Bathroom grab bars

[makes needs known]

OUR REHAB facility has been painting and putting up new wallpaper as part of a big renovation project. Some of our rooms have been completed and a big concern to the nursing staff has been the removal of the grab bars in all the bathrooms. They were there before the painting, the patients have been returned to their rooms and the grab bars are gone. They were attached to a stud within the wall and were very sturdy. We have been told that management does not like how they look. Our patients have been using the toilet paper holder to pull them self up or to steady themselves. We have been using their walkers, but they are not as useful as the bars used to be. We had a patient fall because of this. He had had a grab bar in his previous room and then he was moved to one of the new rooms. He was an independent patient and was to go home soon. His hip was dislocated and he was in the hospital for awhile after this incident. Perhaps this problem is going to be fixed but I don't understand why the patients were returned to these rooms that are not safe yet. $$$ ? Incidentally, before we let these patients leave us to go home we require that their home bathrooms have grab bars installed in them. Who can fix this problem??

[Bug Out, BSN]

If your facility wants medicare patients they legally are obligated to have grab bars.

As the NURSE you yourself are legally obligated to protect your patient and follow all state and federal laws. You must take personal action to protect your patients. If you see a problem you must provide interventions.

Ask the admins where they are going to send all the medicare pts because you are currently in default and must immediatly take action to protect their safety. Let them know that you are obligated to not only self report but also report others and if they are not willing to comply you will have to report them to your applicable regulating agency.

Be nice about it and have a gentle yet firm hand, print out the medicare regs and show that to your DON. Maybe just talk to your DON, if she is worth her salt she will fight for you.

Say, "I thought I read somewhere that we have to have grab bars, might want to check into it before we get an IJ from the state."

[Valerie Salva, BSN, RN]

I will never cease to be amazed at the $tupidity of mgmt.

[K+MgSO4, BSN]

Incident report/ near miss report it and get the physio and occupational therapy depts in on it as well. Get your consultants to bring up the issue as well. That is crazy!!

You should be able to report a near miss or as a danger to staff / patients.

[oarquiza]

As a registered nurse... we must look after patient's welfare, or patient's advocate.

[pennyaline]

If your facility wants medicare patients they legally are obligated to have grab bars.

As the NURSE you yourself are legally obligated to protect your patient and follow all state and federal laws. You must take personal action to protect your patients. If you see a problem you must provide interventions.

Ask the admins where they are going to send all the medicare pts because you are currently in default and must immediatly take action to protect their safety. Let them know that you are obligated to not only self report but also report others and if they are not willing to comply you will have to report them to your applicable regulating agency.

Be nice about it and have a gentle yet firm hand, print out the medicare regs and show that to your DON. Maybe just talk to your DON, if she is worth her salt she will fight for you.

Say, "I thought I read somewhere that we have to have grab bars, might want to check into it before we get an IJ from the state."

Trust me, THIS approach will get you nowhere in a hurry. As a staff nurse these days, you don't have anything near the influence and leverage necessary to get away with such a tactic. Your employer will make your job hell on earth if you try something like this.

Don't even think about confronting your administrators/management unless you really enjoy staring into their shark-like smiles. In their presence, maintain a hear no evil, see no evil, speak no evil demeanor, but on your own go to the ADA and your state's DOH and facility licensing body. Bring down an inspection and whatever consequences may attend, but keep yourself out of the crossfire. Let the facility take the hit directly.

[makes needs known]

Dear Pennyaline,

You are able to see this problem well. According to our management all of the problems that beset our facility are because of us. They do nothing wrong. We are incompetent, and don't work hard enough or smart enough. These are the bosses that never come to any of the floors to observe, help or even socialize. They only read reports and documentation and notes. Many people are worried about their jobs and the future of our facility. Everyone thank you for your responses.

[Bug Out, BSN]

As Nurses we all have the professional obligation to intervene upon our patient's behalf in a professional manner.

I would not go to the Admins directly, you jump the chain of command then. Go to your DON, explain the situation, print out the Med A regs, print out some studies...remember evidence based practice?

You don't have to be a bastard about it, just let them know how they can better improve their facility and lower the risk of lawsuit. If you approach the situation calmly and professionally then I would be surprised if your DON did not fully support you.

Just going on to report the issue to state agencies and taking no furthur action is akin to doing nothing at all.

Remember this is not a job, this is a profession.

Trust me, THIS approach will get you nowhere in a hurry. As a staff nurse these days, you don't have anything near the influence and leverage necessary to get away with such a tactic. Your employer will make your job hell on earth if you try something like this.

Staff RNs don't have power because the common staff Nurse either does not exercise or does not know how to approach business problems professionally.

Admins are people, business people. They are not monsters who only exist to make your life hell. My Admin is bastard of a business woman who has 0% idea of what Nursing is BUT every single issue I have had I addressed it to the DON, gave her my reasons and paperwork to support my idea. Every reasonable request I have had has been addressed to the Admin and changed.

Don't expect change overnight, it is a process. You have to play the political game.

[noreenl]

If you feel like you are not getting anywhere File a complaint with JCAHO I believe this violates 1 of the patient's safety initiatives. Hit them in the wallet!!www.jointcommission.org/GeneralPublic/Complaint 800-994-6610 8am - 5pm central time

[makes needs known]

Alot of you guys are so sure in your belief that management listens to their employees. THEY should know that those safety devices should be there, and they don't give a crap what I have to say. I have contacted the DOH. They are investigating it.

[Inspired By Silence]

You're telling me management is compromising safety for vanity?

I'm fairly certain there are laws that insist on grab bars in certain settings. I'd imagine a health care faculty's bathroom would be one of the settings.