Fall Risk help

It sounds like you did everything you could! I can't think of anything you could have done differently! :redpinkhe

Based on what you're describing, it sounds like the patient was embarrassed about needing help/not wanting to admit to himself that he needed help, and wanting desperately to to maintain his independence.....

Hi,

IMHO, This pt sounds like lots I have had! They are basically independent at home, and hate to have to rely on another person when they really need help (sound familiar? I'm right there in their shoes!). They are afraid of losing control, and although it seems like they are noncompliant, it really is an assertion of their independence, and being able to control some part of their hospitalization. In cases like this especially when I have older patients who may have had a fall at home, I try to first discuss with them the circumstances of the fall (the person who was a high fall risk on admission, may have been playing football with the grandkids, and tripped (true story!)), and therefore is if it is not directly related to the reason for the admission, I ask them to walk for me to assess their mobility. If it is directly related to their admission (i.e. syncope), then I very nicely ask them to call us to be present if they need to get out of bed to the BR, or chair, whatever. I let them know why I am concerned, and I acknowledge their independence, and state that we just want to be able to assess how they move. I assert the facts of their case (they were found on the floor of their house, therefore a fall probably happened), and that we have an obligation to see that it does not happen while they are here in the hospital. I tell them that I am not their keeper, but it is my duty as a nurse to ensure their safety, so would you please allow me to be there when they get out of bed to ensure that they are safe? I assert that I do not need to be there to watch them eliminate, nor brush their teeth, but that I want to be sure they are safe. If that doesn't work, sometimes the "do it to make me feel better" statement works. As a last resort, bed alarms, chair alarms, etc.

If a pt is a true fall risk you will know, and like me, check on them often, and offer help to the bathroom.

Keep in mind patients will fall no matter what the precautions taken.

Amy

Please document all of your great efforts and make sure you are following your employers policy to the letter

if he was confused you could have put him at the nsg. station, but he wasn't. sounds like you did all you could. perhaps explaining the repercussions of his decision to get up alone despite your efforts had an impact on you as well. when completely frustrated with a non-compliant alert patient, sometimes i just tell them i have 2 kids in college and need to keep my job to pay for tuition, if you fall while in my care, that is jepordize.......it's lame, but sometimes works...