What is the first thing you do when you put a fall-risk pt in the bed? - page 4

As nurse what is the first thing you do when you put a pt in the bed that is a fall risk... Read More

  1. by   Vespertinas
    Last edit by Vespertinas on Feb 7, '13 : Reason: someone said it already
  2. by   Dazglue
    Quote from Poochiewoochie
    Isn't the facility being paid to take care of that lady? Why the "her family abandoned her". Sorry, but I don't think the family should be doing what the NH is responsible for. I can see you saying that if the family has never been to visit but if you're just saying that because they weren't there 24/7 doing what the nurses in the nursing home should have been doing that's very rude to say.

    My Mom is in a NH for Alzheimers and she has fallen two times in the last month-the first time was a hip fracture and the second was a femur fracture and both required surgery. She was a high fall risk yet they refused to put an alarm on her. When she fell the first time she was not assessed for over a day-the reason we got is that her nurse thought the DON had assessed her and the DON thought her nurse had assessed her. The two surgeries have taken a toll on her and unfortunately she is dying.

    The passing the buck off to the family doesn't cut it with this family member. I took care of her for 8 years all by myself before I couldn't do it anymore. I almost had 2 nervous breakdowns-I don't think anyone has any idea what it's like to care for someone who is ill 24/7 unless they are a family member who has done it. Your shift only lasts 8 or 12 hours depending on where you work and then someone comes and relieves so you really have no idea what it IS like to take care of someone who is ill 24/7. And I never was paid to do it. So please don't judge family members just because they aren't with their family members at the NH as often as you'd like them to be. You really don't know the whole story and what lead up to them placing their LO in a place like that.
    Guess I should have added more information, considering this is the internet.

    #1. This is not a nursing home.
    #2. This is a SNF inside of a hospital.
    #3. The rule was in order for her to be admitted to our facility the family had to provide someone to stay with her 24/7 such as a family member or a sitter because as soon as you sit her down she was back up again. We can't stay there with her constantly. Not able to either. That's the issue we had with management.
    #4. The family agreed to this rule but disappeared after the 1st day and we never heard from them again. Lady ended up in DHR and the judge was declared her gaurdian just to get her admitted to a nursing home.
    #5. This lady had on a bed alarm AND a fall alarm.
    #6. I am not judging family members. My grandmother suffered for dementia for years and we provided for her up until her death.

    After all of us begging and pleaded with management to get her a sitter, they made the charge nurse sit with her the entire shift, to prevent more falls.

    In this situation her family did abandon her. Not saying ALL family members that just place their loved ones in the nursing homes abandon their family members. Didn't intend for it to come out that way either.
  3. by   MotherRN
    Interesting! This sounds like the beds I saw in school clinicals. There were only 2 rails that could be put up, and they were half-length. But, the instructors kept saying if the bed rails were up X2, it was restraint, without making the destinction about beds with 3 and 4 rails or the older beds with 2 full length rails, so it just stuck in my head that rails up X2 = restraint. Guess I will have to judge the issue on a case by case basis depending on the bed my patient is occupying!

    Thanks for the input!
  4. by   MotherRN
    Thanks for the picture! It really helps. Our beds rails are made of plastic and sometimes don't have openings.
  5. by   Maremma
    Wow, we aren't allowed to have ANY side rails. Beds cannot be against the walls. We are no longer even aloud to have bed or chair alarms! EVERYTHING is a restraint in our facility. They have cut us off at the knees really so most of our fall risks just never get put in bed at all!

    Fall risks that refuse to or due to dementia cannot remember to use the call bells wind up being kept in their wheelchairs being moved down the hall with the nurse they try to do med pass and keep the behavioral fall risks off the floor at the same time. It is sad state of affairs.
    They SAY they want to go to bed but as soon as you try to let them go to bed they try to get up. They wind up sitting in different types of wheelchairs that can sort of lean back somewhat and prop the feet up at the nurses desk when not being dragged with for med passes. That is sadly how they sleep at night to keep them off the floors. HOW we get away with that is beyond me.

    Our facility "doesn't have the staff for one on one" for these patients either so we are left with no other choice but to have "slumber parties" for all our fall risks out in the halls and at the nurses desk! State should come for an overnight visit. I wonder what they would think of that.
  6. by   ybanurse
  7. by   turnforthenurse
    Fall risk bracelet, fall risk sign on the door (it's just a little blue and yellow striped magnet that sticks to the door frame...), non-skid socks, side rails up x2, make sure the bed is in the lowest position and LOCKED, call light within reach. Bed alarm one. Frequent rounding on the patient. We usually order a low-bed with mats to the floor, though I have learned those mats can be a real pain in the behind if end up having to code that patient. Get a 1:1 if you think it is necessary.
  8. by   blackvans1234
    Put on the restraints!

    As a PCT, When they're in bed, we put the rails up, and the last thing I do before I leave the room is make sure they have their call bell, I tell them it's my ''direct line'' if they ever need anything to ring and we will be there to help them.

    My patients are mostly mentally capable of remembering to ring (except the stroke pt's with impulsivity), bed rails are not a restraint in my facility.