Remembering to put up bed rails...

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Hi,

I just received a notice by my clinical nursing instructor because I failed to remember to put up the bed rails on a patient, and leave the bed in the "down" position.

I'm curious, what have other people done to make sure that they always remember to leave the bed in the appropriate position (whether it is a "side rails" or "no side rails" patient)?

Thanks,

nursefirst

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Specializes in Critical Care, Cardiac Cath Lab.

Always think "patient safety"...I make sure to check every time I step away from the bed. Also, I've noticed that when I do something wrong and get corrected, I always remember it better from then on. Hopefully the same is true for you, too! :)

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Specializes in Education, Acute, Med/Surg, Tele, etc.

EEEKKKKKKKKKKKKKK!!!!!!!!!!!! Oh man! Okay guess what..most states have a MAJOR problem with this! GRRRRRRRRR!!!!!!

I agree with you guys....but my state says it is a restraint..and if you leave them up...same rules apply! You must have a docs okay in writing every 2-24 hours!!!!!! UHGGGGGGGGGGg!!!!!!!!!!!

It is the continuous battle of restraints vs safety...and it makes me sick to my stomach! I can NOT allow bed rails up...no matter what...unless we have a docs order..signed in agreement with the state board of nursing...which takes FOREVER!!!!!!!!

Heck...my state says if you put a tray table in front of a resident and they are not actively using it..it is restraint!!!!!!!!!!!

I have been trying to do what I can do in the greyer areas...but still..falls up 70% because of this!!!!!! What is their logic!!!!!??? (no I know the logic, just you can't bend towards law suits..you need to be better than the friggen shady lawers..and us nurses so can be!!!!!!!!).

Check with your facility first..make sure bed rails are allowed..trust me!!!!!! I almost was taken to court over 1/4 bed rail ups! OH man I gave my admin so much heck that the settled out of court vs what I would bring up!!!

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EEEKKKKKKKKKKKKKK!!!!!!!!!!!! Oh man! Okay guess what..most states have a MAJOR problem with this! GRRRRRRRRR!!!!!![ stuff deleted, ENDQUOTE]

Thanks for both responses.

I know that whether to leave siderails up is a controversial issue.

In this case, the side rails were to be up and the bed in low position.

In this case, I am just a poor beginning nursing student who is attempting to learn and remember what she has been taught, and do what is expected.

Thanks again,

nurse first

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Very interesting....Where I live (WI) some facilities have the "ok to use" and mine, is a "NO rails up" place. We don't need a dr. order to use them but we do have to explain the risks and hazzards of siderail use to both the patient and the family and have them sign a consent before we can use them. At our LTC facility, it is almost funny the things we do to prevent falls--bells, alarms, pullaparts, thick mats on the floor at the bedside, and beds that go right down to the floor. YET...those siderails, they are dangerous...:)

So, when I step out of pt's room, I have to remind myself...alarms all on? Patient safety:)

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Specializes in private duty/home health, med/surg.

I was told that side rails up x2 = safety, rails up x4 = restraint & requires a doctor's order.

I am very good at not forgetting to put rails up, etc. is because one of my open lab instructors would shove the manikin out of the bed & start screeching "Nurse, Nurse, I fell out of bed & landed on my head!" if you forgot those very important safety measures. :rotfl:

NurseFirst, being put on notice is something you won't easily forget, & that in itself may help you in the future to remember rails up & bed low.

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Specializes in Education, Acute, Med/Surg, Tele, etc.
I was told that side rails up x2 = safety, rails up x4 = restraint & requires a doctor's order.

I am very good at not forgetting to put rails up, etc. is because one of my open lab instructors would shove the manikin out of the bed & start screeching "Nurse, Nurse, I fell out of bed & landed on my head!" if you forgot those very important safety measures. :rotfl:

NurseFirst, being put on notice is something you won't easily forget, & that in itself may help you in the future to remember rails up & bed low.

In the state of Oregon..yes doc order..but hey..who told the docs??????? They are going.."what is this request..why do we need to deal with this....could hurt my insurance....ummmmmmm NO!" Trust me..I love my docs...(if I don't..they leave...trust me..no one works with my residents without my approvial!).

It is a screwed up deal..and your lovely nurses assoiciation AGAIN made thing more difficult by saying "this is a restraint" DOC's didn't NURSES DID!!!!!

Guess that is why one.I don't subscribe to ANJ or that...and I don't trust unions!

Fine...make bedrails a criminal offence...be bored and have nothing to do but think..oh those mean caregivers! they hate patients!!!!!!!!! BUT don't you friggen dare take away my voice to say......ummmmmmm this may not be premium!!!!!!!

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Specializes in LTC, home health, critical care, pulmonary nursing.

At my facility, we do have to have an order for siderails, but we can use them without an order if the resident "uses them for bed mobility." So if Mr. Jones is a high fall risk, he needs his rails up "so he can reposition himself in bed."

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Specializes in Education, Acute, Med/Surg, Tele, etc.
At my facility, we do have to have an order for siderails, but we can use them without an order if the resident "uses them for bed mobility." So if Mr. Jones is a high fall risk, he needs his rails up "so he can reposition himself in bed."

We are are working on the right angle for patient safety...and actually getting a doc order for side rails....but it is up to one nurse to explain it...and that one nurse likes to do that in person..ME! So far 50 clients have family and written okay for bed rails..be it 1/4 to 3/4...and this seems to be such a waste of time to solve! I have other things to do...but this is an issue..and issues I must solve....kind of Par for the course...like all of us!

I think this whole bed rail thing will be something we don't have to worry about in 5 years...it wasn't something we had to..then when I graduated..huge deal..it goes in waves..ebbs and tides...and that is the distinction...we nurses, and other health care workers...deal with it because we all care!!!!!!

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lovingtheunloved -- I love your name!

As far as unions are concerned, the California Nurses Association (union) has been responsible for increased pay rates and for pushing through the legislation requiring a minimum of 1 nurse to 6 patients. I was never much of a union person myself, but I have to recognize that unions have played a positive force in getting 40 hour work weeks, ending 6 day work weeks and raising wages.

Last term I dealt with LTC patients, most of whom could not carry on a normal conversation. This term, at least, the patients can tell me what they want!!! And I find that I like nursing more and more. Last term I feared having to clean up a patient, or having to give them rectal suppositories. For some reason, this term, not only do I not mind, I enjoy all parts of my "work" (believe me, this surprises me.) Perhaps it is the appreciation I've gotten from my patients.

nurse first

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Specializes in ER/Trauma.

Interesting.

I too face the same problem of "remembering" to put the rails up!

Will just come with practice, yes?

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Try this technique. Before I leave a pt room, I take a few moments to stop and scan the room. Does my pt have all that they need? Bed in appropriate position, call light within reach, water pitcher ect...Also, have I done everything I came in to do? Are there any other tasks I can take care of now? Believe me, an extra moment now will save time in the long run and guard against safety lapses.

By the by, I think that "siderails as restraints" applies in long term care, but not in a hospital setting. Good luck in school! It will be finished in a blink! Really.

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