Over-Restaining Patients

nursespike · Jul 26, 2006

I did too..I am currently an ADON which also includes Director of Pt services, unit manager, infection control, restraints....and the "when you dont know, ask me" person...under the DON who gets the credit...recently accepted DON position at "local competitor"...turned in notice and got instant exclusion from upcoming company events..that's okay..I still feel good about what I do..I cant change the world..but I wont let that world change me. Just keep moving up to make a difference. I would like to go back to school again...just not sure when.

imisscoco · Jul 26, 2006

I did too..I am currently an ADON which also includes Director of Pt services, unit manager, infection control, restraints....and the "when you dont know, ask me" person...under the DON who gets the credit...recently accepted DON position at "local competitor"...turned in notice and got instant exclusion from upcoming company events..that's okay..I still feel good about what I do..I cant change the world..but I wont let that world change me. Just keep moving up to make a difference. I would like to go back to school again...just not sure when.

Wow! Good for you. I would never want to be in LTC management again. The LTC where I worked didn't use Agency, so whenever there were callouts, we were it, and still had to be back the next day at 7:00. I hated that. We also were on the beeper on weekends, and I can't tell you how many times at 9:00pm I would get an 11:00pm callout. Unless I slept all day in anticipation of the callout. Those days I didn't get them. It was only on the days when I was up all day that the callouts came it seemed!

nursespike · Jul 27, 2006

It was very similar at this facility when I first started out..the pager drove me NUTS! It was an expectation of staff that when there was a call out...tag, youre it...after the pager "broke" it was never replaced and the staff got educated on how to use the phone and the call list to help find replacements or actually problem solve before calling me or the DON. Now they call for clinical issues mostly, which I dont mind. We are accepting more and more high acuity patients..you guessed it...with the same staffing "challenges" (pts with TPN, Hickmans w/ antibiotics...throw in some behavioral issues..and voila!)...I dont think there is a such thing as "long term care" anymore. Management isnt bad, you have to have limits and I always remember what it was like working on the floor, and treat others with respect- no matter what their position. Anyways...I think we have digressed...lol...there is no such thing as a "restraint free" facility

imisscoco · Jul 27, 2006

It was very similar at this facility when I first started out..the pager drove me NUTS! It was an expectation of staff that when there was a call out...tag, youre it...after the pager "broke" it was never replaced and the staff got educated on how to use the phone and the call list to help find replacements or actually problem solve before calling me or the DON. Now they call for clinical issues mostly, which I dont mind. We are accepting more and more high acuity patients..you guessed it...with the same staffing "challenges" (pts with TPN, Hickmans w/ antibiotics...throw in some behavioral issues..and voila!)...I dont think there is a such thing as "long term care" anymore. Management isnt bad, you have to have limits and I always remember what it was like working on the floor, and treat others with respect- no matter what their position. Anyways...I think we have digressed...lol...there is no such thing as a "restraint free" facility

Sorry to everyone for the off topic public post but Nursespike, you just sent me a private email and I can't locate it!

achot chavi · Jul 27, 2006

I love it. They always say "walk in another man's shoes". I totally agree about the 4 letter words vs a hip fracture. I hope someone explained that to the family that complained.

I tried, I even tried explaining that he is one of our better aides and has a special needs child at home etc. The family was just overstuffed with self-righteousness. I couldnt calm them down so I had to apologize profusely and we sent the CNA on a two day (paid) vacation to clear his head

imisscoco · Jul 27, 2006

I tried, I even tried explaining that he is one of our better aides and has a special needs child at home etc. The family was just overstuffed with self-righteousness. I couldnt calm them down so I had to apologize profusely and we sent the CNA on a two day (paid) vacation to clear his head

We had a great aide who had been at the facility for 10 years. He was toileting a patient who had been restrained in a straightback chair. He left him for one minute unattended to get a change of clothes (in the same room). The patient fell off the toilet, hit his head, ended up with a subdural hematoma, consequently died. This patient was end stage dementia for a very long time. No excuse for leaving him unattended. Anyway, the family made a huge stink and the aide was fired, even though it was his first offense in 10 years. Even though he was wrong, it was really sad. I know he never would have done it again and I felt badly that the administration didn't stand behind him, even though he made a fatal error.

achot chavi · Jul 28, 2006

You see thats why we end up over-restraining!! Nobody wants mistakes- doctors, lawyers, politicians are all allowed to make a mistake, after all they are only human! But G-d Forbid we show our human side and make a mistake or error in judgement- its the end of the world!!!

People fall, even when they are restrained the patient sometimes succeeds in loosening the restraint and slipping out.

Seriously, I am very sorry for the patient who fell and the aide who lost his job. No matter how careful we try to be this could happen at home or with a private 1:1 nurses aide!

I hope the aide got a letter of recommendation and has since found emplyment

snowfreeze, BSN, RN · Jul 28, 2006

Stroke patients and dementia patients are difficult to work with. Keeping them safe is also difficult as they always seem to be diligent at injuring themselves. Documentation of the behaviors and physical handicaps allows us to use devices for comfort.