Having the "Right to Fall"

facetiousgoddess · Mar 3, 2008

We are perfect roommates! Where were you when I was in college??

We'll be SCA's oldest members...You be Elizabeth and I'll be Mary, Queen of Scots....We'll make Springer look mild.....

And just wait til Beltaine!!!!! Bwahahahaha what do ya think activities is gonna do with that one???? And the potential confusion of Lamas....

My kidlet will provide the wine and homebaked goodies.....and our familiars the entertainment......

blessed be

Tres

witchypoo · Mar 3, 2008

Lamas isn't that the guy so says "you look marlvolous". of course i have a wonderful recipie for lamas bread. but will they let us burn a yule log or will we have to take it outside like a bon fire? or try to make up settle for a cd i can hear the rec staff now "get out the stupid burning log cd for the crazy ladies in 1313." and "what the hell is a wallis" her daughter is bringing it in for the party, that is the booze punch that her daughter gives cheer in old english like romeo and juliette lol

crazdmomof4 · Mar 4, 2008

OMG you two will be a riot in the LTC home. We have a new administrator who sings the "Friday song" over the loud speaker, and once nearly fired a nurse I adore for burning sage incense for a resident (or so I have been told). I would kill to see her reaction to you two.

pinkplumeria · Mar 5, 2008

Okay, I have to admit it, yesterday I actually used the words. I told our patient safety manager that our patients had the right to fall. I am the clinical director of a home care program for the federal government (VA), we have similar regulations to Medicare agencies, and are actually surveyed by three different agencies. One of the big focus areas this year is on falls. I use the right to fall as a way to cover our butts. We do a home safety assessment, a comprehensive fall history, a fall risk assessment, an adaptive equipment assessment, cognitive screening, and much much more. However, in patient's homes, they are the boss. We can bring them all the equipment in the world, get PT and OT involved, and make any number of suggestions, but the patients still do what THEY want, and ignore our teaching and our equipment, and fall anyway. That's not our fault. A patient has the right to refuse rehab therapy, and the right to refuse to use the equipment we bring, and the right to refuse to follow our suggestions/teaching. That being said, having the right to make poor decisions = having the right to fall. Our policy on fall reduction includes something to that effect and we haven't been "dinged" on it yet...

dbscandy · Mar 5, 2008

I am just browsing through and am DUMBFOUNDED at what I am reading!!!

Just how long has this stupidity been going on? My mom was in a nursing home and died in 2000. I distinctly remember the bed having rails and we used them.

What a crock!! I cannot imagine my reaction if this had happened to my mom.

I am an NICU nurse, and the next time one of my charges is traveling to the door of the isolette, I'll invoke his/her 'right to fall' and leave the door open! :uhoh3:

crazdmomof4 · Mar 5, 2008

I am just browsing through and am DUMBFOUNDED at what I am reading!!!
Just how long has this stupidity been going on? My mom was in a nursing home and died in 2000. I distinctly remember the bed having rails and we used them.
What a crock!! I cannot imagine my reaction if this had happened to my mom.
I am an NICU nurse, and the next time one of my charges is traveling to the door of the isolette, I'll invoke his/her 'right to fall' and leave the door open!

Oh, but NICU is a whole other ball of wax... children have no rights. As evidenced by our governments propensity to protect the rights of those who prey on kids...

When I see an elderly person hit the floor or rather the aftermath... I can almost guarantee the course of events if they are 70+.

Stage 1-- surgery by a surgeon who is just practicing and once the incision is healed wont care. ( I have actually been told this by a surgeon who screwed up a gastric surgery "The incision is healed so I really don't care about the problems she having now"... but that's a rant for another day)

Stage 2-- Possible infection, bed rest to be followed by bed sores because your aids are understaffed and they are lucky if they can get to turn her q3hrs.

Stage 3- Disuse syndrome, no energy to move so we end up with pneumonia (if we are lucky)

Stage 4-- again followed by the primary doc's comments "he/she is a no code so why do you want to treat it?" (Again I have been asked this about the same gastric pt. That time I hit the roof and landed in righteous indignation on the doctor's head :angryfire!!! followed by a 20min rant at the nurses station)

It should be mandatory the state regulators work with us to give our pts with broken hips back some of their quality of life before they had the right to fall.

Edith

Who is still ranting about the disposability of people over 80yrs to some physicians

jjjoy, LPN · Mar 6, 2008

The 'right to fall' makes sense for cognizant, active elderly people who perhaps reject certain measures that would decrease their risk for a fall. It also makes sense to ensure that restraints aren't misused or causing harm. But we humans seem to have a propensity to take reasonable ideas and take them to an extreme. And then later have a "new discovery" that that's all wrong - reasonable suggestions to the other directions are made - and we take it to other extreme. I can accept that up to a point. The hope is that we don't have to swing too very far to one extreme or the other before correcting the other way. Sometimes it seems like it's never going to change. Hopefully, (though probably WAY too slowly) it will.

JustMe · Mar 6, 2008

The 'right to fall' makes sense for cognizant, active elderly people who perhaps reject certain measures that would decrease their risk for a fall.

