Having the "Right to Fall"

Simplepleasures · Feb 20, 2008

I have heard that term from state too, seems like an oxymoron. But then again its coming from so called "state". :uhoh3:

oramar · Feb 20, 2008

Do I have a right not to do all the paperwork, or the right not to be sued?

dekatn · Feb 20, 2008

You know as well as I do that some of the diseases facing the elderly today, that as they age the more childlike they become.

If we use safety measures to prevent injury in an elderly person, we are "restraining them", which is a big no no.

If we were to put a child in a crib and FAILED to put the rails up to prevent injury, we would be in deep poop.

Some of these so called policies are, for lack of a better word, stupid.

I have heard statements made that the only reason we want to restrain or keep someone from getting up is to make it easier on staff, yeah right.

We love the extra paperwork involved when a pt. gets injured, and I'm sure the pt. really enjoy the added pain and discomfort a fall causes, sometimes they even get to ride in "the big bus with the flashing lights", what a thrill!!! They get to leave a familiar environment and familiar faces to go to a big emergency room with a bunch of strangers poking and prodding on them. And, OMG, sometimes they even have to restrain them in the ER to prevent them from further injury, because they just don't understand what is going on. But, in the ER environment it is pt. safety, not for staff convenience. What is wrong with this picture? I mean, since they have "the right to fall", why not do it right there in the ER where they have the means to mend cracked heads, broken hips, etc.

ER people, this isn't meant as a flame to you, please don't get upset, I work in a hospital, I live in the real world too. I'm just being sarcastic regarding some of the stupid P&P, that we in healthcare have to deal with.

Penny8611 · Feb 20, 2008

You know as well as I do that some of the diseases facing the elderly today, that as they age the more childlike they become.

Precisely. I know my Mom sure has. I had relatives in LTC when I was a child, but I hadn't been in a LTC center for many years when my Mom had a massive stroke. I was STUNNED to find no rails on the beds. I know that people can sometimes get tangled in them, but people sometimes get tangled in seatbelts, too.

It's nuts. Pure-d nuts.

The reason my Mom's falls have decreased is because her physical ability to move her own weight around has gone down. She was never seriously injured from a fall, but she had many. I never yelled at the staff when they called to tell me, but I fear I was in the minority in that regard. They did the best they could with the tools available to them.

So...we should start making crib rails illegal and just put foam on the floor next to the crib. Gotcha. :banghead:

Simplepleasures · Feb 20, 2008

We had an incident several years ago here in WI, in which a patient got her neck caught in a half rail the one at the top of the bed( no bottom rail) and she suffocated. Big law suit, after that no more rails period. No good answer to this problem.They consider it a fall, even if the patient is in a low bed, with a thick mattress next to it and the patient is still on the thick mattres, so much paperwork, glad Im out of it. Dont miss that part at all.

CapeCodMermaid, RN · Feb 21, 2008

Again with the same problem...the DPH hasn't caught up with the way it is in LTC these days. At every turn they are trying to take money away from us yet demand we do more and more and take care of more and more patients.

We have started writing risk vs. benefit notes on most everything. It's awful to have to look at everything from a potential law suit position, but in this day and age, that's what we have to do.

If a family member balks at a restraint, and we have very few in my building, we are pretty blunt and say "Most likely your mom(dad, grandma,grandpa, husband) is going to fall again and they may break a bone. Do you understand that?" If they say they understand, we are very careful to document what they say. One woman whose mom had fallen 2 times in as many days and who really is clueless about the extent of her mom's dementia, said "I'd rather have her fall again than be seat belted in her chair"...fine ...we document that so when the surveyors come in , we can say..."Wait...look here...the daughter made the choice."

Katnip, RN · Feb 21, 2008

Let me get this straight.

The state surveyors, who basically decide whether or not you get Medicare payment, says patients have the right to fall.

Yet, now the newest thing down the pike is, if your patient falls and is injured Medicare will not pay for the extra time and care that may result from that fall.

Lexxie, LPN · Feb 21, 2008

Yep, residents may have the "right to fall" but then the facility is penalized if too many residents are falling. And then you have some of those family members who are constantly threatening to sue as soon as something happens to mom/dad/grandma/grandpa. Go figure.

Nascar nurse, ASN, RN · Feb 21, 2008

But on the other hand, we have had family members insist that we restrain their loved one and surveyors tell us that family has NO authority over this decision, because "they have that right to fall. (Excuse me, but it will be the family that sues me later for not following their directions).

elkpark · Feb 21, 2008

Please keep in mind that all these rules that seem "ridiculous" now came about because of decades of abuse (restraining clients for staff convenience, punishment, etc.) in the past ... Sure, we all say, "Oh, I would never do anything like that ..." but plenty of people have over the years, and it didn't stop until the authorities made people stop ...

I assure you that no one in government has ever done anything in healthcare regulation proactively -- the rules are all there because of bad things that happened in the past (something gawdawful happened, and the legislature sat up and said, "Golly! We need to make sure that never happens again!)

SuesquatchRN, BSN, RN · Feb 21, 2008

Am I the only one who thinks state surveyors sound incredibly silly when they make statements such as, "Well, the resident has the right to fall"?

And the residents exercise it. What's ridiculous is the citations when they do.