Patient fx hip after family refused alarm - page 8

by Emilyinsc 14,512 Views | 100 Comments

Ok, the family for a short term rehab patient did not place an alarm due to family's refusal (this happened on a wed). He fell a day & a half later, breaking his hip and nose. The NH is coming down hard on the admission nurse... Read More


  1. 0
    why is this so complicated? It's very simple- if you want to keep your job, you follow the rules, albeit very stupid unproven rules. I hate the idea, but it's the rules, and im not about to lose my job because someone doesnt want the bed alarm. If you are aox3- then feel free to sign out. I didnt make the rules- the idiot hospital admiistration did. I think I will tell my pts to take it up with them,but untill then, on it goes.I need my paycheck , and a rule is a rule.
  2. 0
    Quote from jrwest
    why is this so complicated? It's very simple- if you want to keep your job, you follow the rules, albeit very stupid unproven rules. I hate the idea, but it's the rules, and im not about to lose my job because someone doesnt want the bed alarm. If you are aox3- then feel free to sign out. I didnt make the rules- the idiot hospital admiistration did. I think I will tell my pts to take it up with them,but untill then, on it goes.I need my paycheck , and a rule is a rule.
    You blood pressure is 250/138 and you are refusing your BP medicine? Our standards say that we have to treat that. Feel free to sign out (while you still are A&Ox3).
  3. 0
    yes- and I've had that happen before.
    Ive been told by the patient's they can refuse. It's my job to educate, but if they refuse that, what are we to do? get a psych eval?
    Makes me wonder why anyone comes in to the hospital.Maybe they wanted the free meal.
    oops , sorry to derail original topic.
    Last edit by jrwest on Oct 7, '12 : Reason: forgot something.
  4. 2
    Quote from psu_213
    You blood pressure is 250/138 and you are refusing your BP medicine? Our standards say that we have to treat that. Feel free to sign out (while you still are A&Ox3).
    Oh my God! I'd just go ahead and call a stroke alert.
    anotherone and enchantmentdis like this.
  5. 0
    Quote from redhead_NURSE98!
    Oh my God! I'd just go ahead and call a stroke alert.
    May you never ever ever have the very rare type of stroke that I've had FOUR of and not have the conditions of your living will and DNR document respected. I've been there before. If I would choose to have all treatment measures but comfort measures withdrawn or withheld and I'm legally competent, heads will roll. Legally, if I sign a form absolving you of any and all responsibility in the event of such an event, (did I sound just a bit like one of my parents or other relatives?!)you're off the hook legally.

    Back to bed and chair alarms before the thread is totally derailed.
  6. 2
    Quote from sharpeimom
    May you never ever ever have the very rare type of stroke that I've had FOUR of and not have the conditions of your living will and DNR document respected. I've been there before. If I would choose to have all treatment measures but comfort measures withdrawn or withheld and I'm legally competent, heads will roll. Legally, if I sign a form absolving you of any and all responsibility in the event of such an event, (did I sound just a bit like one of my parents or other relatives?!)you're off the hook legally.

    Back to bed and chair alarms before the thread is totally derailed.
    .....this was more of a joke about blood pressure. Honestly I thought I was in the "things you'd like to say to a patient but can't thread" when I replied.
    anotherone and enchantmentdis like this.
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    Why did the patient have a POA if they were so rightfully A&0x3?. Bed alarms may not prevent falls but if you get there quickly it can. Also you are then alerted and the patient doesn't stay on the floor too long (any amount of time is too long). I would have put the alarm on anyway. If he threw a big fit about it I would've called the doc. Then if that didn't work I would wait until he fell asleep and then put it on. Are they going to sue you for following safety protocol? It sounds like the family had the problem. What kind of bed alarm was it? I think if places are going to honor requests such as not putting an alarm on a person whose score off of whatever tool they use to assess fall risks clearly indicates they are a fall risk. Have them sign a contract as suggested previously absolving responsibility (would that hold up in court?).

    Sorry you were fired. That means they might sue. Does the facility have a p/p that says the bed alarms are mandatory if patient is assessed as a fall risk? Why didn't anyone call the doc? I don't mean to beat a dead horse but the information could be valuable for others reading this.
    Last edit by tyvin on Oct 7, '12 : Reason: editing
  8. 1
    It sounds to me like the LTC had a policy that bed alarms were to be used if resident met xyz criteria ... but no back up plan if alarms were refused.

    So they feel like they have no choice but to fire the nurse who allowed a circumstance to exist that the LTC has no policy to deal with.

    I think the OP might possibly have a case for wrongful termination.

    The lesson I would take from this is ... if you're in a situation that goes outside of your facility's policies ... in addition to documenting it in the patient/resident's record ... you need to make sure that you have documentation that you notified the rest of the appopriate chain of command via email, etc.
    wooh likes this.
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    At my hospital they have a form for the pt or POA to sign that is very detailed for alarm refusal. Also in the alarm refusal form it goes in depth about forfeiting rights to sue in a result of a fall (something like that, the form is very long and in small print). If I was a patient and saw that form I would say never mind turn the alarm on. Lol! After they sign the form we still have to document every shift about the alarm refusal on our fall flow sheets.

    Also the nurses and MD can import a video about it on patient's tvs. They can not watch whatever they want to watch on tv until this video is played. Once they watch the video, it is noted on the chart electronically that they watched the video.

    Kind of off topic, but there was a pt at my hospital that fell and he did not sue the hospital, but he sued the nurse only because she forgot to turn the bed alarm on. That scared me. I just follow the policies and teach the patients/families why they are in place. I make sure forms are signed and my documentation is detailed.
    anotherone and lindarn like this.
  10. 2
    I hate that. Right to fall? Ok. Enjoy your right to bust a hip!!! GRRRR
    anotherone and lindarn like this.


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