Safety issues in Home Health - Do you ever become comfortable?

[erinp88]

Hi, I'm an LPN seeking incredibly flexible hours to complete my remaining requirements with my RN degree. In my area, one of my only options is home health. There are numerous jobs in this area - some with training, some without.

I have some major concerns with going on someone else's "turf." A few years ago, I heard this horrific story of a home health aide being raped by a patient. Apparently he had some mental health problems as well. Anyways, that story has always stuck with me and I know there's staffing issues, but it's always made me wonder why staff isn't sent out in teams.

I decided to dabble in doing medications setups about 2 years ago. It was paid per case and I ended up doing a few cases that were 30+ miles away from my home. I was of course sent into the most undesirable areas of our city. During the time, there was a lot gang activity going on in one specific area. I wasn't too concerned about that as I didn't feel I would be targeted. However, the house itself was infested with rodents and termites. Ironically, my mom was the social worker case manager on this case and I'd spend my entire time on the phone with her trying to figure out how to get this guy in better living conditions. Come to find out, the man had a "record" that prevented him from living in a community setting. I won't elaborate of the details of the record, but it was enough that my husband said no more.

I guess my question is does it take a while to get comfortable? Do you do anything (carry pepper spray?) to help ensure your protection? I'm hoping to find a place that will let me specify the area I want to be in. Not to mention, get paid for my travel time and mileage. With my med setups, by the time I'd spend an extra hour and half driving, it wasn't worth it.

I searched through several old posts and didn't see much about safety issues. Sorry if this has been addressed already!!

[traumaRUs, MSN, APRN]

You have to feel safe in order to be okay with home health. I think I would search out agencies that would provide for your safety. Other options might be: private duty nursing where you pick the area.

[paradiseboundRN]

I would feel unsafe if I had to go into some of the poorer areas. The worst story that I've heard is that a mental patient locked a nurse in her closet. Fortunately, The nurse had her cell phone and was able to call for help. I do carry pepper spray but that is because I was bitten by a patient's dog. I would not work for an agency that has visits in bad areas. That should be one of your questions when you interview for positions. What areas of town am I expected to see patients?

[caliotter3]

You always have the option to refuse to visit in areas that you do not care to enter. I read a long time ago about agencies in the big cities that employed body guards to accompany home health nurses but have never seen anything since. I would think that a lot of them did away with that due to the extra costs involved. You have to be proactive about your own safety. One of the best options available to you is your ability to refuse a case or to ask to be pulled from a case where you feel uncomfortable for any reason.

[erinp88]

Thank you for all of this information! When I've asked local home health nurses in the area about their feelings of safety, most of them tell me they are sent into the bad areas and constantly feel uncomfortable. This is with a variety of companies as well.

Thanks again for the input!

[RN'n'AZ]

You should be concerned for your safety! We all have a right to be safe. If an agency expects you to do something that is unsafe then do not let that be the norm or what is acceptable. In my experience with several agencies (field nurse and supervisor), us home health nurses have always been able to refuse to participate in a case that is unsafe. I have even called my director outside of a patient's home before even entering for the visit with safety concerns, only to turn around and drive the other way. I have heard several stories of nurses who did not follow their gut and were assaulted or found themselves in very uncomfortable and dangerous situations. This even happened to me on a few occaisons . . . one partial quad had a 22 cal. stuffed under his pillow, another lived in a meth house, another was a physically aggressive psych patient. Actually, most agencies in my area do not even accept psych patients due to the risk involved. You should always come first and as for your agency, well they put themselves at risk by risking you as workmans comp for employee injuries plus the lost productivity of the affected nurse. I understand that every geographical region has their trends and methods, but I stand firm on this one . . . my opinion. :) Our families needs us, the profession needs us.

[KateRN1]

Maybe it's my area, maybe it's my personality, but I've never felt unsafe in home health care. Plenty of times I've felt unsafe in the hospital, though.

[IndianaHH]

Several years ago one of our nurses was shot and killed sitting in her car in front of a pt's home. The corner drug dealer thought she had needles, drugs, ..he walked up, shot her point blank. Since then the agency has a policy that at anytime a nurse fears for her safety she is to remove herself. I have had a couple of uneasy moments where I positioned myself next to the door, fortunately no incidents.

There is no job, no patient worth getting killed for. Listen to your gut.