a scary call light experience...

a scary call light experience...

Joined: September 4th, 2007, 12:39 pm

October 8th, 2007, 12:50 pm #1

There was a call light on in my particular hall one night, and it was about supper time. Lots of routine requests this time of night, nothing usually too serious. By the time I fought my way down to that end of the hall, something bad was happening, I just didn't know it yet. Our beds were the old 3 cranks at the end of the bed type, and they were too high to put food in front of a patient without dropping a siderail. Everyone did it, and nothing had ever happened. I remember clipping the call light to her pillow when I set her up for dinner earlier. When I got back in the room, she was sitting on the floor with the call light cable all the way around her neck, face pointed upward, and purple. I thought she was dead, or pretty close. I quickly tore the call light out of the wall and put her back into bed by myself (I was pretty strong back then). She immediately started breathing again, and her color returned to normal. It was at that point that I decided that I had to get out of long-term care. I just happened to be walking in the parking lot and one of my associates was transferring to the hospital, i said "take me with you". 2 weeks later, I was out of there.

peace always,

xtech64
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Joined: September 27th, 2005, 5:09 pm

October 9th, 2007, 4:53 pm #2

Never never never leave the cock-a-doody siderail down!
I'm sorry, but there had to be something else you could have done.
I know I sound harsh, but that patient obviously needed siderails for a reason... so then you elevate the head of the bed and lower the siderail??? Tell me that's not an accident waiting to happen?!
COMMON SENSE is the key.
Just because "nothing ever happened" before doen't mean it won't. It will, and god forbid it happen on your watch.
I know bedrails and bed tables don't always jibe together: slide the table through the rail, ajust the height of the whole bed, get the patient out of bed for the meal... STAY with the patient... anything... but don't leave your patients vulnerable!
Tell me, am I wrong to be annoyed by this post?

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Joined: September 4th, 2007, 12:39 pm

October 9th, 2007, 6:35 pm #3

Sometimes sliding it through the siderail did not work, they would complain that the bedside table was smooshing their legs (on those patients who had large legs), or was too close to their chest, but yes when you can slide it through the sidereail, it's a good thing. I absolutely agree with you. I can't remember exactly what was going on that night, but I do remember exhaustion and understaffing being a part of that evening. This resident was actually fairly oriented, but I guess, fooled me. I suppose it's just like leaving people unattended on toilets, I'm pretty sure that everyone has done it for at least a minute. Anything can happen, and when staffing gets low, we make poor decisions because of fatigue, and that night, I took a risk and paid for it. The thing that annoys me about LTC is that there isn't a staffing pool to draw from like there is in med-surg when things are going to hell. Thank god I got out of LTC and into med-surg and eventually ICU.

thanks for the reply, you are on target as to how things should work.

peace always,

xtech64
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Joined: September 27th, 2005, 5:09 pm

October 9th, 2007, 9:38 pm #4

Yep, squooshed knees, contracted knees, the table up to the patient's chin... I always did hate serving meals in bed!
I just get aggravated when I hear, "It hasn't happened before, so it probably won't happen" or "I don't have time!"
I remember two silly girls (one was a nursing student) who decided they "didn't have time" to put a patient in bed with a hoyer lift and didn't think it was necessary to take the footrests off the chair... patients don't really get caught in the footrests, right? Oh my.
Well, sure enough, the patient was alot heavier (dead weight) than they had anticipated. The patient was too heavy for them to complete the transfer and the patient's leg got trapped on the footrest. The patient was stuck in mid-transfer. The aides couldn't get her back in the chair and they couldn't get her on the bed.
Finally, the aides just whipped her onto the bed. Unfortunately, the trapped leg was completely twisted. The patient ended up with a spiral fracture that would not heal. Her leg was eventually amputated.
TAKE TIME! Think it through.
Believe me, those girls ended up with plenty of time. They were fired.
As for time, well, you waste more of it having to stop, get a nurse, file an incident report and get chewed out and written up.
I remember a patient that fell and whacked her head on the sink because I stupidly turned my back on her. I was an 18 year-old smarty pants who thought, "I don't know why I have to be with her every second. She's steady!" Well, duh! Her blood pressure had a tedency to drop snap just like that.
I've been at it for 20 years now and I've never forgotten it.
Sh** happens when we think it won't.
In the words of Mad Eye Moody, "Constant vigilance!"
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Joined: October 4th, 2006, 2:10 am

October 11th, 2007, 3:55 am #5

In most facilities and/or states it is considered a restraint and illegal to have all side rails up on a resident/patient without a MD's order.
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Joined: September 4th, 2007, 12:39 pm

October 11th, 2007, 12:02 pm #6

I did not know that. Perhaps all of those years, we had srx4 as a standing order. I knew chemical restraints were not a good thing, but was not aware of the siderail thing.

peace always,

xtech64
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