"New" seizure precautions???

[AJPV]

Just took Kaplan - taking the NCLEX 2 weeks from today. They taught us in Kaplan that padding the side rails is NOT appropriate for seizure precautions (contradicting what we were taught in school). They said that the correct method for seizure precautions is to place a mattress on the floor next to the bed (to "catch" the patient if he/she falls out of the bed during a seizure!) The instructor said that padded siderails are not to be used since siderails would be considered a restraint, and you never want to restrain a seizing patient. Any thoughts on this? Should I believe this is actually what they want on the NCLEX?

[caliotter3]

I work in home care. This is impractical there. For that matter it is impractical in a facility setting too. All beds of patients with risk for seizures are going to have mattresses next to them? Where are all those mattresses going to come from and how does anyone work around them? Or, you can go get a mattress and drag it to the bedside whenever you need to?

[AJPV]

I know!!! It's totally idiotic. Seems like the kind of thing that only a nursing instructor could come up with who doesn't care about real-world nursing at all. I just want to know what is considered "correct" in NCLEX-land.

[Jolie, BSN]

As impractical as this may be (and is), it does represent the current thinking and recommended practice by those in the ivory tower whose jobs it is to make up stupid crap that bedside nurses get dinged for failing to implement into practice.

And don't even ask what happens when the patient falls out of his bed for lack of side-rail use, but misses the mattress on the floor. That will be your fault, too.

[rodmarkq]

yeah it sucks and confusing. But on the NCLEX world, this is how it is. Perfect world, always having the order for something, infinite time, infinite resources. It's just how it is on this test. What matters is passing this darn exam right? We can worry about real life situations later.

[caliotter3]

I laugh when I think about room after room with four patient beds surrounded by mattresses all the time. Or, the CNA or nurse dragging a mattress behind them as they go up and down the hallway throughout their shift. Just think, you could sneak away and take a nap in any room, just make sure you use the mattress that is between the bed and the wall farthest from the doorway!

[AJPV]

JC investigator: "And how long was the patient hanging out of the bed head-first with their neck bent at a 90-degree angle against the mattress?"

[fiveofpeep]

I laugh when I think about room after room with four patient beds surrounded by mattresses all the time. Or, the CNA or nurse dragging a mattress behind them as they go up and down the hallway throughout their shift. Just think, you could sneak away and take a nap in any room, just make sure you use the mattress that is between the bed and the wall farthest from the doorway!

My bf had a patient like this. She was MRCP and kept falling so they just put her mattress on the floor and put fall mats over the entire floor of the room so she was in like a big cushy room.

[ro2878, ADN, BSN]

I, too, just completed Kaplan and found this "mattress thing" crazy! I know that in NCLEX world everything is perfect and we were told by our Kaplan instructor that this is a new JCAHO standard. Don't you think our instructors would have heard about this change and informed us?

I tried to search this on the JCAHO site and could not find anything. I would like to submit an inquiry to JCAHO but the site said it takes up to 8-10 days for a response.

Are you going to go with Kaplan or still use padded rails

[ro2878, ADN, BSN]

I, too, just completed Kaplan and found this "mattress thing" crazy! I know that in NCLEX world everything is perfect and we were told by our Kaplan instructor that this is a new JCAHO standard. Don't you think our instructors would have heard about this change and informed us?

I tried to search this on the JCAHO site and could not find anything. I would like to submit an inquiry to JCAHO but the site said it takes up to 8-10 days for a response.

Are you going to go with Kaplan or still use padded rails

[ro2878, ADN, BSN]

sorry - don't know what happened with that post!

[CompleteUnknown]

Can't help you with your NCLEX question OP but the Kaplan answer does make sense to me.

A patient who is going to have a seizure will have it whether he or she is walking in the hallway or resting in bed. If they're walking at the time, they'll probably fall.

If they're in bed, they probably won't fall out of bed unless they were already trying to get up at the time the seizure occurs. If the seizure does happen to be so violent that it would cause the person to fall out of bed, I'd think there'd be less risk for injury with a low bed and a mat on the floor than with padded bed rails.

Lowering the bed all the way to the floor and placing a mat next to the bed is something we do fairly often where I work, usually for confused high falls risk patients who keep trying to get up. You do get used to it and the mats are light and easy to move when needed. If there's some sort of urgent thing happening and there's no time to fuss with moving mats, we just step on them. Because the bed is so close to the floor, they don't need to be very deep, ours are maybe an inch deep, a bit like a yoga mat.