Hops requiring nurses sign no Falling contract, Is this legal???

Decade1 · Oct 1, 2016

Not legally binding. You could also argue the nurse was forced to sign the contract under duress in order to keep their job. Plus all they are stating is that they will "do everything they can". This does not mean they will prevent every fall. Bunch of ********.

nutella, MSN, RN · Oct 1, 2016

My acute care facility is requiring nurses to sign a no fall policy with each patient. The patient is stating they will not fall and the nurse is stating she/he will do everything they can to help their patient not to fall. Is this legal and if a patient does fall and gets hurt or even dies, would the responsibility fall on solely on the nurse? I don't like this one bit. Esp on a fast paced med/surg unit where you are always busy.
Any thought???

LOL .

So - I have seen such thing. It is not an "actual contract" in the way we understand contracts - a binding agreement. They call it "contract" to use a strong language that will encourage patients to adhere to their "prevent falls" strategy. The thought is that if you point out to the patient that the nurse / aids but also the patient make a commitment to adhering they will not jump just out of bed.

I would say that the work "contract" is not the luckiest one and perhaps "commitment" would be better.

It is a way of holding staff and patients accountable and make sure that patients understand they have to do their part as well.

Having said that - I feel that the intention is good but execution poor as a lot of the patient population do not adhere to fall prevention because they are confused, overestimate abilities, display poor judgment when sick, or can't wait for somebody to come get them to the bathroom.

Which is also the reason why there are bed alarms and chair alarms ....

IMO - if a patient is willing and able to adhere to fall prevention interventions they will for the most part. But the system is not setting anybody up for success because we ask them to wait but it takes more than 10 minutes for somebody to show up when they ask to go to the bathroom...

If your patient falls with or without injury - it is reportable and usually investigated in some way. When following up on falls there is usually a form or format used to see which factor contributed to the fall. If you have a patient on all fall precautions but the patient falls despite bedalarm and staff running to assist it is one story. But if you forget to put a bedalarm on, patient has slippery socks on and gets up and falls it is a different story. Or if you have a young patient who is perhaps 30 and usually not a risk for falls, you give dilaudid iv for pain - now the patient is drowsy and may have lack of judgement. You do not put the bedalarm on and the patient falls - it is a problem. As I said earlier, it is not a "legal contract" but a tool that attempts to hold people accountable. If your patient falls and dies as a result of it - you have a problem regardless of a fall contract....

DeeAngel · Oct 1, 2016

No facility would ever compel me to sign any sort of contract with a patient. That would be a career ender for me, because I won't do it. I already left nursing for retirement 3 years ago because it's just no longer worth it to be a nurse. This takes it to a whole new level, if it's authentic.

Kooky Korky, BSN, RN · Oct 1, 2016

In reading the original post, it says nothing about a contract. It states 'policy'. It seems to me that a specific policy has simply been highlighted as being amongst the most important to bring awareness to patients' responsibilities to help keep themselves free from injury....kinda like a 'you have to help me help you' type deal.
If the patient still falls and all safeguards have been implemented, the RN cannot be held responsible if she has other patients to tend to as well. The patient didn't uphold his/her responsibility such as calling for help and waiting for that help to arrive before attempting to get up.
In short, that form is to let the patient know that we have expectations of them, too. That's how I would interpret that policy.

Having other duties and patients has never been taken into consideration when flaying a worker. Everyone knows a nurse can be only one place at a time, can do only one thing at a time, but this has never been allowed to infuence anything, despite the reasonableness of bringing into consideration All factors in a matter.

Kooky Korky, BSN, RN · Oct 1, 2016

No facility would ever compel me to sign any sort of contract with a patient. That would be a career ender for me, because I won't do it. I already left nursing for retirement 3 years ago because it's just no longer worth it to be a nurse. This takes it to a whole new level, if it's authentic.

Why did you go back to NUrsing, just curious, if you care to share?

ClaraRedheart, BSN, RN · Oct 1, 2016

Are we going to include terminology that states "I will not get up without help, even if that means that I must soil myself and sit in it before help can arrive"? MOST of the times that patients fall without medical staff present, they are attempting to go to the bathroom. Sometimes they are confused, in which case... they wouldn't remember the dang contract anyways. Other times, they don't care. They just don't want to be sitting in a puddle of pee and no one has answered the call bell yet. Often, there is nothing you can do about it because you are already taking another patient to the toilet. You can't drop one to assist the other though. And now, we're not even allowed to leave fall risk patients alone in the bathroom to assist other patients. This is usually ok, and usually our staffing is great, but sometimes our acuity goes through the roof and sometimes more so for some nurse/tech teams than others. Had a day like that yesterday... came close to having my first patient fall in my short 2.5 years as a nurse. Caught it just in time.

Loracs72 · Oct 1, 2016

Some hospitals have a general "Rights and Responsibilities" form for a patient to read, but are not obligated to sign. They are just statements, and are not mandatory to read.