To report or not to report?

[spejsa]

I have a question for all of you... I live in an area of Northwest Arkansas where it is usually pretty good, but you never know... We do have some issues with drugs here, nothing like LA, but we have them. So, I have been seeing a patient here for a few weeks (actually the LPN I work with usually sees the man, but I go when she is off). I just have a very weird feeling about him and have from the start. First of all, he was a referral from the husband of a nurse at the agency who is a pain management doctor... He has an abscess on his butt cheek. We have been packing the wound for a week and a half now... he was supposed to go to the surgeon to have it checked last week and couldn't go d/t money issues... So, we are still going once a day.. I had made it less than that but the LPN changed it back. Therefore, I have been able to go the last 2 days cuz she was off and I work this weekend... So, there has always been weird stuff there since I first went. Crap all over the yard. A mattress that has been "burnt" up, that is up against the side of the house. . Just random crap all over the place. Then, when you go in I feel like it is bad in there but who knows.. The man is around 50 years old and has a wife there and they take care of a grandchild... The man and wife always go into this bedroom and always make sure the door is shut behind them... Then, the man last week said that his pain meds were gone since a week or so ago as somebody there took them.. And, every time you go there are random people on the couches, etc... Then, he just drops his drawers in front of everybody to change the dressing on his butt... Just so many weird things. I don't think they are making meth cuz I don't smell anything except for cigarette smoke... But, I just don't know. W onder if anybody could give any advice...

[caliotter3]

Be careful, go with your gut, and look for a new case. You can report your misgivings to the supervisor, but don't expect any action or response. If you don't actually witness a crime taking place, there is nothing you should do. And as far as calling the police about anything, they will tell you that the crime must be taking place when you make the call, so there is something for them to walk in on. Not much help there. Just be mindful of your personal safety. If you don't feel safe, you are justified in asking for a different case. You definitely should have written up an incident report about the missing drugs if they are controlled substances, or at least a communication note to the supervisors. Who do you think the client is going to accuse of stealing them when push comes to shove? I would leave that case.

[spejsa]

Well, he didn't tell me about the drugs being stolen, he told the LPN I work with. He did say he didn't get his antibiotic filled since a week and a half ago.. and, I left a message about the doctor on that one... In your experience, in a situation where you feel unsafe should you tell yoru supervisor you need another nurse to see that person?

[Melina]

Do you have social workers at your agency you can bring in? What about Protective Services? If you suspect abuse, not only physical but financial or emotional (and stealing pain meds is abusive) you need to do something. APS doesn't always do much, but if something does happen with your pt, and you and your LPN have had suspicions but didn't take any action, what then? A social worker could also help set your pt up with money to get to the doctor.

[caliotter3]

In a way, I am the wrong person to approach for the "textbook" answer to problems of this nature. I was physically assaulted twice as a result of my home health job and when I reported the situations to my employer, I was treated as if I was the criminal. I ended up out in the street with no job and no help at all from the employer. Their "help" consisted of blacklisting me when I tried to get work elsewhere. This action, after I had been promised a good reference. How, in heaven's name, is a nurse going to expect to be treated like this from their employer when they are assaulted on the job? Make a written report to your supervisor, a formal incident report if warranted, contact the police or other authorities yourself if warranted, and expect your employer to do nothing, or to take "action" to get rid of you. Ask to be removed from the case if you do not want to work there, but again, expect the employer to twist your arm, or label you as the "problem". Start looking for a new employer when you encounter the employer behavior I have described. It is one thing to be aware that you have no backing on the job in the matter of day to day occurrences, quite another to find out that your personal safety is an "inconvenience" to the employer.

[spejsa]

I am going to request to not have to go back to this home as of tomorrow. I have already interviewed and been offered a position elsewhere. Last week I backed out of quitting this job cuz I really kept telling myself it is this way everywhere. I do know that I had a friend who worked for the agency that wants to hire me for many years and she said they have problems but this type of stuff wouldn't happen. The supervisors in the office take care of the field staff. So, I just feel like that might take some of the pressure off of me. So, I think I will go with what my gut has told me for a month and leave.

[caliotter3]

Sounds like a sound decision to me. Good luck with your new position.

[spejsa]

Thanks. I know life isn't perfect. But, I love doing visits. I love seeing the people. I love the puzzles I get to figure out. I just need more training and support.

[caliotter3]

Hopefully, you are going to an agency where you will get positive support and will be able to enjoy your work even more.

[spejsa]

I hope so.. They say they will train me at least. I haven't done HH before and had 1 1/2 days in office listening to a woman talk about how much she has sex, mixed in with going over policies & procedures. Then 2 days with a nurse in the field... Then, on my own.. . No help with OASIS to this day. Just get many things back that I have to fix and have lots of office people knowing more than I do and telling me "Why did you do this?" or "why didn't you do this?"