NOTE: These tips are meant to supplement any agency safety policies and practices.
In my previous blog, I shared the three steps that can result in an efficient and effective home visit. Essential in planning visits is staff safety before, during, and after the home visit. These safety tips are based on experience, research and stories from visiting staff who were endangered simply by, in their words: “not being aware and making stupid mistakes.”
Know and follow your agency’s safety policies
Memorize your agency’s safety policies and procedures. Some agencies have an escort system; and many have specific policies and procedures concerning safety in potentially dangerous service areas.
A duress phrase
Every agency should have a word or phrase that visiting staff can use to alert the office they need help while in a client’s home. In the scenario below, the agency’s phrase is “Lisa needs her medicine.”
- Nurse tells family: “I need to call my office to respond to a text from the director.”
- Everyone in the agency, especially those answering the phones, should know this is a call for help when the nurse says: “This is [staff name] and I’m at [patient’s name] on [street name]. I’m returning a message from [director’s name]; Lisa needs her medicine.”
- The person that answered the phone stays on the line until police arrive while someone else calls the police.
- If staying on the phone is not possible, both people should leave the phone on so that the agency staff member can hear what’s happening in the home.
Trust your assessment and gut feelings
- If you think a visit is potentially unsafe, talk with your supervisor before making the visit.
- If you feel in danger during the visit, don’t be afraid to end the visit before completing the plan of care or use the duress phrase outlined earlier in this article. Your safety is most important.
- Some indicators that you’re in danger:
- If you are yelled at, shouted at, sworn at or threatened and your response didn’t change the situation, LEAVE.
- If there are people other than the patient who appear drunk, have guns or drugs in any area of the home, LEAVE.
- If you are in the middle of a domestic argument, don’t try to intervene since the situation can quickly turn on you. LEAVE.
- If you become concerned in any way about your safety, LEAVE.
Be prepared
- Have the telephone numbers of your agency, the local police, and the fire department in your cell phone using codes for quick retrieval.
- Dress within your agency’s guidelines. Don’t wear anything that can be seen as provocative. Always wear comfortable shoes that you can run in if necessary.
- Never carry a purse. Lock it and any other valuables in your car’s trunk before you start visits. Keep small change, identification, car keys and phone in a zippered pouch in your pocket.
- Know where you are going and how to get there. Use the Global Positioning System (GPS) in your laptop, tablet or smart phone. Having a paper map in your car is a good backup.
- Know how you will gain access to the client’s home or apartment (front, side or back door, etc.) and if anyone other than the client will be present.
- Park as close to the client’s home as possible. Lock your car doors each time you exit.
- Avoid walking down alleys or on private property as a shortcut to or from a client’s residence.
- Carry a flashlight for poorly lit corridors. Ask a family member to meet you at the entrance to the building to show you the way.
The visit
- Never walk into a home uninvited. Always knock and be verbally assured that someone is home before entering, even if the client has left the door unlocked for you. If someone other than a familiar voice says “come in” and you can’t see who is talking, ask them to come to the door to meet you. You can then better evaluate the safety of entering the home.
- Insist that pets (other than goldfish and birds!) always be placed in another area that can be closed off. Yes, always. You may love animals and the client may assure you that “Bozo wouldn’t hurt anyone.” Your response should be: “Bozo doesn’t know me and as I work with you, such as taking your blood pressure, you may grimace. Bozo may think I’m harming his master.”
- Keep your nursing bag within sight. When not using it, keep it closed and latched so curious pets, children, and unwanted pests don’t get in.
These safety tips plus your agency policies and hints you’ve received from others can help you prevent dangerous situations and make your work day more enjoyable.
Carolyn Humphrey, MS, RN, FAAN is President of CJ Humphrey Associates and a national leader in nursing, home care clinical practice, operational efficiency and regulatory compliance.
