Having the "Right to Fall"

crazdmomof4 · Feb 27, 2008

Clients have the right to fall.they have the right to keep as much dignity and independance as long as possible but if the educated staff of PT deems them incapable of walking, it is our job to keep them safe. and alarms are a help but by the time I race down the hall over the call light queens sitting in the door way waiting for bingo to begin or place their dinner orders to the kitchen and I have some one on the floor. because I can't jump a hurtle let alone a wheel chair with a person in it.
I wish we had the right to make the state survey team work on a live unit. Once a year like renewing your i v or cpr certification . I can see it now:rolleyes:
I want the unit of 35 understaffed one aide till 3 and one going at 10 am. and it is flu season on that unit. I want them to accidentally lock their med cart keys in the med room and have to wait an hour for maintaince to open the door:smokin:.
A full unit of call light queens, who really belong in assisted living and are just testing the call light to see that it is working and cause you are new to see how fast you answered and she waited 3.5 seconds so she call the state ombudsmans office which she has on speed dial. and could you please write down your name so she had it right for when her daughter comes in and for when the ombudsmen's office comes in she'll have it. and it is her shower day and she won't let a man shower her and we only have 2 male assistants:D
A Combative alzheimers patients who's families do not want any medications and that has you by your hair because you are a nazi spy, and Mary lou Ritton couldn't hold the back bend you are in, and he know you area spy because you spoke yiddish to the dying hospice resident next to him . :dzed: and you are like this for 35 minutes because your aide can't hear you call, one is in the dinning room for his 1/2/hour shift and the other one is in with your opera diva and she is singing on the top of her lungs and he couldn't hear her room mate over the din let alone you on the other hallway you finally get loose with the help of 6 after a visitor gets you some help .
Former violent psych residents who are refusing their meds and are angry because it is supposed to be pizza night and it was cancelled and are now lobbing feces into the hall way at anything that moves, and you have to move faster and with more twist and turns than Jackie Chan just to shut the door, and the 911 psych line is sending someone but you are not a priority right now. you're 15th, and because of some medical emergency, you are not getting any support help from your supervisors any time soon .
Harry Houdini's. who climbs out of bed, wheel chairs, and anything else faster than a speeding bullet and can turn off the chair / bed alarm with the skill of a bomb technician.
A stripping patient that run down the hallway and into the lobby in their birthday suit for the corporate horse and pony show or better yet a live feed of a local tv crew for the art show. One of the visually impaired residents shows you the beautiful bird on the privacy curtain and it is a bat, now you call the administrator and tell him and it is halloween and what the heck do i do with it. I got it trapped in the day room. and the exterminator can't come till tomorrow.
Throw in a few disgruntaled families just to ice the cake. and lets see how well they handle it
Well it's my fantasy that they handle some of the thing I have dealt with in my career. but it is unrealstic that the state would ever mandate their own work to be regulated by the same standards. Our state inspections have been late and they are not punished, They expect regulations they force on us,such as no side rails, no falls, food to always be hot and med passes in under 3 hours,when you have only 5 min per client 19 meds per resident and nurses only have 15 minutes per resident in an 8 hour day. it is a miracle if you pull it off in the allotted time frame and get to eat or go to the bathroom and get out on time.

OMG Your post is too funny and so true, but you left out the pts who are with it enough to sit there and ask you what each individual pill is for, and why they are taking it. Now mind you they have 10 pills in that little cup. Oh and don't forget, you can't rush them because then the drama is on and your being awful to them because they can't have more than 45 freaking minutes of your time and its 6:30pm and you were supposed to be dining room supervisor at 6pm... I bow to the state regulation gods:bowingpur

witchypoo · Feb 29, 2008

thank you , my other favorite is when you look like a soap star after a honeymoon scene, your sweating bullets and your hair is all over the place, you are dealing multiple emergency. your one pt is hypo glycemic and one other needs cpr and you had to defib him, so for the last hour you been your own personel emt crew, your doctor order for transfer have been taken by your house keeper because she was the only one free to answer the phone, she also called 911, You, your supervisior and your 3 aides have been a little preoccupied and your call light queen has called the administrator because her pill was late and it is only a colace and her aid promised her a box of tissues. :banghead: just so you get the mental image of this patient check out brit coms on pbs she is a cross between Hythician Boucket and Dianah Trent, funny to observe hell to work for. the following day you get a a notice from the DON to organize your and your staffs time management better, I can not give you the responce i gave my DON.:argue:I can only tell you my union rep should be from the long shoremens association rather than 1199. and my mother would be embaressed, let just say it was removed from my files,

Valerie Salva, BSN, RN · Feb 29, 2008

I have worked in several restraint free facilities. you never saw such a group of bruised and injured old folks.

I recently joked "There are so many black eyes around here, I feel like I'm working in a home for retired boxers."

My feeling is that for an elderly person, a posey vest is a temporary restraint, but a broken hip is a permanent one.

FireStarterRN, BSN, RN · Feb 29, 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"?
We all have the right to fall as much as we please, but it could turn into an unsafe and potentially deadly situation.
Note: I'm probably too tired to make sense to any of you.

You're darned tootin', it's one of the more absurd things they have come up with to date! :uhoh3:

jjjoy, LPN · Feb 29, 2008

My feeling is that for an elderly person, a posey vest is a temporary restraint, but a broken hip is a permanent one.

Good point! Sometimes we need little one liners like that to counter the one liners like "right to fall"... though hopefully, that can lead to thoughtful discussion of the gray areas between the extremes.

