Fire safety, who is responsible

Do you have an emergency preparedness department? I might start there, as they handle planning and coordinating the responses to fires and may be able to provide some direction. Also, your department of safety could be helpful too.

You can also see if you can find any policies related to patient belongings, accessible rooms, etc. to help bolster your concerns.

Can social work help the patient to locate either a storage facility or friend/family member with a basement to store the belongings?

I would just have security evaluate it and if they feel it is necessary they can contact the FD.

Annie

It sounds like administration is turning a blind eye, not wanting to address an unpleasant issue with this patient/family. In the event of an emergency, you can bet they will hold throw the staff and unit manager under the bus for any harm that might result.

If your risk manager is unwilling or unsuccessful in intervening, I suggest a call to your fire department. In most municipalities, they have the right to free access to facilities for unannounced inspections to address safety/compliance issues. And they won't take "no" for an answer. Ditto your local health department.

An upcoming JCAHO inspection would undoubtedly prompt action as well.

Unless these items are particularly flammable (oxygen tanks not secured, hazardous chemicals, etc.), I don't see this as a Fire Safety issue that the fire marshal would care about. It sounds like more of just a tripping hazard / accessibility issue.

If the patient coded, would you be able to get the necessary personnel into the room in the right positions to run the code? Can the bed be pulled away from the wall enough for the RT to get behind there and intubate and ventilate? Can the crash cart get close enough to the patient?

If not, I would approach it from that angle. If Charge Nurse and/or Unit Manager don't address the issue after pointing out the accessibility problems in the event of a code, then I would contact Risk Management. I would also fill out an "incident report" (or whatever your organization calls them -- we call them Patient Safety Reports).

As for the people saying to just tell the family to take the stuff home... the OP said that the patient has placement issues -- the patient HAS NO HOME to take the stuff to. That's why all the crap is boxed up in the patient's room in the first place.

I am kind of at a loss how to circumvent the process so that real action is taken.

I don't recommend trying to "circumvent the process" -- unless you don't want to stay at your job, that is.

Use the chain of command... Charge nurse, unit manager, Risk Management, DON, VP, CEO, etc. If the charge doesn't do anything, go up the ladder to the unit manager. If the unit manager doesn't do anything, go up the ladder to risk management, etc.

The chain of command is there for a reason. If you circumvent the ladder instead of following the chain of command, you'll anger The Powers That Be, and that's a sure-fire way to find your butt out on the street and walking to the unemployment office.

Nurses do not circumvent the process. In this case ,you would report the issue to security. If they feel it is a safety issue.. the ball is now in their court.

Make an anonymous complaint to the Fire Marshall and JACHO, just go straight to the big guns, don't bother with anything else. What they are allowing to happen is completely inappropriate not to mention dangerous and they know it. This *will* correct the problem, probably within hours of the complaint.