I had a guy one night in the CICU who was on a GII/IIIB inhibitor (like Integrilin) and WOULD NOT stay in bed as instructed. He was told that if he fell and hit his head he could die from bleeding into his brain. Didn't help--he kept getting OOB without help. He was A&O, just stubborn. Everytime I found him OOB I documented it, put him back to bed, made sure he had his call light and urinal. The night nurse was told to watch him. She also documented his being OOB without help. Then it happened--he got up and fell, hit his head and bled into his brain. Died that night.

Our supervisor wanted to know why we hadn't restrained him. That's because restraining a patient against their will is ILLEGAL! Yes, they have a right to fall--just make sure you document each and every time they put themselves at risk.

On a similar note, when my 92 yo grandfather was in the hospital they had to restrain him. My family didn't like it so WE stayed with him 24/7. I spent 2 nights sitting in the chair next to his bed so he wouldn't need to be restrained. Best 2 nights I ever spent with him. He lived to be 102 and never once needed to be restrained again.

facetiousgoddess · Mar 6, 2008

OMG you two will be a riot in the LTC home. We have a new administrator who sings the "Friday song" over the loud speaker, and once nearly fired a nurse I adore for burning sage incense for a resident (or so I have been told). I would kill to see her reaction to you two.

We'll be right over in costume with sage in hand. :nurse:

And totally concur with Edith....that is one of my ongoing rants....the perception that our residents are disposable.....

Back to topic....just had annual orientation..our education director stated something to the effect that the whole "right to fall" concept is "going in the other direction." Next time I see her I will ask her to elaborate..

Tres

"Ack don't fall !!!!" (oh wait that would be breakdancing...wheww)

Valerie Salva, BSN, RN · Mar 6, 2008

If demented pts have the right to fall and hurt themselves, then why not let them just run wild, wander out into traffic, eat poop, etc?

It's their flippin' right, isn't it? :uhoh3:

godfirst · Mar 7, 2008

did you know the new rules for falls, this year it goes into effect. if a pt falls the insurance company no longer pays from that moment to d/c on that pt. all medical care is charged to the hospital. but we are still not allowed to restrain for safety purposes. makes you think doesn't it.:wtosts:

witchypoo · Mar 7, 2008

Originally Posted by crazdmomof4

OMG you two will be a riot in the LTC home. We have a new administrator who sings the "Friday song" over the loud speaker, and once nearly fired a nurse I adore for burning sage incense for a resident (or so I have been told). I would kill to see her reaction to you two. {you can come with us too, we can make it a whole unit}

I don't think i did this quote thing right , but i do not think we wouldn't have a problem with the "Boss man" since we are the real boss man over him and my daughter has been taught to ride a broom with the best, it is in our dna. GG was president of ILGWU, GM was a civil rights worker in the 60's, and my hobby is Parent rights education for developmentally delayed kids. besides ren fairs and reading tarot cards and palms, That being said,

It frosts my onions that everything is being directed at us is by lawyers and insurance companies, 99% of our goverment are lawyers and a great deal of their campaign contrubitions and lobbying jobs are from insurance co. It is not working nurses and assistants, if they ask any nurses It's a goverment nursing, {Not VA or County facility staff more like} state regulator positions who are usually so far removed from the field they have forgotten how hard the work is.

A hospital is not like a nursing home, true they too have nursing shortages, our staffing is constantly being down graded, do more with less, be more effecent. Next time i'm asked to do something faster i'm using this line "I'm 5'5 and 235 i'm not the bionic woman, and i refuse to indanger my guys to impress the likes of you, it may garner me a insubordination vacation. but i'm getting to the point i really do not care. I'll take a day off with out pay. i hope it is a nice day. and i'll brag about my plans, because it really ticks off the bosses that you are not fazed by a threat of a day off Without pay.

I'm still getting over being written up for being out for sick 4 days since november, I'm allergic to the air freshner they use at work i call it instant asthma attack. and this is well known, I went out 911 from it. {and they can't change it because of the company formulary for supplies and even though i have purchased antistench for my unit that doesn't make me ill it always disappears because it smells nice and clean not like floral pesticide.} if it is used i have to leave my unit for about a 1/2 hour. but it still can start me off and i'll miss the next day because it just pushed my already taxed system over the top to a er symedrol vacation. that was november, and january, January my allergist changed my meds, {just because i sounded like darth vader}i had an allergic reaction to a new med {I was a massive red hive and the benedryl they gave me made me comatose maybe i still could have given out pills we could have called it mystery medication cause i don't know what i'm giving you }so that was another day and the last I was sent home early on a sunday because i had a temp and the compazine wouldn't do it. called in sunday night for monday, was off tuesday and wed, came in thursday {still looked like death warmed over, based on comments by my fellow staff and residents.} Mind you I have notes for all these days from my doctors, and i was only paid for i sick day. because i only asked for i days pay. i was told if i did it again i would get a day off without pay. i commented about this and copied my md notes and attached them, and said if i was sick i would call in. and if they have a problem take it up with the labor board. just venting