Plagueis · Feb 29, 2008

I have worked in several restraint free facilities. you never saw such a group of bruised and injured old folks.
I recently joked "There are so many black eyes around here, I feel like I'm working in a home for retired boxers."

This is what I was wondering about: whether restraint-free facilities had less injuries, because I always hear from managers that restraints are more likely to cause injuries than to prevent them. I would really like to see them handle residents who want to jump up, or lean forward 90 percent of the time they are in a wheelchair, even when redirecting doesn't work. Without a restraint, some residents would have to be 1 on 1, and I know that most nursing homes will not be willing to hire extra staff to cover these residents. I just don't think that CNAs and nurses should be blamed if a resident falls (but we are), since it's the resident's "right" to do so.

crazdmomof4 · Feb 29, 2008

My charge nurse the other day jokingly said regarding my Sunday admit from hell... "at least if she falls and breaks something, we can give her back to the damn hospital who thought it was ok to release someone having visual hallucinations" ... I dare the state, most of whom probably never worked a day in a nursing home to do our jobs...

IowaKaren · Mar 1, 2008

As far as restraints go, we wear seatbelts for safety but occasionally the seatbelt is responsible for loss of life or injury. Why is the norm saying that some injuries come from restraints but is it really the norm.

witchypoo · Mar 1, 2008

now that is a idea, :lol2: we can make the restraints more like baby car seats a 5 point hitch, over the shoulders across the chest and belly and hips locking in the crotch area, they couldnt slide to choke would have multiple strap adjusters for comfort and the wheel chairs would be more like a handicapped child wheel chair/ stroller so you can tilt it back for the forward leaners and butt schoochers, and they could be made to have leg mobility like a merry walker. or leg rest like a normal chair.

I just caught holy hell because harry houdini got out of the wheel chair and fell:angryfire his son visited and turned off the alarm because that noise gives him a headache and he was with his dad so he did not need it on, so he left dad in his empty room and instead of bringing dad to the nurses station or turning the alarm on himself, he came to the desk to have us put it on :nono:and before we were told it was off the old man was on the floor and his son got to escort him to the er for evaluation, we grabed sonny boy before he got out of the lobby. and i'll have to deal with the broken hip. this sucks. I want a unit with a big circular desk so I can park the harry houndini's so I can see them.like a 50's drive in, the alarms are attached from the desk to the patient's back and the families sign a waver, if they shut off an alarm they have to do the paperwork. you have to bring them back to where you got them from i don;t know maybe the quarter thing like grocery carts have. or a fine for a over worked staff outting. with the families i have i think we can do a few broadway plays a year, with seats the front row. with a limo taking us.

people can die from restraints but they also die with out them. and i do not see an improvement since we went restraint free, 20 years ago, you put straps on your baby to keep it safe in the the stroller or the car i can't see the reason why it would not work with the elderly which has more dignity a little strap vest, you can take off and walk them with or surgery that is a danger god forbid they are on blood thinkers that can stroke them or bleed them out, a 10' scar or an injury that could imobilize them for the rest of their lives. i don't know. i think i'd opt for the strappy thing if they put sequins on it cause i'll be a flashy old lady and i'll also have a psychadelic colored walker just to humuliate my kids. and my wheel chair will have a bumpersticker on the back saying my other car is a broom.

facetiousgoddess · Mar 2, 2008

i think i'd opt for the strappy thing if they put sequins on it cause i'll be a flashy old lady and i'll also have a psychadelic colored walker just to humiliate my kids. and my wheel chair will have a bumpersticker on the back saying my other car is a broom.

ROTFLMAO....

Can I be your ltc roommate?

What you write is so true....

Tres

witchypoo · Mar 3, 2008

Tres we can be roomies. as long as you will let me watch late night tv since my body is accustom to at least watching letterman:lol2: i'll wear head phones and draw the privacy curtain, so you are not blinded by the light of the tv. i also will shower at that time because if i learned nothing else from dorm life 3 am is the only time hot water is available in abundance.

i have 2 lovely kids, who will do my bidding:bow: and bring me all the contraban foods, we are not suppose to have like chocolate and chips and real coffee. who have been trained to bring chinese, pizza, and real cake cause the food here is dreck. and we do not want a room close to the beauty parlor it smells like perm solution for hours after they close.

ocassionally i like to put on my ren fair gear and go to ren fairs so don't freak out, you can come if you want but you have to wave at anyone who stares at the car, like you are the queen of england, because elizabeth tudor is driving us. and i wear more italian/spanish style ren fair things and if you want to dress up too i'm sure we have something in your size. and i will always dress up for halloween. and i celebrate all the solstaces because it will drives the rec staff crazy. i want to see them find decorations for that one.

i think of nursing homes like college dorms, very expensive rooms with limited space, with awful food and are clueless in setting up room mates. have some of the stupidest regulations, and you are trappped using monopoli money to buy things at inflated prices. most of the parties have dumb themes. i think a halloween party called witches and warlocks,is more dignified than one called scarecrows and pumpkins, i want a oscar and tony party cause i don't care about the super bowl. just a thought. rae

witchypoo · Mar 3, 2008

oh i forgot i have a little joke one of my patients told me. it's cute:lol2:

question: what do you call it when you have a client that rolls into other clients chairs and causes an abrasions?

answer: a bump and grind.

That is why i work in geriatrics so i'll always be the sexy nurse to some one lol

"the night nurse is gone and the sexy one's here and she tells us such beautiful lies" from the song jimmy neumann