Unsafe situations...Your thoughts please

Specialties Home Health

Published

Hi all, here is the situation. The agency I work (ed) for 2 months has had 6 nurses quit in 1 1/2 weeks. I was on call last w/e & this one after being told I would only have to take call a weekend every 3-4 months. Another thing I was told was call means take calls and answer nursing judgement questions & do w/e openings. Never once told that if someone calls in I have to cover all HH visits along with my own. Well, it seems that the coordinator on Wednesday did the Thurs-Sun schedule (because agency is closed for holiday w/e) and put nurses down to cover some of the open shifts but neglected to tell them...get the picture...anyway one pt has numerous things we see him for, the nurse that found out she was scheduled was angry but said she would go anyway. She went in blindfolded basically and did g-tube meds, feeding, BS check, Insulin etc, he told her he had a bowel program and she needed to do that and it would take a few hours, she stated she didn't know anything about that and no paperwork in the home, he became angry cussing and told her to get out and never come back. Ok now today at 11am I get a call that no nurse showed up there...no surprise...so I called him and he called me a F'ing B and told me to get my a$$ over there immediately because he needed the bowel program, and he was not going to pay us (he is medicaid), mind you I have never heard of this guy an know nothing about him except his main diagnosis, his regular nurse's last day was Wed (she quit) and no one took over the case. I asked him if his evening nurse did the program and he screamed that it was not her job to do that, it was the morning. I asked him what it was and he said "You are a f'ing nurse you should know, you use your finger B****" at this point I told him I had to call my supervisor who is also on call and hung up. She did not call back for over 1 hour and then told me that he wanted dig stim and I had to go do it, I stated that I had never done it and was not trained not to mention all of the things he called me. She said you are trained because you are an RN and proceeded to give me instructions over the phone...her exact words...(lay him on his side, stick your finger up there and twist a couple of times then wait for 5 minutes and continue to do that until you get return, it shouldn't take 2 hours). This is the same nurse that had me hauled into HR 2 weeks ago because I refused to transfer a 187 lb quad from chair to bed by myself (no lift) so that I could do a dressing change. At this point I refused she said "you have no choice, you are on call" and hung up. I phoned the w/e coordinator and told her to try to find someone who had done this before she could not and called the supervisor who in turn called me back and asked what my problem was and told be I better get out there, I stated -my license, my insurance, my call- I am not doing it and she said are you quitting effective now and I replied yes.

How do you all feel about going into the home and guessing what you are supposed to do? Having your patients tell you how much insulin they take because their nurse quit and the pt chart is at the office which is closed? Should I have just done the dig stim because I am an RN, does that automatically make me qualified? Maybe I am being unreasonable because I am new to home health. Thank you for letting me rant.

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Great rant...horrible agency. Thank God it's behind you. I thought suppositories were for routine bowel care and fingers for dis-impaction... but I'm not a home health nurse. Due to the huge variety of independent care and decision making, most home health nurses are very experienced. My friend did 10 years of med-surg before home health. Good luck in your next job and don't be afraid to tell prospective employers you quit because of the agencies unsafe practice and policies.

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If that many nurses quit in such a short time, then there are major issues with that company right off. Just be happy that you are out of there. And don't look back.

No one needs to put up with that, from the patient or from a supervisor in that company. It is just not acceptable.

And most patients, if they are on an appropriate bowel program, do not need digital stimulation for each BM. Sounds like this patient has other issues to deal with as well.

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It sounds like you were put into a very bad situation and did the right thing by refusing to go. I have worked for two different hh agencies in the five years that I have done hh and can tell you that it makes a big difference if there is no teamwork. If there is a procedure that you feel unsafe with or have never done, it is the responsibility of the agency to make sure you are oriented safely. I am also not sure why digital stimulation is part of his bowel program- most patients on a bowel program can be controlled with meds. Also, if you don't know the patient and don't have access to his records (which you should at least have a copy of his 485 if you are taking call for the agency), you don't know if there is any cardiac history, etc. which would matter with digital stimulation. There are good agencies out there and hh is a wonderful area of nursing- you just have to find an agency that is supportive of their staff.

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What a scam! I would be willing to bet that this pt. gets sexual gratification from his "bowel program," and that's why he got so angry when it wasn't done. Digital stim. should not be needed on a daily basis.

There is no way I would have seen that pt. It's unacceptable for a pt. to scream obscenities/verbally abuse staff. Your agency should have a policy about how to handle such situations.

(You are looking for another job, right?)

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Specializes in MS Home Health.

AWwww wow I am sorry. When patients start cursing at me, I ask them nicely once , " I always treat you with respect and I ask the same of you", they keep being all nasty, I call my super and leave.

Very sad,,,,very,

renerian

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I would have done exactly what you did. It's not fair to you or the patient to walk in there 'blind'. I'm also not comfortable going by what the pt. says should be done.

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Whoa! :chair:

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Very unsafe! Lots of other ways that agency could have handled it and supported you!

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I also worked as a home health nurse! Way to stand up for yourself! I am also a cardiac nurse and strongly agree with the cardiac concern related to digital stimulation!

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This is EXACTLY what I was thinking! What a JERK! This agency you work for is very unprofessional! They should have sat down with you and had case conference on each of these patients you took on so you would know something about them. I can't stand to go into a patient's home and knowing nothing about them. To me that is unprofessional and unfortunately I haver worked for some places like that. Don't give up on home health. There are some good agencies out there and it is a very rewarding career. Unlike the hospital, you get to spend quality time with your patients and that's what it's all about. Best of luck to you:)

What a scam! I would be willing to bet that this pt. gets sexual gratification from his "bowel program," and that's why he got so angry when it wasn't done. Digital stim. should not be needed on a daily basis.

There is no way I would have seen that pt. It's unacceptable for a pt. to scream obscenities/verbally abuse staff. Your agency should have a policy about how to handle such situations.

(You are looking for another job, right?)

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It's a good thing to not do things that you are not experienced at. As for lifting the 187 lb man, be careful not to try to lift someone that is too heavy for you to lift, because you might injure your back. I hope things go better for you the next place you work. I'm sure they will! Good luck!

I just finished a case where I was supposed to turn a 250 lb quadropolegic. I just quit last night after having had my purse torn off of my shoulder while trying to board a bus. This is the 3rd successful incident of robbery I have suffered while going to this client's home. Someone robbed me at the bus stop once, my purse was missing from the client's house (it was in the livingroom while I was doing his tx in his room), and last night when my purse was torn from my shoulder. He (the assailant) tore it off so hard that he almost caused me to fall. He didn't get anything much, but still, it upset me. I made a police report, as I did with the other 2 times. There was another attempt at the bus stop to rob me, but after the first one, I prayed that the Lord would take away fear, and when the person stuck something into my right side in back of me, I jumped and pushed him away. He went running down the street. I never got to see his face. I quit this case and I feel bad, but don't want to encounter any more things like this. What does anyone else think about this? Has anyone else ever quit a case due to personal safety issues? :.(

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