I have this letter in another forum...but thought the general discussion group might be able to help.
Was doing home visits, hospice, and was told that a significant other was psychotic, and showing violent behavior. I called my administrator for backup prior to the visit, and was denied, x 3!
Got through the visit but have bruises to show for it...and an attorney...now that I have been terminated, wants me to find policies other agencies have re: DANGEROUS HOME VISITS. So far no luck, nothing written. We had been told to take a second nurse if we felt threatened, yet I was denied. Attorney wants to see other policies....and have witnesses, which ain't gonna happen. Appreciate any input. Oxymorons don't belong in healthcare! Especially hospice! and Administrative!
I don't know how this works in the legal system. However, I was thinking you might want to talk with a legal nurse consultant on this matter. She is likely to have some good imput to help you and your attorney.
Where I work, if we feel a home is unsafe, we leave immediately if we are already in the home. If we haven't gone in, we don't go in. We have a security guard that is available to our nurses to call, day or night, to go to a visit for any reason, be it an unsafe neighborhood, or whatever. We recently had a patient who was noted by one of the therapists to be "packing heat", and the decision was made not to even service this client, and the Dr was notified.
Our agency says if a pt or family person is aggressive we need to 1) put space between ourselves and the aggressor
2) if dangerous dial 911
3) last, notify office
I cared for a very combative Alz pateint for quite some time, and the policy was to mamnge the agitation so it wouldnt be taken out on the caregiver. We almost never sent new staff in, and if new staff was sent in, the company always made sure they were expereinced with combative patients and knew that the lady could get violent at times. I never got hurt. The family and MD were supportive,
I think the fact that you were informed prior to going in that there was a potentially hostile, aggressive, combative, violent, - - - not responsible for his own behavior - - - psychotic in the house,..........................and you decided to go in alone anyway,
.......I think that you are up against the wall.
If you polled 100 nurses, I'd be interested to know the % that
would decide to go in.
A judge or jury might think that it was your responsibility to look
out for your own safety. The psychotic would not be held responsible.
I work in home health and the policy in our agency is if you feel unsafe, either get assistance (security, manager, etc) or don't make the visit. We are a department of the hospital and hospital security has gone our with nurses. We have had team manager and even our department head (who had experience in the field before moving up to management) make visits that were not necessarily unsafe but potentially uncomfortable. Our agency has a policy that outlines when we may terminate care and for what reasons.........drugs, violence, and guns are just some of the reasons. We have in the past terminated care for sexual inappropriateness, profanity (way above and beyond normal) and for loaded guns in the house with confused patients. We document steps taken to resolve the issue and a deadline to resolve or terminate care. In 12 years of homehealth I have been in one really scary situation (vet with PTSD and LOTS of loaded guns).....left the house, went to the office and said I would never go back. My agency backed me up and another nurse did see the patient and family and the pt was d/c. On the flip side.......I have had family members escort me to and from my car when seeing pt in potentially dangerous neighborhoods........they wanted to make sure "their" nurse was safe and would be back to take care of the patient. We have also called the local police dept when a patient was actively suicidal or making threats against others and potentially out of control. Mental health warrant and 72 hour involuntary....... bottom line is be safe.
passing through- I disagree. I dont think the op chose to put him/herselfin harms way. Just because an individual is psychotic does not mean they are not responsible for their actions if harm is caused- If that were the case there would be no such thing as a "mentally disordered offender".
Our agency says if a pt or family person is aggressive we need to 1) put space between ourselves and the aggressor
2) if dangerous dial 911
3) last, notify office
Laura
HA ! Sounds real "proper" on paper.... ever tried this in real life?
Those who have violent intentions will ensure there is no space between you and him (her) from the get-go, as well as no exit out. He will be blocking any exit or have you backed into a corner or up against a wall.
Dial 911? Yeh right. You'll be lucky if you just get your hand broken and not have the receiver bashed into your skull.
Notify office... how administratively correct. Give me a break.
"uh, would you excuse me for just a moment, sir? Can we take a time out from your abuse and threats long enough for me to notify my office of your intentions?"
Do NOT go in alone if there is ANY doubt whatsoever. Do NOT go in alone if there is a history of violence of ANY kind (regardless of against whom). You may not come out again... ever.
Anything can be a trigger for some ppl. Including your smile.
I think the fact that you were informed prior to going in that there was a potentially hostile, aggressive, combative, violent, - - - not responsible for his own behavior - - - psychotic in the house,..........................and you decided to go in alone anyway,
.......I think that you are up against the wall.
If you polled 100 nurses, I'd be interested to know the % that
would decide to go in.
A judge or jury might think that it was your responsibility to look
out for your own safety. The psychotic would not be held responsible.
The employer is responsible to provide a non hostile work enviroment. It is true they cannot control every situation including what goes on in a client's home. However, because she went into such a home does not make her responsible for what occurred. That is putting the responsibility for the actions of another on the victim:nono:
She needs to at the very least recover for damages, lost wages, pain and suffering and legal costs. Either from the employer or the person who did this.
Keep in mind she was between a rock and a hard place. Protect herself or care for the client. My guess is if she refused it would have meant her job. (though it apears she lost it anyway)
I think the fact that you were informed prior to going in that there was a potentially hostile, aggressive, combative, violent, - - - not responsible for his own behavior - - - psychotic in the house,..........................and you decided to go in alone anyway,
.......I think that you are up against the wall.
If you polled 100 nurses, I'd be interested to know the % that
would decide to go in.
A judge or jury might think that it was your responsibility to look
out for your own safety. The psychotic would not be held responsible.
WHOA.... I initially phoned the administrative call person, which was the executive director, and told her prior to the visit, that I had been forewarned and insisted on some backup...I asked 3 times.....stopping on the way as she directed me to go alone...and called, asking for help again. She refused to send backup, and advised me that I was not to call the police. When I arrived, the police were already there...and they wanted me to go on. I told them who I was and they asked me to park and come in. With police on his back, he was still able to bruise me with his grip. The rest of the visit was all right, but the psychotic friend started looking for the drugs I was about to dispose of, and it was decided that he needed evaluated somewhere, and was sent to the ER.
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Give me a break.
Agnus
2,719 Posts
I don't know how this works in the legal system. However, I was thinking you might want to talk with a legal nurse consultant on this matter. She is likely to have some good imput to help you and your attorney.