I guess she's trying to see if we can kill her daughter . . .

[Crescent Cat]

It's been a while but this woman continues to be a piece of work.

Over the past few months there have been several times in which the daughter has come to work on the verge of crashing. Basically we have a break at 9:30 in which the consumers will bring snacks from home to eat. As stated before we check this girl's (I'll call her BLUE for simplicity's sake) blood sugar and measure out the carbs for her insulin pump. She's come in and been rather low - less than 70 - and when that happens I ask her what she's had for breakfast. She'll tell me that she's had a granola bar. Anything else? No, just a granola bar.

This is not an isolated incident. I've brought it up with my supervisor but there's little we can do since we can't go in to their home and tell them what to do. But, since it is an issue that is affecting her work we have been documenting it.

Yesterday, BLUE came in and she was alarmingly low - 36. How she was even still responsive is beyond me. But before first break her sugar sky rocketed to 410. Two extremes in less than two hours. I don't know the specifics of what happened between those times as a coworker was handling it rather than myself. I think she gave her some juice and didn't bolus her to get her sugar up.

BLUE does have directions from her PCP stating that if she's above 400 she needs immediate medical attention (call 911 is states specifically). My coworker and supervisor notified BLUE's father. When supervisor told him what her glucose was at he said "okay". Just okay - nothing else. Supervisor asked him what he wanted us to do and he said he'd pick her up.

Well, he called BLUE's mother - the know-it-all nurse. She came into the workshop and was very short with my coworker and supervisor. She wanted to know why they didn't give her insulin immediately. Well, the pump won't administer any insulin unless there's carbs entered. She said we should have just entered 15g and let it work. My supervisor points out that there's no way we would have known that and shows her the doctor's instructions regarding it. He also points out the outrageous jump in her glucose from 36 to 410.

She responds that it's not going to kill her and that she'll be fine. She says to just enter in the current glucose, 15 carbs and let her stay at work. BLUE states that she really doesn't feel good and wants to go home. Her mother tells her that she'll take her home but she's going to be home by herself.

So in short -

- BLUE's glucose is very poorly controlled.
- BLUE's mother is rude to the staff who are only trying to keep her daughter safe.
- She doesn't seem concerned about her glucose because it's "not like it'll kill her".

Yeah, fuck those other long term effects of badly managed diabetes like organ damage and gangrene. Who needs feet anyway? Just cut 'em off! And why worry about potential blindness? I mean, who actually uses their eyes anymore?

I really wish there was something we could do, but for now all we can do is document. Hopefully we can get BLUE out of her mother's "care" before she has her legs amputated.

[Hanzoku]

At this point, especially if you have security cameras with video and audio where you're having these conversations, I'd be trying to find SOMEONE governmental who can intervene.

Otherwise, how old/capable is BLUE? Can she help monitor herself if given coaching?

[Crescent Cat]

BLUE is 28 with Down's Syndrome but I honestly believe she could prepare her own meals and take care of herself with coaching. The problem is that she's not in a licensed facility - she's in a private residence with her parents - so there's little we can do.

We do have respite services that we can provide but I don't know if the mother would accept it. She was so rude to my coworkers who were only trying to make sure BLUE got the best possible care and that they were doing the right thing for her. I really don't get what this woman's deal is. Life would be so much easier if she would work with us and not against us. TBH, I've gotten to the point that I'm not going to bother contacting the mother if I don't absolutely have too. I'll go by what her doctor wrote out for her. It's safer that way for us and for BLUE.

[Teskeria]

It sounds like her mother does not want to be bothered with a child who is developmentally disabled, not even to the point of trying to get her into a facility where she can be taught to the limits of her ability. I am a cynical B**** and I really get the feeling she is hoping it WILL kill her daughter, while her daughter is not at home, so she can push the blame off onto your place while getting rid of what she considers a burden. She probably doesn't really believe everything is being documented so doesn't realize you will be able to prove what has been going on.

[Sapphire Silk]

Call Adult Protective Services and let them handle it.

Crescent Cat, are you guys mandated reporters where you live?

