Hey all. I'm a hospice nurse who visits patients in their homes in a rural area. I have a patient now who has a really bizarre spouse. First of all he answers all the questions I ask her and she kind of just sits there passively. Second of all, he's a religious zealot who gets all worked up about how everyone is going to he-- because they don't read the Bible etc. Then he spouts out gems like "Those kids in schools who kill other kids shouldn't kill the other kids. They should go after the teachers and principals instead because it's their fault." and "I should have punched out the doctor who saw my wife last week because he stuck his hand UNDER her bra to use his stethoscope, and no man has any business touching my wife like that." He gets all wild-eyed and raises his voice when he says these things. He has also said he's thought about using his gun against a principal of a school because his kids were picked on, and the principal wouldn't do anything about it, but he's afraid of he--, so he decided not to kill the guy. He takes extensive notes about presidential candidates and the only issue that concerns him is homosexuality and whether or not the candidates are 'immoral' because they support homosexuals. He seems pretty volatile, and I don't feel safe around him. He has specifically requested that no male nurse visit his wife, he only wants females in the house. Am I overreacting, or is the situation really unsafe? It's a rural area, and there are not a lot of police, etc. around. There is no possibility of buddying up with another nurse as we are severely under-staffed. Sorry this is so long! Any advice would be appreciated.
Wow. I didn't expect so many replies! Yes, my instincts are telling me that it's probably not such a good situation to go in to. Hmmm....now how to handle this with my supervisor. She has been out to the home once (as have I) and as far as I know did not feel that the situation was dangerous in any way. Another nurse who worked for us but has moved on didn't like going there, either and had gone a couple of times. It's a relatively new patient. I feel that there is at least the issue of mental/emotional abuse, and yes, the man could definitely use psych services. Both are in their early to mid 50's. Do I write a nurse's note? How do I document my feelings of unease about the situation? I feel I should document it in some way, I'm just unsure how.
Specializes in LTC, assisted living, med-surg, psych.
Yes, you should definitely document this in the patient's chart, using direct quotes as much as possible and using wording that's as objective and unemotional as you can make it. If you describe events as though you were merely an observer, the charting should speak for itself should it ever be necessary to take further action with this couple.
Again, good luck, keep us posted........and don't go back!
I not only wouldn't go back to that house, I would report this unsafe situation to Adult Protective Services (I'm assuming the couple in question are age 65 or over).
Good point. As a mandated reporter, this would still be reportable to APS if the wife is considered a dependent/incapacitated adult, regardless of her age.
Intuition was given for a reason. Talk it over with your supervisor so that he/she is alerted to the situation. Be assertive and clarify that you want someone else at the home with you.
:smiley_abThat's me, always fighting the Dark Side. Oops! Sorry I meant fighting myself again
I not only wouldn't go back to that house, I would report this unsafe situation to Adult Protective Services (I'm assuming the couple in question are age 65 or over). ]
Find out if there are adult children and if there is anything they can do.
You don't want to get APS involved in any way if you can keep from it.
They can cause a lot of trouble and make matters worse, especially if the couple has a substantial amount of assets, which it doesn't sound that way, but I'd check out alternate options, anyway.
Thank you all for your great replies! You guys rock! I'll document what I've heard and witnessed and talk it out with my supervisor on Tuesday. I just feel that it's not a good situation as it stands right now. The good thing about the situation is that the couple lives on a reservation (patient is Native American) and when she passes the tribal police will deal with the situation, and they destroy the drugs left in the home and take care of pronouncing patient, so there is no need to go back after the death. I'll let you all know what comes of all this.
The OP has a societal obligation to notify the police of this man's stated intentions. He has continued to express a desire to inflict harm and the next logical step for this guy is to go ahead and do it.
I don't care how unpolitically correct it may seem for you to blow the whistle on this guy, he is very verbal about his intentions and sounds like he is becoming even more stressed and agitated. I appreciate the situation, small town, sick spouse, etc. Please don't waste precious time wringing your hands wondering what to do. Go directly to the police, ask to speak to an officer, state exactly what this man is saying. Let them handle it. Don't go back there, notify your manager of the situation.
School has started up again. If this man were to act upon his stated intentions and you did not notify anyone you may wish you had. The life you save could be my child, my spouse, my neighbor, my family member. Please tell the police.
I would write up an incident report from your agency regarding the verbal threats and unusual statements made by the husband. I agree should be notified about the threats of bodily harm to specific people. Even if the authorities do not act on this atleast you have reported it. This sounds like a potentially dangerous situation. Keep yourself safe and document objectively.
tencat
1,350 Posts
Wow. I didn't expect so many replies! Yes, my instincts are telling me that it's probably not such a good situation to go in to. Hmmm....now how to handle this with my supervisor. She has been out to the home once (as have I) and as far as I know did not feel that the situation was dangerous in any way. Another nurse who worked for us but has moved on didn't like going there, either and had gone a couple of times. It's a relatively new patient. I feel that there is at least the issue of mental/emotional abuse, and yes, the man could definitely use psych services. Both are in their early to mid 50's. Do I write a nurse's note? How do I document my feelings of unease about the situation? I feel I should document it in some way, I'm just unsure how.