Uncomfortable returning to patient's home

[NurseP1113]

I am a new LVN in Texas, working in home health. I recently put in my 2 weeks notice. While on my night shift last night, the patient's parents left her baby sister who was congested in the living room for me to watch while they slept. They did not ask, just left her in there and told me to let them know if she woke up. The baby was sick so she was awake a lot and choking on the secretions. I let her dad know, he came out and suctioned her once, force fed her a bottle and she went back to sleep but was easily stirred and they still left her with me while they slept in their rooms with the doors shut. She seemed to sleep so long as it was perfectly quiet, which is wasn't due to my patient's feeding pump, O2 monitor and nebulizer. In the morning when they woke up, they STILL didn't come get the baby. They continued to leave her in the room with me while they got ready for work. I informed the scheduler at the office that I was not comfortable returning to this home again tonight but they just said they would talk to the mom and brushed off my discomfort of being placed in this situation. At this point, I already have another job lined up that I am set to start on the 17th. Can I just let them know I am not returning to this client's home? Can I refuse this assignment since I am not clocked in?

[Scottishtape]

I wouldn't refuse to go in, but I would approach the situation head on with the parents when I got there .

If they don't like it, they can ask you to leave. The baby is not your responsibility, and I would be adamant that you cannot give proper care to your patient if you're having the added responsibility of the baby.

ETA: yes, you can tell them you refuse to go in. As long as you have not taken responsibility for the patient for that shift, then it's not abandonment.

[caliotter3]

Write an incident report for what happened and keep a copy. It is your right to refuse to return. Easier to not go at all than trying to deal with the situation as it might present itself. Should you decide to go in and they pull that again, causing you to not accept care and leave, make certain that you clearly state so and call the agency immediately. Just easier not to go back at all.

[Kitiger, RN]

That baby sister is not your responsibility. In my agency, the nurse is not allowed to care for anyone other than their assigned patient. The liability to the agency is the reason given. You do not have a nurse-client relationship with anyone other than your assigned patient.

If the parents tried to leave her in my care, I would immediately call my supervisor, who would tell the parents that I was not to care for - or even watch - that sister.

I don't think I could work for an agency that would not support me in this.

[NurseP1113]

Thank you everyone. I actually ended up leaving the agency and I now work for a dialysis center. I love my new job and I am so much happier in this position.

[caliotter3]

Good that you did not give in to the agency's requests and that you have now moved on to a better situation. Most of the time instead of listening to reason, they will argue a nurse down until s/he gives in to doing that which is not safe, legal, or practical for the situation.

[feelix, RN]

First of all, as a nurse, please develop a strong spine and learn to say 'No'. That was not the last situation where you were bullied into doing something illegal. Yes, illegal. A nurse client situation was created that did not exist. If that baby had died or got hurt that night, the parents would have called the police on you and your agency would claim you did it on your own.

Next time it might be a doctor giving an incorrect order or a colleague asking you to do something you are not comfortable with. Remember, your license is the only thing that is non-negotiable. Jobs and opportunities come and go.

Please read your state Nursing Practic Act and memorize parts that apply to your practice. Live by it.

[Travel_RN1]

I think you meant to say "will not be your" instead of "it was not your," bc yes, this will not be your last time being a brush an uncomfortable situation. Especially now that you are in dialysis, and they may try to give you more than two dialysis patients at once in a hospital setting, unsafe. You must state your claim to unsafe practice for yourself, if you feel overwhelmed. Thank goodness the child didn't choke or aspirate while sleeping. Good luck! Keep us posted!