Published Sep 26, 2013
pinkessence_58467
46 Posts
I know two residents who are confused at times and if wheelchair isn't close they will try to walk to it. Even used bedside table to. They are very unsteady. It's a fall just waiting to happen, but some other people views are different. They think by moving wheelchair they won't get up. I've been in conflict about this issue with another shift. Me and this other nurse addressed issue with our supervisor. The issue is being dealt with by giving the residents therapy but they still allow that certain shift to take away there wheelchair. There fall intervention on cardex is keep items they want close and taking wheelchair away is following it. I fear that a horrific fall will occur.
amoLucia
7,736 Posts
If you really want to stretch a point - taking away a pt's wheelchair can be considered a form of physical restraint. The definition of restraint can be expanded to include any means by which a person's free mobility has been restricted or impaired. And to take it a point further, if the pt becomes injured from a fall while trying to walk (to get to his whch), a shrewd lawyer can claim moving the whch was unlawful restraint.
Think about it - you've impaired his ability to walk safely and have caused him to become upset. Sounds like restraint and abuse to me.
And be very careful what your care plan interventions specify.
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I also think those low-beds we use in LTC can fall into this category. Some think it's just a measure to make a fall less of a distance to the floor. But it freq hampers the pt's ability to 'oomph up' off the bed. That's restricting mobility also.
Glycerine82, LPN
1 Article; 2,188 Posts
When I worked in LTC we never, ever, ever left the wheel chairs next to the bed. (for patients who weren't capable of getting into or out of them) The mentality was that it would encourage the patient to try to get up to get in it. More falls can actually happen that way because they see the chair and think its OK to get up alone and because you have no way of knowing if they get up/go back to bed. Most of the time when they do this they won't lock the chair on the return trip and will fall for sure the next time they try to get into it.
I understand what you are saying, though, and we did have one or two patients that just wouldn't stay in bed that we would do this with, but we would add a bed alarm. This way when they got up they had the chair right there but we'd usually get there in time either way. (I would say this is probably what y'all should do with these two patients)
We also didn't leave patients access to their wheel chairs in the rehab unit I worked at in the hospital. They were not permitted to get up alone, doctors orders, and were instructed to use the call bell if they wanted to get up. DHEC and JCHO were there all the time so I am certain it's not "abuse" or a "restraint".
I see what the pp is saying about the restraint thing, but I really don't think not putting a wheelchair next to the bed is a restraint. The patient is free to get up if they want to, but are advised not to. One could even argue that putting a wheelchair in front of the bed would be a restraint if it blocks the patient from getting up.....
I absolutely do not think its abuse, at all. The patient has a call bell. If they are truly capable of getting up and into a chair alone the doctor can write orders saying they don't need help or whatnot. I didn't see this happen very often but it did from time to time.
Sorry to go on and on but I've really never heard of leaving a patients wheelchair where they can get to it.
People based there opinions on experience. But the those residents can safely transfer themselves in wheelchair
People based there opinions on experience. But the those residents can safely transfer themselves in wheelchair and if you take wheelchair they will try to walk instead. If they are gonna fall I would rather have they fall from transferring from wheelchair then ambulatory unsteadily the point of impact to the floor would be less.We've done away with majority of tabs mainly because considered as a disturbance to others. [/quote']But it's better at work, the previous shift understands now, it just took a conflict.
But it's better at work, the previous shift understands now, it just took a conflict.