Comments on: the incident report http://www.aboutanurse.com/2007/10/the-incident-report.html a nurse blog. Thu, 20 Nov 2008 09:00:36 +0000 http://wordpress.org/?v=2.0.7 by: canoehead http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62844 Sun, 04 Nov 2007 09:41:28 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62844 I would rather be independent and fall than be restrained and "safe". You did good work. I would rather be independent and fall than be restrained and “safe”. You did good work.

]]> by: PD Warrior http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62418 Sat, 27 Oct 2007 08:45:47 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62418 Bravo!! I wish there were more nurses like you. I am the ADON of my facility - a long term care facility. Some people would call my facility a "nursing home," but it is so much more than that. It is a place where people come to live, not to die. We area restraint free facility, meaning a doctor can order all the restraints he/she wants, but they will not be applied without a "team meeting" including representatives from all departments; nursing, socialwork, dietary, clergy, housekeeping, and maintenance to determine if there was anything else that could be done, or if the restraint really should be applied. In all the years I have been there we have never opted for the restraint,mainly because we can not make it past the last question; "Is the restraint for the benefit of the patient, or for the convenience of staff?" Our safety care plans assume that everyone will fall eventually, and the goal is to decrease the frequency of falls, minimize injury, and maintain patient dignity. I applaud you for your sincerity, and your dedication to the "whole" patient, promoting their sense of dignity and independence. Bravo!! I wish there were more nurses like you. I am the ADON of my facility - a long term care facility. Some people would call my facility a “nursing home,” but it is so much more than that. It is a place where people come to live, not to die. We area restraint free facility, meaning a doctor can order all the restraints he/she wants, but they will not be applied without a “team meeting” including representatives from all departments; nursing, socialwork, dietary, clergy, housekeeping, and maintenance to determine if there was anything else that could be done, or if the restraint really should be applied. In all the years I have been there we have never opted for the restraint,mainly because we can not make it past the last question; “Is the restraint for the benefit of the patient, or for the convenience of staff?”

Our safety care plans assume that everyone will fall eventually, and the goal is to decrease the frequency of falls, minimize injury, and maintain patient dignity.

I applaud you for your sincerity, and your dedication to the “whole” patient, promoting their sense of dignity and independence.

]]> by: nocturnalRN http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62365 Fri, 26 Oct 2007 17:12:03 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62365 I think it is great you made such an effort to help this lady out. And obviously you were having a pretty good night to be able to be in her room so often to help. I wish I were as fortunate. I am usually running from room to room and probably would have actually thought about restraints. But since she was alert and oriented I would have just given her a bedside commode and charted several times that she was aware of my wishes to use the call light for assistance. Then when they fall, I have at least done all I could without restraining and foley-ing. You can't just tie everybody up! Especially if they are just stubborn--not confused. Don't feel guilty. But I feel for you, because you prob had to stay late writing an incident report. Glad she wasn't hurt bad..I think you are a great nurse. With real feelings and am glad you are not ashamed to admit them. I think it is great you made such an effort to help this lady out. And obviously you were having a pretty good night to be able to be in her room so often to help. I wish I were as fortunate. I am usually running from room to room and probably would have actually thought about restraints. But since she was alert and oriented I would have just given her a bedside commode and charted several times that she was aware of my wishes to use the call light for assistance. Then when they fall, I have at least done all I could without restraining and foley-ing. You can’t just tie everybody up! Especially if they are just stubborn–not confused. Don’t feel guilty. But I feel for you, because you prob had to stay late writing an incident report. Glad she wasn’t hurt bad..I think you are a great nurse. With real feelings and am glad you are not ashamed to admit them.

]]> by: Chuck McKay http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62345 Fri, 26 Oct 2007 07:07:53 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62345 Mary, thoughts don't count. Actions do. Your actions are what this patient will be remembering, and they'll be positive memories. Mary, thoughts don’t count. Actions do. Your actions are what this patient will be remembering, and they’ll be positive memories.

