Restraining a patient. What can I do?

As my daughter says, somebody did a survey. My Mom was put in a Geri chair that slanted backwards. Made it hard to get up. So glad you weren't written up.

Lanana, you sound like such a nice, thoughtful caregiver. Thanks for all you do for your patients!

Lanana, back in the bad old days, the asylums physically restrained the mentally ill in ways we would now consider abuse. I applaud the restrictions that prevent this. But an alarm on a bed or a chair is hardly a straight jacket! The intentions of these rules are good, but, my goodness, common sense says they have gone too far.

Obey the policies of the facility where you work, for the sake of your career and for the good your compassion can do for the residents. But I agree with you that the pendulum on restraints has swung way too far in the other direction.

With dementia, my mother did not understand/remember that she could not stand up. It took two aides with a lift to move her from the bed to a wheelchair. What if she tried to stand up from the chair? I'm sure that would be a calamity, but no restraints such as a seat belt could be used. We asked if she could get a tray for the wheelchair so she could do her beloved crossword puzzles. Because the tray can be opened by the person in the chair apparently the tray is not considered a restraint. But Mom would never think how to swing the tray aside and so it was effective in keeping her from falling out. Thank goodness!

I’m with you miss jjariz, the laws are very wrong when it comes to nursing homes, there are so many procedures and rules that I don’t really agree with, I guess they prefer someone to fall instead of being restrained, like I kind of understand where they are coming from, with that patient for ex. The administrator explained to me that because he is confused the restrain could’ve agitated him and he could’ve fallen with the chair and wouldn’t be a able to get up or the chair might hurt him too. But I did have another patient that had dementia, he used to have seatbelt on his chair and alarms on his bed, oh well, the therapy people said it wasn’t necessary and they removed all alarms from the room, making the story short a week later the patient died from falling out of his bed. And just like him many other residents have died from falling. Unfortunately they don’t see it from the same point of view that we do.

Lanana so glad you were not disciplined for something you have never been trained on. I hope during your meeting the procedure they want you to use in the future was communicated to you.

As the wife of a person with dementia, I would have preferred that my husband be restrained temporarily instead of falling. Unfortunately, the LAW doesn't agree with me, and doesn't let you use your judgement to decide what's prudent. Please don't let this incident upset you. You sound like a caring person and I'm glad that your record will remain clean.

I went to the meeting with the administrator and thanks god everything went well, I didn’t get written up and didn’t get a disciplinary action, instead explained to me that this is consider a very serious crime by the state and that the nursing home can be penalized and I can lose my job and also my license. I’m so glad.

Lanana I wish you the best of luck and I hope your employers will make sure you get the training you need and deserve.

It's very unfair that you were placed in that position and then made to feel at fault for doing your best.

Thank you very much for your answers, they had schedule some in-services about that stuff but I have never been in one, I have a small baby at home so I can only work every other weekend. And yes the nurse did reported me to the director of nursing and she called me to confirm that I did restrain the patient, my answer to her was that I did it because he was going to fall and there was nobody around to watch him, I didn’t do it with the purpose of shutting up the alarm, i was trying to prevent him from falling. So today I have a meeting with the administrator and will keep you guys posted. Thank you for the answers.

When Mom was/is going through her periodic episodes of hallucinating and trying to get out of her wheelchair and would fall, I would have hugged and thanked you for restraining her! I couldn’t even get them to install a magnetic alarm because that was considered a restraint! I’m sorry you got in trouble for trying to do what you considered a safe response, but I agree that you should find out what the standard procedure should be in your facility. If the resident was popping up and then sitting back down in his chair, the alarm, though annoying, may have been having the desired effect of having him sit. Have you had documented training in their procedures?

What you did seems logical and well-intended to me. But there are specific rules about patient restraint that aren't always intuitive or based on logic. Have you been given any training about this in the one year you've been there?

Is the nurse who finally responded going to report you?

What happens to you will depend on the disciplinary policies of your employer, if this is a first offence then hopefully nothing more than a note in your employment record and a reminder of proper procedures. Being proactive and reading up on the definition of inappropriate restraints wouldn't be a bad idea.

I would take this up with your director of nursing. That way whatever she says, you need to follow and won't get in trouble.