? about resident throwing self OOB

[Sensoria17]

At my LTC facility, there is a rather challenging drug-seeking resident I have to deal with when floating to another wing. On at least one occasion, after having consumed his maximum daily dosage of prescribed narcotics, he has somehow managed to throw himself OOB (he's a paraplegic) in order to be sent to the hospital to get more pain meds. How do I deal with him should I start to notice he may getting to that point again? I suppose I can put his bed in the lowest position though I suspect he doesn't not like this at all as his bed is never in a low position. Any advice would be appreciated.

[xtxrn, ASN, RN]

For those patients/residents who were either too demented to be safe, or behavior problems, we had beds that were about 8inches off the ground, but raised to a decent height to get the person in and out of bed.

Get the ombudsman involved. They are great resources when there could be potential state issues down the road, and are "facility friendly"- and it looks good if the state somehow does get involved (this lovely resident could easily call them himself).

http://www.noamedical.com/

Good luck

[maggiemae1013]

15 minute watch, scoop mattress on the bed, bed in low position, mattress on floor next to bed, and document everything.

[xtxrn, ASN, RN]

15 minute watch, scoop mattress on the bed, bed in low position, mattress on floor next to bed, and document everything.

Can't see 15 minute checks in LTC- if someone is that acute they need to be sent to a psych facility. :)

How does it work to get a paraplegic out of a scoop mattress? (seriously- not being snarky; just never seen it done :))

[leslie :-D]

hell, if i was a young person, ltc is the LAST place i'd want to be.

very, very depressing.

i do believe he needs some sort of consult...i'm thinking psych as a start.

poor guy.

too bad there isn't some sort of facility that takes younger people only.

leslie

[nursel56]

I think we will start to see that soon. Trends are usually so slow to develop but this (far more young people in LTC/rehab) stands out very clearly. I wish we'd had some of these solutions before (scoop mattress, bed position on low mattress on floor,etc) but it sounds a bit like a 70s dorm room minus the Lava Lamp.

Nursing had so many very rigid rules in the past, and however practical an idea was, the "it is because it is" circular reasoning prevailed. Glad to see that's changing!

[Sensoria17]

The man is probably about 60 yo. He receives methadone, oxycodone, and a patch (sorry, I don't want to get into too much detail). He used to be on more meds but he kept going into respiratory distress and end up being sent out. The thing about his "pain" is it appears to come on very suddenly and then it disappears within 5 minutes of popping a pill in his mouth:rolleyes:.

For the record, I always give people their pain meds in a timely manner according to physician orders regardless of whether or not I personally think they are in pain.

[1bigmedicRN]

Please be careful about using side rails as they are considered as a restraint devce (according to JCAHO or now called TJC). But when I do use them I like to the patient and family that it helps the patient move a little easier as the patient has something to hold onto. I know it is a little white lie but it usually works other than the truth. Because in the past I have told the truth and the family or patient expects someone one to sit with the patient 24/7 .

[tyvin, BSN, RN]

Wow ... thanks, TJC (The Joint Commission) is so much easier then JCAHO.

Thanks 1bigmedicRN .

[Esme12, ASN, BSN, RN]

It is TJC now.......

I'd put the matress on the floor......