]]> by: Bobby http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62341 Fri, 26 Oct 2007 04:29:51 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62341 May, first I agree with Curmudgeon that when I'm in the hospital, I would pick you over your co workers, as my nurse, I can so relate to why you are glad it wasn't you. I also have guilt issues, and wear my heart on my sleeve. When my loved one, my best friend Ardis was dying in a hospice last August, I smashed her leg between the bed rail and the bed. I still to this day do not know how she managed to let her leg slide that far off the bed without me noticing, but it did. And it was because I had begged the hospice nurses to wait as long as possible before they placed a foley, because I knew she hated them. So I asked her when I noticed she was awake at 4 am, and she nodded that she needed the bedside commode. I don't understand , did your patient have a bedside? Anyway, I smashed it, and thought it would bruise and it didn't. I don't know how, cause her gums were already bleeding from her liver failing, and the nurse told me her platelets were gone. Yes she was very drugged with roxynol, yes, she shook her head no when I asked her over and over did I hurt her, and there was no bruise. God saved my butt, because even though I was her medical proxy, they would not have trusted me anymore. in the end, I was alone in the room when she went to heaven. I don't remember how many beers I drank trying to drown my guilt. May, first I agree with Curmudgeon that when I’m in the hospital, I would pick you over your co workers, as my nurse, I can so relate to why you are glad it wasn’t you. I also have guilt issues, and wear my heart on my sleeve. When my loved one, my best friend Ardis was dying in a hospice last August, I smashed her leg between the bed rail and the bed. I still to this day do not know how she managed to let her leg slide that far off the bed without me noticing, but it did. And it was because I had begged the hospice nurses to wait as long as possible before they placed a foley, because I knew she hated them. So I asked her when I noticed she was awake at 4 am, and she nodded that she needed the bedside commode. I don’t understand , did your patient have a bedside? Anyway, I smashed it, and thought it would bruise and it didn’t. I don’t know how, cause her gums were already bleeding from her liver failing, and the nurse told me her platelets were gone. Yes she was very drugged with roxynol, yes, she shook her head no when I asked her over and over did I hurt her, and there was no bruise. God saved my butt, because even though I was her medical proxy, they would not have trusted me anymore. in the end, I was alone in the room when she went to heaven. I don’t remember how many beers I drank trying to drown my guilt.

]]> by: RN http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62340 Fri, 26 Oct 2007 04:22:11 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62340 I know that kind of guilt, too. You are not alone. I know that kind of guilt, too. You are not alone.

]]> by: shrimplate http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62284 Thu, 25 Oct 2007 12:46:45 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62284 Of course we've all had patients whose urge to urinate was not alleviated by the presence of a urinary catheter. And we've also had patients get itno trouble trying to get out of bed despite restraints. Patients do not have falls because of lack of foleys or restraints. They fall because staffing levels are as low as possible. Hospitals would rather suffer the expense and pain of a patient fall than hire more staff. Of course we’ve all had patients whose urge to urinate was not alleviated by the presence of a urinary catheter. And we’ve also had patients get itno trouble trying to get out of bed despite restraints.

Patients do not have falls because of lack of foleys or restraints. They fall because staffing levels are as low as possible.

Hospitals would rather suffer the expense and pain of a patient fall than hire more staff.

]]> by: shrimplate http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62282 Thu, 25 Oct 2007 12:33:55 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62282 Way off-topic: October 27th would have been Sylvia Plath's 75th birthday had she not dies tragically at age 30. Way off-topic: October 27th would have been Sylvia Plath’s 75th birthday had she not dies tragically at age 30.

]]> by: unsinkablemb http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62270 Thu, 25 Oct 2007 07:19:28 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62270 May, As usual, you treated your patient with dignity and respect. It's obvious you had her best interest at heart no matter what those other nurses said. And as for your evil thoughts, you are only human. Believe me, if you could record some of the things that cross my mind at work... :P Take care, M. May,

As usual, you treated your patient with dignity and respect. It’s obvious you had her best interest at heart no matter what those other nurses said.

And as for your evil thoughts, you are only human. Believe me, if you could record some of the things that cross my mind at work… :P

Take care,

M.

]]> by: SeaSpray http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62265 Thu, 25 Oct 2007 06:10:47 +0000 http://www.aboutanurse.com/2007/10/the-incident-report.html#comment-62265 I think it was compassionate of you to try to help her retain her dignity and independence. Feelings are feelings. We can't help what thoughts come up. But we can learn from them and make appropriate choices when presented. I think it was compassionate of you to try to help her retain her dignity and independence.

Feelings are feelings. We can’t help what thoughts come up. But we can learn from them and make appropriate choices when presented.

]]>