State mandated elder abuse

[happydays352]

I work at an adult foster home with dementia pts and two bed bound pt. I heard recently that the state inspectors are going to be making us do fire drills. They did this recently at another adult foster home. They made a nurse who is a bit aged herself lower her pt's off of the roof into 37 degree weather and rain. She suffered a severe spinal injury as a result. When she complained about the damage to both herself and her pts the inspector stated that it could be worse since they might do it at night.

Now I as the night staff and weekend caregiver am faced with an ethical dilemma. Do I take my dementias pt out of their warm beds and into the pouring rain and cold in the middle of the night? Do I actually lower my bed bound 102 year old pt with severe osteoporosis onto the floor and drag her out into the rain and cold? I told my manager I would not do this because the potential risks were so high, heck this pt perceives gentle pressure to be painful.

I have no problem with fire drills for my pt's who are oriented and can safely navigate outside, although I do worry about the freezing temps. I have no problem having a plan of action which we are already mandated to have. We have all equipment ready to go in case of a fire and we do simulated drills all the time.

Fortunately for my other bed bound pt we have a letter signed by the doc and POA that forbids anyone from doing this unless the emergency is real.

The risk of psychological and physical damage from this drill in my opinion far outweighs the benefits of practicing for a hypothetical situation that may not happen.

I would love to hear other's thoughts on this issue because right now I am so :angryfire.

[Agnus]

When I saw the title of this thread I thought it was about mandated reporting of abuse. So I was going to tease you about your mis-speak but I see you actually mean it.

Well I think you know the answer. The real question become how far are you willing to stick your neck out to do the right thing.

[happydays352]

I'm willing to lose my job to protect the health of my pt's I can always get another job.

My manager and the owner back me 100% (she's an RN btw) even though she could lose her license to operate a foster home. I just can't believe they would come up with an idea that will hurt the very people they are supposed to protect. I'm just sick over this.

[Agnus]

There is always the media. I think the average news consumer is capable of comprehending the risk out weigh the benefits here.

[ShayRN]

Just one more example of someone making the rules who don't understand real life. Good luck, I wish I had an answer for you.

[bagladyrn, RN]

To prove that you are not being obstructionist and that you are considering only your patients' well being perhaps you and the owner could write up a formal plan to do a mock drill using dummies (or something approximating the size of a patient) to demonstrate your plan. That would seem to me to be a reasonable alternative.

I once absolutely forbid a fire marshall to set off an alarm on my unit for a fire drill as I had a very unstable preeclamptic on the unit and told him I would hold him responsible if the overstimulation of the noise and excitement caused her to seize. He went away and held his drill elsewhere.

[leslymill]

You might check for some legal advice as well as the local media for a public opinion poll.

[Quickbeam, BSN, RN]

happydays, I was a night charge at a freestanding rehab unit in the 1990's. The building was very old and had only one w/c accessible entrance. The other was a long staircase. I went through almost exactly what you are going through. We were told we were going to have to have night drills and slide these people down the stairs on a board and then drag them out into a nearby cornfield.

I todl the mgt and therapy staff that we'd be happy to do this once they all came in on nights and agreed to be shoved down the stairs on a board and left out in the cold in a farm field. I never heard about it again.

[babynurselsa, RN]

I guess drills are different in the hospital than in LTC or Rehab.

We never have to drag our pts into them.

That is asinine to drag alzhiemers pt or fragile pts out bed. I like the idea better for substitute pts. Let admin come in and be the pts.

[Hellllllo Nurse, BSN, RN]

happyday,

I felt bad in the pit of my stomach after reading your post. I hope these rediculous inspectors come to their senses.

[catlynLPN]

Patients shouldn't be used as the experiment. Can't they use staff instead?

That's just crazy.

When the fire department practice rescues they use their own staff, don't they, in hypothetical situations?

If that elderly patient gets hurt someone is going to have to pay big time.

[RNAnnjeh, MSN, CNS]

That's disgusting. Help your boss find a lawyer.