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Soma or Enclosure Beds... Cruel or not?

Posted

Has 13 years experience.

At my hospital we use Soma beds. Usually for the safety of dementia patients, or confused elderly ones. For awhile we weren't allowed to use them because family members of the patients and some employees deemed them as cruel "cages." In my opinion it is better to have a patient in a Soma bed versus posey vests, or wrist restraints, leathers, etc. Plus we have more CNA's available on the floor. Prior to these beds we had a ton of safety care/one to ones, in which a CNA would sit with these patients 24/7.

What is your hospital's restraint procedure for confused patients? Do you find these beds useful, or cruel?

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 40 years experience.

Compared to a hip fracture or restraints- they're a blessing.

My large academic medical center uses them sometimes as a less restrictive alternative to restraints

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

My workplace uses bed enclosures, also referred to as vail beds. While their appearance might disturb families, the only other alternatives are private sitters (not in the budget), frequent rounding (ain't nobody got time for that!), and seeing the patient sustain a broken hip after falling for the 15th time in a four hour period.

In my opinion, the vail bed is far better than the 100+ falls that would occur without it.

Emergent, RN

Specializes in ER. Has 28 years experience.

Life is cruel, dementia is cruel, budgetary considerations are cruel. In a perfect world I would be able to fly, we would all live in perfect harmony, and no one would ever suffer. Plus there would be free food, fruit on the trees, and everyone would be happy and healthy. And no cockroaches or thistle weeds.

In other words, these beds are the lessor of two evils. They are relatively good.

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience.

My workplace uses bed enclosures, also referred to as vail beds. While their appearance might disturb families, the only other alternatives are private sitters (not in the budget), frequent rounding (ain't nobody got time for that!), and seeing the patient sustain a broken hip after falling for the 15th time in a four hour period.

In my opinion, the vail bed is far better than the 100+ falls that would occur without it.

Agree.

What's better: a person who is enclosed in a vail bed that can move around, or a pt on the floor with fractures and a possible hematoma.

I'm going with former; appearances be damned. :yes:

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

I've never heard of these before. Can someone post a photo?

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

I've never heard of these before. Can someone post a photo?

Go to google.com and enter "vail bed image" in the search field. A bunch of pictures of vail beds will appear. I'd post a picture, but cannot because I am using my workplace's computer right now.

It basically looks like a cage wrapped with breathable synthetic mesh cloth. Staff has to unzip the vail bed from the outside to get it open.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

What a marvelous idea.....far better than Posey vests or limb restraints. I'd rather see a confused loved one in a bed like this than regular restraints.

studentnursemon86

Specializes in ER/Emergency Behavioral Health.... Has 8+ years experience.

We don't have any enclosed beds. We have Hi-Lo beds that pretty much go to the floor to help prevent injuries if someone falls. We also have cushioned matts to put on either side of the bed on the floor.

Other than that, we have bed alarms that go off if the patients try to get out of bed, and mitts for patients who pull at tubes.

Many times they end up with a sitter because they keep challenging the bed checks.

Those beds sound way safer, but I could see how a family would be put off by it.

Holy Guacamole. I work on a medical floor that specializes and Geriatrics and we have TONS of confused/dementia patients. I've never seen these beds. We ONLY use restraints of a patient it going to hurt someone, and sometimes not even then. (We had a pt pour coke on a nurse, then throw things at me, then pour coffee on a tech and still nothing). We are 6:1 at night. Sometimes we have half of those pts confused. We use bed alarms to prevent falls, ace wraps to try to keep IVs in. If that doesn't work we get a sitter. I honestly don't think the idea of those beds. It does seem cruel to me. I'd rather run in the room to a bed alarm going off and reorient my pt 20 times a night than feel like I'm caging them. Does this not just multiply agitation?!

sistrmoon

Specializes in Oncology. Has 14 years experience.

I've never heard of these but I'm intrigued. We have a ton of one to ones, restraints, safety sits. Are they expensive? The appearance is pretty off putting though.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

I'd rather run in the room to a bed alarm going off and reorient my pt 20 times a night than feel like I'm caging them. Does this not just multiply agitation?!
These beds do not increase the patient's agitation as long as they have a diversion while in bed such as TV, towels to fold, newspaper, snacks, etc.

It's nice that your ratios are 1:6, but the ratios at my hospital run from 1:7 to 1:12 on both day and night shifts, so we do not have the time to keep running into the room. We also do not have money in the budget for 1:1 sitters. Long live vail beds.

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

I've known of a few patients over the years (children) who have these beds even at home. They look like cages, but sometimes they're necessary.

Swellz

Specializes in oncology, MS/tele/stepdown. Has 6 years experience.

I'm learning to appreciate them. I think they agitate certain patients. I also think it is hard to keep them clean. I don't prefer them but then I don't prefer my patients to be disoriented either. I had a patient do push ups in one once. They keep patients safe and are better than restraints.

catmom1, BSN, RN

Specializes in LTC, Psych, Med/Surg.

I had never heard of Vail beds before this either.

When I googled the term, I found several references to recalls of these beds and even one mention that the Vail beds were not to be manufactured any more because patients have asphyxiated by getting caught between the mattress and netting.

Are any of you knowledgeable folks aware of this issue? :confused:

Catmom :paw:

Paws2people

Has 13 years experience.

My workplace uses bed enclosures, also referred to as vail beds. While their appearance might disturb families, the only other alternatives are private sitters (not in the budget), frequent rounding (ain't nobody got time for that!), and seeing the patient sustain a broken hip after falling for the 15th time in a four hour period.

In my opinion, the vail bed is far better than the 100+ falls that would occur without it.

Agreed. Much better than a broken hip. Plus it keeps dementia pts and sundowners from wandering off.

Thanks for the alternate word vail bed. I hadn't heard that name. I believe Soma is a brand name. These beds always remind me of upside down playpens!

Edited by Paws2people