Vent: Difficult Case

[Adele_Michal7]

Basically would like to vent, but would like input, as well.

My current case (31 hours a week) is interesting. My patient lives with her three siblings, her mother, and on Monday-Thursday, her mother's boyfriend. On Friday- Sunday, the patient's FATHER lives with them. (Patient's father= mom's ex husband. Well, they are still married and he pays her rent.)

In addition to this large family, the mother's drug addicted, jobless, homeless by choice brother stays with them 3-5 nights a week. He is a pro couch surfer.

All of this, in a 2 bedroom small apartment. One child sleeps in the living room, one shares a room with my patient, one sleeps with the parents (she's 3.) The vagrant drifter sleeps on the floor, or kicks kid out of bed to crash.

We currently run out of essential supplies like wipes, diapers, soap, toilet paper, paper towels, Tylenol, OTC meds and other things. Patient doesn't always have clean clothes or drool cloths.

Mom doesn't have a job, she claims she can't work due to having four kids. I give that credibility, because four nights a week she assumes care of the child due to having no NOC nurse. However, she sleeps in her bed, she doesn't stay up for the shift.

The apartment is absolutely filthy. Walls, carpets, grimy grimy grimy. You don't want to sit down.

The 7 year olds bed has cases of rotten formula stacked under it- I asked mom why and she said "so the bed doesn't sag."

The brother has weed in the house, I've seen it several times.

Agency knows all of this, is doing nothing. Thoughts?

Sent from my iPhone using allnurses.com

[Madras]

New York State = Mandatory Reporting.

It is your duty/obligation as a health professional to protect the interests of a child.

We all must go through this mandate to get licensed. OP:Training:Mandated Training Related to Child Abuse

Reporting is anonymous, it is not required for them to trace back to the source of the report. You report, you get a case number for your records. New York State Office of Children and Family Services (OCFS)

Unfortunately this is seen all too much, especially in certain areas of NY.

[Kooky Korky, BSN, RN]

Everyone seems to agree that you must report these conditions to Child Protective Services. I agree, too. What did CPS do before?

It sounds like you need a change of cases. Otherwise, you just have to either ignore who lives there, who sleeps where, or if supplies are out, or see if you can help Mom get some help (social worker? churches?) to clean up the apartment, get her drug addicted son proper care, and get Mom back to a paying job, especially now that welfare and food stamps could be cut due to budget revisions. Maybe she could even get paid to take care of her own child. But if she's asleep during her "shift", that could be problematic. It's not your job to clean, but you could do a little cleaning sometimes if you would like to. Mom is probably very depressed and overwhelmed. Or is she? I hope she won't bear any more children.

I don't think this is an unusual case unfortunately. This happens quite often I'd guess, as others have stated.

[SinikRN101]

When in a situation of mandatory reporting as nurses are it's not an option to report, hence "mandatory reporter". You can tell them (if you so choose) that you need to report because you are a mandatory reporter, if they choose not to have you back that is up to them, emphasize on the fact that they need additional help to care for all the children involved and especially the patient. What happens after you send in the report is up to them(CPS), not you. They can do something, or do nothing, but you've done the part you needed to. You can be charged with a crime for knowing something is going on and not reporting. When reporting, make sure everything is objective.. I saw ______ on ___date. Report only the facts and nothing subjective. If you really feel awkward and do not want to go back that is understandable and should be communicated with the agency. Really crumby that they don't care about the patient/ only the $$$.