physiologic needs first or safety first?

[meemee lpn]

One of my residents is diagnosed with schizpphrenia. And most of the time she is wandering, sleeplessness at night, restlessness, anxious, may become agitated. She is a fall risk. Bed alarm is ordered and was used. But her bed alarm is defected and now using chair alarm until the bed alarm is replaced. The chair alarm is so sensitive and sounds even with a slight move in the bed which keeps wake her up and irritate her which could progress to agitation. In the textbook, physiologic needs (oxygen, water, food, temp:, elimination, sexuality, physical activity, and rest ) are first priority and safety is the second. According to this knowledge, I wanted to remove the chair alarm to provide her with stimulation free environment so that she can get a full rest. But when I asked other nurses, they would put safety first. If you were in my shoes, what would you do?

[traumaRUs, MSN, APRN]

Let me move this to the LTC forum for you where you will get more responses.

Personally, I would say safety has to take precedence also.

[lina.561]

1. Physiological Needs- Food, Water, Shelter, Oxygen, Elimination, Sleep, Rest

2. Safety and Security

3. Love and Affection

4. Esteem

5. Self Actualization- Problem solver, one who meets all other needs first, confident, willing to accept criticism, self respect, reaches out to others

[Sun_danc3rRN]

Well, I don't think this needs to be moved to the LTC forum per se. I have only been out of school for about 8 months, so this rings of things we learned the entire time. You should look up Maslow's Hierarchy. It tells you where everything falls as far as what needs should be met first.

Edited part: And of course if I hadn't just tried to read this thread, after having just worked 16 hours over night, I might have not bungled the whole reason to move this to LTC forum...sorry for being a dunderhead.

[CapeCodMermaid, RN]

Maslow's hierarchy not withstanding....if she isn't getting enough restful sleep, the rest hardly matters. Try a different alarm or do a risk/benefit analysis of using an alarm. Can we prevent all falls? NO. Can we do the best we can to balance the need for restful sleep with the need to keep the resident safe? YES.

[SuesquatchRN, BSN, RN]

Low bed with mats. Posey rolls on either side. Call bell within reach. Clip alarm on her johnny.

[Nascar nurse, ASN, RN]

- OR -

non-skid strips next to bed, motion sensor alarm pointed to the area she is most likely to attempt to stand up at, keep potential items that may cause tripping out of the way, move close to nurses station, motion

[SuesquatchRN, BSN, RN]

Motion detectors? Kewl! But her facility sounds more like mine, meaning you scavenge.

[CoffeeRTC, BSN, RN]

Motion detectors? Kewl! But her facility sounds more like mine, meaning you scavenge.

Yep:uhoh3: