Having the "Right to Fall"

[TheCommuter]

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.

[Warpster]

Nurses have been put into an impossible position about this stuff for far too long. If we please the bureaucrats and ivory tower dreamers, we risk not only the patient's well being but our own licenses and livelihoods.

We always called families to come sit with confused and/or wandering patients. When the family refused, we got that restraint order. I would much rather have to put up with a complaining bureaucrat than an injured patient and a lawsuit.

"The right to fall," my ass! They'll have that right as soon as people stop blaming the nurses for "allowing" it to happen.

[ohioln, RN]

dekatn, if they don't know what's going on, I think they can be restrained against their will to prevent further injury intil they are lucid again. Correct me if I'm wrong.

[crazdmomof4]

dekatn, if they don't know what's going on, I think they can be restrained against their will to prevent further injury intil they are lucid again. Correct me if I'm wrong.

You can do a 24hr restraint without an order, but you need a very good reason for doing it. i.e danger to themselves, or others. Falling and breaking a hip doesn't qualify, we are talking level of suicide here.

[goldeneyes181]

I have seen many residents, for instance, who lean forward most of the time they are in a chair (non-weight bearing), and unless they have someone right there with them, they will lean forward and fall.

I've seen those same residents! (Do you work with me?) But seriously, many of those residents we've seen are going to topple right over whether they're belted in or not. I, for one, would rather they be protected with hip pads/helmets and fall to the floor by themselves, rather than falling to the floor and having the wheel chair they are tied to fall on top of them.

Interestingly, toddlers are another group that fall quite a bit, but most parents don't tie them up. They "child-proof" the house, i.e., sharp edges on furniture are padded, sharp objects put out of reach so they won't be fallen on, gates placed at stairs, etc.

I fall at least once a week (Ok, the secret's out--I'm a clutz!), but I don't think that I need 1:1 supervision OR to be tied up. I think we need to treat everyone with dignity and protect them as best we can. The best fall prevention technique I've ever seen is "anticipating the resident's needs". If they aren't in a hurry to meet a physical or psycho-social need, falls are naturally less frequent.

[CapeCodMermaid, RN]

You can do a 24hr restraint without an order, but you need a very good reason for doing it. i.e danger to themselves, or others. Falling and breaking a hip doesn't qualify, we are talking level of suicide here.

I thnk you still need an ORDER. You can do a 24 hour restraint without family consent if it is an emergency situation. In the case of a threatened suicide, you'd be better off sending them to the ER instead of belting them in the chair!

[ohioln, RN]

goldeneyes181, I agree.

[WeimaranerluvinRN, ADN, RN]

The side rail issue has become a big one where I work. There was someone who got their head caught in a rail and died somewhere and I believe that is when this all came about. Most of our beds have half rails. Which are not considered a restraint as the full rails are since a lot of times residents try to crawl over them. We also use a lot of low beds with mats on the floor for safety.

[Valerie Salva, BSN, RN]

dekatn, if they don't know what's going on, I think they can be restrained against their will to prevent further injury intil they are lucid again. Correct me if I'm wrong.

A lot of facilities are retstraint free, and restraints cannot be used for any reason. They do not even allow restraints in the building where I work.

I have a number of demented pts who will never be lucid again in their lives.

They are put on low beds, and we pick them up off of the floor multiple times a shift.

[Valerie Salva, BSN, RN]

I've seen those same residents! (Do you work with me?) But seriously, many of those residents we've seen are going to topple right over whether they're belted in or not. I, for one, would rather they be protected with hip pads/helmets and fall to the floor by themselves, rather than falling to the floor and having the wheel chair they are tied to fall on top of them.

Interestingly, toddlers are another group that fall quite a bit, but most parents don't tie them up. They "child-proof" the house, i.e., sharp edges on furniture are padded, sharp objects put out of reach so they won't be fallen on, gates placed at stairs, etc.

I fall at least once a week (Ok, the secret's out--I'm a clutz!), but I don't think that I need 1:1 supervision OR to be tied up. I think we need to treat everyone with dignity and protect them as best we can. The best fall prevention technique I've ever seen is "anticipating the resident's needs". If they aren't in a hurry to meet a physical or psycho-social need, falls are naturally less frequent.

One nurse to 60 or even 20 pts in no way anticipates their needs.

[elkpark]

I've seen those same residents! (Do you work with me?) But seriously, many of those residents we've seen are going to topple right over whether they're belted in or not. I, for one, would rather they be protected with hip pads/helmets and fall to the floor by themselves, rather than falling to the floor and having the wheel chair they are tied to fall on top of them.

Interestingly, toddlers are another group that fall quite a bit, but most parents don't tie them up. They "child-proof" the house, i.e., sharp edges on furniture are padded, sharp objects put out of reach so they won't be fallen on, gates placed at stairs, etc.

Excellent points. Thank you.

[SuesquatchRN, BSN, RN]

Toddlers are a bit more resilient that my brittle-boned old folks.

One of our ladies went head first out of her wheelchair a few weeks ago. Broke her neck. Died over the weekend of pneumonia and weakness and misery.

[ohioln, RN]

I've also seen mats on the floor which is the pt's bed. Has anyhone else seen this?