[michelle126]

Originally Posted by cnyrn

Sounds like unlawful imprisonment to me, are there no standing orders for prn soft restraints on an emergency basis? Most facilities have these, requires an MD to sign in 24 hours.

There is not one restraint to be found in our facility...no posey wrist or waist restaints are kept in supply. Now we do have "positioners" for wheel chairs like a lap buddy or self releasing seat belt, but has been quite a few years since I've seen anything that ties. BTW, we have a mixed pop of demetia residents and it does get pretty crazy at times One of my current residents loves to lowere them self on the floor and climb all over the place (yuk)..he also spits everywhere

[Dixiedi]

Originally Posted by michelle126

There is not one restraint to be found in our facility...no posey wrist or waist restaints are kept in supply. Now we do have "positioners" for wheel chairs like a lap buddy or self releasing seat belt, but has been quite a few years since I've seen anything that ties. BTW, we have a mixed pop of demetia residents and it does get pretty crazy at times One of my current residents loves to lowere them self on the floor and climb all over the place (yuk)..he also spits everywhere

This reminds me of one of the kids I have in home care. We couldn't get him any kind of bed that would keep him in it (Traumatic Brain Injury) after he became too big for a crib. We just had to keep watching him very closely as he would wriggle himself over/around siderails and end up on the floor. He was a shaken baby and does have a seizure disorder though it is well controlled. A couple of nurses have seen seizure activity but I personally have witnessed none. However, because a seizure is always possible we were able to get him a very nice net bed. He is safe from falling on the floor now. Just seems so silly we couldn't get it for his TBI safety but could get it under the guise of "seizure safety." Seems a person who simply doesn't know any better can not be restrained but a person who has a seizure disorder can. Let me say though these beds do not actually restrain a person, they are simply netted on 4 sides and top from the mattress to well over 6 ft height to prevent falling out.

[michelle126]

Originally Posted by Dixiedi

This reminds me of one of the kids I have in home care. We couldn't get him any kind of bed that would keep him in it (Traumatic Brain Injury) after he became too big for a crib. We just had to keep watching him very closely as he would wriggle himself over/around siderails and end up on the floor. He was a shaken baby and does have a seizure disorder though it is well controlled. A couple of nurses have seen seizure activity but I personally have witnessed none. However, because a seizure is always possible we were able to get him a very nice net bed. He is safe from falling on the floor now. Just seems so silly we couldn't get it for his TBI safety but could get it under the guise of "seizure safety." Seems a person who simply doesn't know any better can not be restrained but a person who has a seizure disorder can. Let me say though these beds do not actually restrain a person, they are simply netted on 4 sides and top from the mattress to well over 6 ft height to prevent falling out.

I cant picture the netted bed, but it sounds dangerous for the dementia residents... for the constant faller-getting out of bed resident, we sometimes use low beds or even beds on the floor. Hey if thats where they like to be...

[mandykal]

[Mister Chris]

""Working in a Nursing home can be very tough work physically and emotionally. Some of these stories would blow your mind. The State turns a blind eye to Nursing Homes though. Nurses and CNAs have way to many residents to care for. I would like to see the state inspector get up 15 patients in an hour and a half, give each res. a bed bath/ proper peri-care with warm water, oral care, hair brushed. clothes matching, etc....no short cuts. I would like them to deal with the combative patients.....""

I have to agree with you (I have been around nursing since the dark ages of restraints of all kinds - in psychiatric units and dementure units and old people's homes.) Hard work, thankless work, short of staff, sometimes almost impossible conditions, dealing regularly with death and dying clients and their relatives and then having to put up with Agencies and other temp. staff, along with some some bad practices still carried out by some.

Been ther and done that too many times but now I have to agree - document, name names, times, details and make copies and make sure that you get them to the people at the top and in official positions. You are not to blame - we need more nurses like you over here in Australia. Love you. Chin up, you are doing something that majority of nurses would not - aged care "Real Nursing".

[steff_rn1]

I don't think anyone has mentioned this, but......
according to federal regulations, when abuse or possible abuse occurs, it should be reported immediately to the Abuse Coordinator or Administrator of the facility. The nurse should have been removed from the facility immediately.
Then an investigation is done. It is not your job to decide if it is abuse or not, but it is your job to report it as soon as you see it.
(I am trained as an Abuse Coordinator in a facility that had similar problems in the past.)
Just remember to tell the truth.
And don't feel bad that you didn't report it right away.
If there's one thing I have learned about nursing, it is that you always remember your mistakes and never make the same one twice!!!!

[NurseFeelGood]

Originally Posted by mattsmom81

Hmm. Well have ya'll been in a situation where you didn't HAVE a posey, chair restraint or wrist restraint immediately available? (Guess nobody here works for HCA or places like that...LOL)

Sometimes we improvise for a time. If someone is gonna fall or pull a line and hurt themselves and you'll be liable for something either way, we sometimes have to make choices. I don't know WHY this nurse did what she did...I just object to the whistle blowing and finger pointing before a reminder face to face. That may have been all it took...someone saying "You know, we really can't do this anymore...let me go find the proper equipment and we'll talk about it later".

I primarily do ICU where I WILL be liable if the patient hurts themselves so we sometimes make choices based on this knowledge. Its not a policy nor best practice to use sheet restraints, but I HAVE in extreme circumstances UNTIL I could find appropriate equipment.

I have to agree with you on both points there. I can recall a time when being overloaded with 60+ residents, 2 IV's, 8-12 TF's, accuchecks and insulins for the IDDM's and after already filling out an incident report for a resident who fell out of her bed, after which she was gotten up to her wheel chair, (assessed with no injuries noted) and as soon as I'm gone to the other hall, being in charge of 2, I learn she has fell out of the wheel chair. We had 1 CNA to each hall. I was even helping to do rounds. The facility doctor was quite slow on 3rd shift to return calls, yes I've been there, done that. We do what it takes when it comes to keeping a resident safe. Also, in LTC more and more residents are being "weaned" off psych drugs. Understandably these are fall risks but still for some weaning them off without a PRN makes for a combination for one very irritated resident who wants to hit everyone and everything in sight as well as stand up and walk on her/his own forgetting their balance is certainly not up to par. I realize restraints are and have been abused in the past but I also believe they are sometimes neccessary. We should not whistle blow until we have talked with the person, found out the reason and tried to help with solutions. IMO