went over the steps the agency had taken, the steps they would take, and pest control and traps were set out that day. Exterminator is going to revisit the apartment. Case management went to the site to assess the patient. They are attempting to have the baby moved away from the kitchen area (where the concentration of bugs is highest) and into the bedroom (where a nice clean crib is that for some reason Mom was adamant about us not using). The equipment company has been called to come check the machines since the roaches have been taking their evening jogs up and down the enteral feeding pole and suction machine. Plastic tubs have been brought in to protect supplies/meds, and one fantastic nurse came in to set up and organized the entire space so it doesn't look like a cringe-inducing pigsty anymore (although Mom was too busy getting new hair and nails to assist). The food has been cleaned up and the floors cleaned with bleach.

I also found out that DCF has been called in the past, but no action was taken because the building was considered to be a contributing factor to the bugs (reeeeaaally run-down low-income housing), and the patient had no bug bites. Because of this, and also the immediate actions taken by my agency, I ended up not calling DCF. The conversations were all recorded, and everything was documented, and at this point, I don't feel like the patient is in immediate danger.

What did surprise me was how hard I had to push to get things done. The first words out of the CM's mouth were "you don't have to go back," and it took a while to explain to her that I didn't call her because I wanted off the case...I was calling her so the situation could be fixed, and also as a courtesy before I called DCF. If I hadn't gone to the office and spoken to staffing, HR and other case managers to light a fire under the CM's butt, I don't think anything would have happened. I was the 17th nurse assigned to that case in the past thirty days, and it's more than a little frightening to realize how easy it is for patients in bad situations to slip through the cracks. Other CMs in the company are amazing and wonderful, so I think I was just dealing with a very tired, very burnt out woman who needed careful, deliberate prodding.

In any case, thanks for the moral support and suggestions, folks! It was definitely a learning experience, and I feel much better equipped to continue working in the seedy underbellies of the PDN world.

Specializes in General Surgery, NICU.

Oh my goodness, I was shocked to read this. So glad you advocated for your little patient!

I like that phrase, "seedy underbellies".

Specializes in Clinical Research, Outpt Women's Health.
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