Helpless Visitors

[Caffeine_IV]

On two occasions we have had "helpless" visitors come to our floor. What do you do in these situations.

1. An older wheelchair boud lady was brought by her son to visit a patient and essentially abandoned. It was in the evening and she kept saying he was supposed to come back and get her. She was incontinent at times and needed assistnace to transfer to the toilet when she wasnt having incontinent episodes. Our asst nurse manager was able to contact appropriate family the next day to come and get her if I recall...but for that night a tech assisted her.

2. A morbidly obese woman...over 400lbs came to visit her mother. It started with the ER calling our floor and asking if someone would wheel her from there to our floor because she wasn't able. We did not and security brought her to the room. At some point the woman needed tp use the bathroom and could not get up. Eventually security + 3 staff got her on a bariatric bedside commode and back into a wheelchair with much difficulty. Our night supervisor warned after this incident that if injured the staff wouldn't get workers comp and also assisting someone is entering into a contract with them and we could be liable for injuries.

My question for the 2nd one is how did this lady even get from her house to a car to the hospital and in a wheelchair anyway. Of course no one asked. And for both we are busy as it is without having essentially another patient needing full assistance but these people were helped as not to be cold.

[JDZ344]

.It's funny how people can get to the ER but once they are there, they can do nothing for themselves :)

[Zookeeper3]

1. A person "left" in a wheelchair, I would offer to bring them to a phone and phone book and provide a snack until they were able to secure a ride. If they were going to "miss" life saving drugs like insulin and heart meds, I'd offer to have security take them to the ER for an eval.

2. There is no, NO way workers comp will cover me to help lift a 400lb VISITOR anywhere. If a visitor "falls out on the floor, we call rapid response and security shows and once stabalized, the patient transport team of strong men can lift them up. Have to go to the bathroom? I can call transport, or in an "emergency" push you into a handicapped toilet. lock the wheels on the wheelchair and alert you to the emergency call button if you feel unsafe.

3. Comp. will not cover me for any of the above, unfortunately I am not a volunteer and a healthy back and knees are required for me to continue to support my family, no one will undermine this, ever. I will always be respectful and maintain what ever safety I can... but my safety to care for patients I am legally bound to comes first, always.

[Caffeine_IV]

Katie- We have lifts as well but they are for patient use and probably true emergencies but this was a VISITOR. Getting the mechanical lift out for a visitor is going above and beyond to me.

Zookeeper- I don't remember how alert and oriented this lady was but I wasn't notified until in the middle of the night (like 1-2am) that she had been "left."

I agree about having only one back and being extra careful. I did not assist with the lifting but I was there. It was very time consuming to have multiple staff helping a visitor with a NON-EMERGENCY when we had patients to care for.

I think the issue in that case was noone wanted to be the "insensitive" one to say that she needed to go home/stay home if unable to toilet herself. It sounds mean but it's really not unreasonable. And it was during night shift.

[BrnEyedGirl, BSN, MSN, RN, APRN]

In my hospital the first lady would be Hot lined. Social Services would investigate. What kind of family/caregiver goes off and leaves an elderly person who is unable to care for themselves all alone?

[JDZ344]

Katie- We have lifts as well but they are for patient use and probably true emergencies but this was a VISITOR. Getting the mechanical lift out for a visitor is going above and beyond to me.

Zookeeper- I don't remember how alert and oriented this lady was but I wasn't notified until in the middle of the night (like 1-2am) that she had been "left."

I agree about having only one back and being extra careful. I did not assist with the lifting but I was there. It was very time consuming to have multiple staff helping a visitor with a NON-EMERGENCY when we had patients to care for.

I think the issue in that case was noone wanted to be the "insensitive" one to say that she needed to go home/stay home if unable to toilet herself. It sounds mean but it's really not unreasonable. And it was during night shift.

Wow, i missed she was a VISITOR. No way would I have lifted her, either, and my facility would not have expected us to. I will sometimes give visitors (elderly) food if they have been sitting with their relative for a long time, or I will happily get them a drink...but that is ALL I will do!

[TickyRN]

I would not have "assisted" either. I would have notified charge or supervisor about the "helpless" visitors.

What if someone had hurt their back or fallen when helping the 400lb lady?

[canoehead, BSN, RN]

Send them to the ER if providing a phone and a drink does not solve the problem.

I would not be OK with lifting anyone either.

[Caffeine_IV]

I would not have "assisted" either. I would have notified charge or supervisor about the "helpless" visitors.

What if someone had hurt their back or fallen when helping the 400lb lady?

If they were hurt, they would have been out of luck! The charge nurse was the nurse for the patient the obese lady was visiting. No one really knew what to do.

Wow, i missed she was a VISITOR. No way would I have lifted her, either, and my facility would not have expected us to. I will sometimes give visitors (elderly) meals if they have been sitting with their relative for a long time, or I will happily get them a drink...but that is ALL I will do!

I thought you may have missed that visitor bit. I have no problem giving someone ice/juice/coffee.

In my hospital the first lady would be Hot lined. Social Services would investigate. What kind of family/caregiver goes off and leaves an elderly person who is unable to care for themselves all alone?

I thought that was really sad that they left her there in the wheelchair. AND she hadn't eaten. Unfortunately, I did not know how to handle the situation at that time but I do now and I wouldn't leave it unresolved.

[himilayaneyes]

At my hospital, the abandoned lady would have been sent to the ER and social services would have been called. And as far as the fat lady on the bariatric commode...that is just ridiculous. It may sound mean, but I have to protect my back first and wouldn't have helped her since worker's comp won't cover that...not to mention you're liable if you help her and she hurts herself. If anything wheel her into the handicap bathroom and leave her be. Maybe hospitals should post signs that only visitors capable of independent self care are allowed to visit patients...lol.

[canesdukegirl, BSN, RN]

So how in the world does this 400lb lady get to the bathroom at home? Sorry, lady but you are gonna have to get there yourself! I am simply aghast that you were put in this situation.

No, I don't think it was cold of you AT ALL to have this point of view. As much as our nursing studies remind us to provide holistic care to both patients and families, having several staff take the time and risk personal injury (uncompensated, nonetheless) to help a visitor like this is clearly outside of our expected guidelines. To think of the potential risks here in this situation makes me shudder.

Did you happen to call patient/visitor relations regarding this? I would love to hear their answer. I think I am going to call PVR at my own hospital just to see what our policy is. Thanks for posting this-it has made me think about what I would do in your situation.

[canesdukegirl, BSN, RN]

. Maybe hospitals should post signs that only visitors capable of independent self care are allowed to visit patients...lol.

As sad as it seems, I think you have a good idea!