Working with Families that dont control their kids

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I just started working with a new home health case and the infant is precious and the parents are very kind. They speak another language as they are from another country so we have to call a hotline to communicate aside from pointing and a handful of words they know in English.

The case would be great except they have a 3 1/2 year old who runs rampant and they do not have any control over her whatsoever. She always wakes up the baby when he is sleeping by poking his face, shaking/kicking the crib, playing loud children songs on her iPad next to his head as he sleeps, etc. Yesterday we had to go to the ER because she pulled out part of his GJ tube! He was ok but that's not the point. We all see plenty of children outside of work that are out of control and parents who just let them do whatever they want..

I Really really don't want to offend any parents out there but it makes my work very difficult because if she isn't bothering the baby, she is in my work bag pulling out everything or trying to get papers out the chart or drawing on my nurses notes,etc! I've had translators tell the parents time and time again and they always say they will try harder to control her but as soon as she goes and does something again, they completely ignore her until I speak up!

The other nurses are fed up and considering leaving now too. I can't leave as my job requires me to open the cases and stay with them for a certain amount of time so I can't leave...

What advice do you guys have for me? I am at my witts end with this little girl and her parents!

Additionally because I don't speak their language and they don't speak mine, it's very difficult to even (professionally/firmly) scold the child even if I wanted to because we can't understand each other! I do tell her NO an STOP in English and every child understands Tone of voice regardless of language but she ignores me because she knows there are no consequences for her behavior...

Help!

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Put your bag out of the child's reach. Let your employer know that you will leave the case as soon as possible and do that. Since the parents have been spoken to on several occasions, they are aware of the problem and you have their answer. The other alternative is to try to come up with a solution. The best one that I can think of is to engage the child in their own activity away from the baby. I've found that closing the door to my patient's room works well with the sibling in my patient's family.

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This is a very tough situation and I'm sorry you have to deal with this. I have dealt with some sibling issues but on a more toned down level than this. I agree with the comment above. I would also tell you to make sure you are documenting everything that has to do directly with the patient, such as the g tube issue and even poking the baby in the face. Also document every time you report this to the office or when you have the translaters telling them. Not only are you covering yourself but you need a paper trail going because the case manager will probably have to intervene and will need documentation. Sorry I couldn't be more help than that.

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Specializes in Peds Homecare.

I agree with the poster above, get the case manager involved ASAP. You also need to speak to your boss and explain what is going on, this is a disaster waiting to happen. And as others said, document everything. God bless you and good luck.

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If the patient has their own room, explain to the parent through the interpreter that the sibling may no longer be around the patient while she is in your care. Legally you can not be responsible for the sibling. Let your case manager know and document everything. Make sure that the parents understand that if they can not control their child that they will not have nursing.

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These are great suggestions. I spoke to mom again and let her know that if she doesn't control the child, she will have no nurses. That was Friday at the end of my shift. We will see how Monday goes!

If anyone else has more suggestions- I'm open to them! And thanks for all the ones I've received so far! :)

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