[Crescent Cat]

The previous incident has been documented and reported to the state. As to where it goes from there, if it will go anywhere, I do not know. I'm frustrated, my coworkers are frustrated, my supervisor's frustrated and we all wish there was more we could do. I want to call APS soooo badly, but I'm leaving this in the hands of my supervisor for a couple of reasons.

He's not any less concerned about BLUE's well being than I am, so I know his apparent "inaction" (if you will) is not due to him not caring. Something is keeping him from proceeding any further. What that is specifically I don't know. He's been in this business for at least 26 years so he knows what he's doing. Trust me, if there wasn't a reason he couldn't call APS and start some sort of investigation, he'd have done it already.

So please, not to be rude, but don't tell me I need to call APS because I know already. I'm really just venting at this point both because if the mother's attitude and our inability to proceed any further at this point. I'm hoping it will change soon. I'm hoping something will come up that will let us call APS on this bitch's ass ASAP but until then all I can do is what is best for BLUE.

[Sapphire Silk]

Not to be rude back, but if Blue is a mandated reporter, then he must report. Nothing "keeps" anyone from reporting, other than reasons that have nothing to do with the law.

You've made it pretty clear the parents are indifferent, and that this girls health is at risk.

The reporting system exists to allow continued documentation of at risk cases. That one incident was documented does not mean future incidents should not be; if anything, it adds to the state's case.

And if you are a mandated reporter, and you don't report, then you are liable if something happens. You can request anonymity when reporting in most states.

I once had a dad go apeshit on me for reporting suspected physical abuse on his daughter, who was about 4, who was a patient in my ER. She was a textbook case: multiple ER visits for injuries, and the injuries didn't match the description of the event. What was not in the chart, and what I was not informed of, was that the girl had a rare blood disorder that caused her to bruise at so much as an evil glance. I refused to back down: lacking that information about her health history, I was justified in making the report and in fact required by law to do so.

I charted the health history so it would be available to the next nurse, but I refused to apologize to the dad.

[Kristev]

I agree with Panacea on this. It is time, in fact, over-time, to get someone else involved in Blue's care.

And yes, Panacea is right again. Medical personel are required to report suspected abuse, as are school teachers. (My mother was a nurse herself for over twenty years.)

[Pixilated]

And it will take either the daughter being sick and nearly, or even, dying, or a massive hospital bill to make this nurse realize how stupid she's being.

I'd like to think so, but I think more than likely if this happens she will flip it so that it's somebody else's fault.

It sounds like her mother does not want to be bothered with a child who is developmentally disabled, not even to the point of trying to get her into a facility where she can be taught to the limits of her ability. I am a cynical B**** and I really get the feeling she is hoping it WILL kill her daughter, while her daughter is not at home, so she can push the blame off onto your place while getting rid of what she considers a burden. She probably doesn't really believe everything is being documented so doesn't realize you will be able to prove what has been going on.

I don't think you're a cynical B**** -- or if you are, so am I. That was my first thought as well, given the number of times the mother has been advised that her actions -- or lack of same -- are endangering her daughter's health (and for crying out loud, she's NURSE! Shouldn't she already know this??)

[redsox33413]

If the mother of Blue is a nurse and is not taking the proper care of her OWN DAUGHTER, then I am willing to wager all the pocket lint I own that she is doing the same thing to anyone who is a patient of hers or under her "care". Perhaps an anonymous call to to board of nursing certification detailing her lack of interest/responsibility in these events is in order. Nurses are also mandated, even if they are NOT working---it depends on where you live, but the rules are almost the same everywhere. And I'm sorry that you are going through witnessing this. THAT is the hardest part of it all!

[Seshat]

Being a carer is a difficult, demanding position to be in.

I'm cynical enough to believe that there ARE people who would try to get out of it by 'accidentally' murdering their relative or patient.

They're too unwilling to see themselves as 'bad parents' to give up care to the State, or to a residential facility. But if the disabled person dies 'by accident' then it's 'not anyone's fault', it's 'just one of those things'.

And I honestly doubt that carers who do this will allow themselves to be consciously aware of what they're doing.