My nurse tied a resident in here wheelchair - page 2

Night before last I was alone on the Alzhiemers unit, my partner was on lunch and the housekeeper was cleaning on the unit. I was washing my hands in the medicine room when she came and got me and... Read More

  1. by   nurse555
    I agree that the nurse that did that was very wrong even if she had the best of intentions for pt safety. I have been on both sides of the agency dilemma and knowing that the agency nurses are usually scapegoats that always made me more aware of my actions. I've also seen very poor excuses for staffing coverage in agency nurses. Its a good thing you did everything you did. Chances are if the buyers are thinking of pulling out its not a sudden decision so don't beat yourself up over it. One person can only do so much and you aren't in anyway responsible for anyone else's. Maybe your management will realize that there is an underlying problem and take actions to correct it. You did the right thing. Hopefully your management will dnr the nurse from your facility. On the plus side you've learned the most important aspects of documentation-covering yourself and protecting your patients. Keep us posted.
  2. by   CHATSDALE
    I don't know what the rules are from state to state...i would think though that a facility that hires agency nurses should have guide lines available for them to make decisions...what would you do with a pt who climbs over the bedrails and harms themselves...it the nurse responsibable for the injuries sustained...what did she write down on the incidient report...i know that the form that we use includes what happen and what steps were taken to prevent reoccurance...in any case cna should write down facts as they occured and let the don and adm make decisions...some problems don't have any solutions
  3. 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.
  4. by   RN92
    I worked in a charity hospital emergency room...we had pts come in high on "something" (no telling what). It would take 4-6 firemen/paramedics to hold him down on the stretcher - they'd get them transferred to our stretcher and LEAVE!!! We werent allowed to use posey vests. We'd use 4pt leather restraints and the pts can still wiggle/fight and get out of them. Sometimes we'd have to use a sheet in addition to the restraints to keep them from raising their chest off of the bed. There is a FINE LINE between restraint safety and pt safety. Truth is - if someone wants to sue, they're going to do it anyway. Check out WWW.NURSINGLAW.COM One nursing home was sued for not restraining a pt who had fallen out of the bed in the middle of the night at least 3 times over the past several years. The nursing home and nurse was found at fault for not maintaining pt safety. Also, to CHAD - you could have also written an incident report that night - just to make sure they got your version of the story in writing. Anyone can write an incident report. There can be more than just one. Actually, the more versions of the incident the better.
    GOOD LUCK
  5. by   Chad_KY_SRNA
    I talked to the social worker today. I have learned some very important things. They told me that she didn't pass the seven narcotics that were scheduled that night on the ICF/PCF unit. She didn't pass half of the meds the next night on the skilled unit. The administrator got her to admit that she had tied her down. The medication aide that was working with me that night said that she told her about it that night. Carole the CMA told me that when she told the nurse that she could not do that she said that she would as long as she worked there. One of the temporary administrators told me tonight that she was not to be allowed in the facility. She knew that it was wrong and the bad thing is she was going to do it again before two CNAs went and told the administrator. I told the new acting adminstrator today that we needed a shift report book like the CMAs and Nurses that we could document in. She said that she would look into it.
  6. by   stevierae
    Quote from Chad_KY_SRNA
    I talked to the social worker today. I have learned some very important things. They told me that she didn't pass the seven narcotics that were scheduled that night on the ICF/PCF unit. She didn't pass half of the meds the next night on the skilled unit. The administrator got her to admit that she had tied her down. The medication aide that was working with me that night said that she told her about it that night. Carole the CMA told me that when she told the nurse that she could not do that she said that she would as long as she worked there. One of the temporary administrators told me tonight that she was not to be allowed in the facility. She knew that it was wrong and the bad thing is she was going to do it again before two CNAs went and told the administrator. I told the new acting adminstrator today that we needed a shift report book like the CMAs and Nurses that we could document in. She said that she would look into it.
    You did good, Chad!!!!! You really are a true hero to your patients and a great role model to nurses everywhere who don't want to "get involved" or be "whistleblowers." I would be proud to work with you.

    You know, makes me wonder why that patient was "down" in the first place. Wonder if she did not get meds that were due her and was disoriented?

    Chad, I wnat you to type in "medicare fraud" and "whistleblowers" and "qi tam" on google and see if you run across anything that fits your situation. You may just qualify for a monetary award, or will, for following the appropriate steps to report this and improve care for your facility.

    Do it, and feel free to p.m. me if I can be of help. I know some attorneys that handle medicare fraud and qi tam lawsuits.

    I hope that this is a message for all CNAs everywhere: YOU ARE NOT POWERLESS. YOU ARE SOMEBODY. YOU HAVE A VOICE. DON'T BE AFRAID TO SPEAK UP.

    I also encourage you to call the board of nursing and report her. Don't assume somebody else will, as they most likely will not. She will end up in another LTC facility, doing the same thing, if a formal board of nursing investigation is not launched.

    Here is their contact info. According to their website, you can report a nurse anonymously.

    Kentucky Board of Nursing
    312 Whittington Parkway, Suite 300
    Louisville, KY 40222-5172
    Phone: 502-329-7000 or 800-305-2042
    Last edit by stevierae on Jun 17, '04
  7. by   lifeisbeautiful
    Working in a Nursing home can be very tough work physically and emotionally. I worked in one for 4 years, then decided to work in a hospital. Many of the people that I graduated with also started in Nursing homes. We use to share stories all of the time. 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 feel this is what makes staff frustrated. 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. The topic of restraints? I think I saw more broken hips because of the big fight against the use of restraints. Anyway, it is a tough and frustrating issue. I do miss the challenge geriatric nursing though.
  8. by   CoffeeRTC
    Quote from 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 :uhoh21:
  9. by   Dixiedi
    Quote from 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 :uhoh21:
    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.
  10. by   CoffeeRTC
    Quote from 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...
  11. by   mandykal
    Last edit by mandykal on Sep 29, '04
  12. by   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".
  13. by   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!!!!

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