What to do about an abusive parent, home health

[MAS]

I'm a pediatirc nurse who works PRN for a home health agency and recently I had a horrible encounter with a patient's foster mother. My patient was trach/vent/g button, and the mother spent the entire 12 hour shift belittling me and criticizing everything I did. The shift started with her drilling me on this patient's plan of care. "What's the patient's trach size? where's the spare trach? how do you set the machine up? what if the machine isn't working? where's the ambu bag? Diapers? Meds? Doctors phone number? foster parents phone number? spare g button? etc". In between her drilling me, she criticized everything I was doing saying things like " you're not positioning the patient right, you didn't set the machine up in the right order, you're supposed to do CPT before you give nebs (I was always told to do it during nebs or after, but we didn't have an order for CPT anyway), etc. I literally couldn't do anything right by her standards all shift and she was so consistent that I couldn't even chart and had to chart everything down when I got home. It finally boiled over when she saw that I had moved a padding that she put on the floor out of the way because I was tripping over it and she said "if you ruin my carpet, you're f*cking paying for it"! I told her that I was dumping the water from the vent tubes on the padding and there was no water on her carpet which she didn't believe me. I told her she could feel for herself and she said "there you go, being a smart a*s, you must not like your job very much!" I didn't say a word to her the rest of the shift. When the morning nurse came in, the patient began to de-sat in the high 80's, low 90's and the foster mother immediately began blaming me and making really obnoxious comments like "who gave you a license?", etc. Thankfully, I contacted my supervisor after my shift and I don't work for that patient anymore; but I was wondering if anyone had experienced something like this before and if so, what's the best way to handle it?

[caliotter3]

The “private duty” forum, where extended care home health topics are posted (as well as sometimes in the the home health forum), abounds with such stories. You made the correct call. On occasion, I have been forced to leave even before the end of the shift. If at the client’s request, I always repeat myself clarifying their requests several times, so I can clearly report and chart showing that I did not abandon the patient. And I always make that call immediately before driving off. If at night and/or I get an answering machine, I leave a message. Cover yourself always. The client will misrepresent what happened 100% of the time. BTW she was correct in her grilling at the start, even if her approach was negative. The client has the right to determine your suitability to provide required care. Where she went wrong was the belittling and foul language. If she actually thought that way about your competence, it was her responsibility to send you back to the agency then and there, not verbally abuse you. Likewise, I will do the same if I see this will be impossible for me. However I will finish the shift if humanly possible. I do not need negativity, especially from the employer. And sometimes they will dish it out, making the nurse out to be the problem.

[Emergent, RN]

I'm sure the agency is well aware of this women's abusive nature. Their goal is to satisfy the client and make money. They are not interested in mediating, or bringing truth and justice, or solving family dysfunction.

When you are in someone's home you are basically at their mercy. I did two home cases years and years ago, and definitely found that that wasn't my cup of tea.

Mothers of children with chronic health problems definitely can become understandably over-protective, I found when I did inpatient Peds in a small community hospital. Not my favorite demographic at all. Once they have had a negative experience with a nurse or other caregiver, they can become hyper-vigilant.

[Crystal-Wings, LVN]

They’ll be lucky if the agency doesn’t drop the case.