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My Mom (84) was admitted into the hospital a week ago with a urinary tract infection. She's had a tough time of late. A couple of years go my Dad got a bad blood infection which we believe took early stage dementia into a full-blown case, and now he can't do or remember much of anything. Since Mom relied on him for everything, I took over their finances (I'm a CPA) and got health proxy for him. This year Mom gets lymphoma and recently finished chemo and then needed further radiation. Just the quick back story.
She's been in the hospital before, hooked up to IV on the wheeled tree before. A nurse or aide takes her to the bathroom, cracks the door open and stands outside. All is good. Three days in they move her to another room (nicer/larger). So I'm visiting her in the new room with my brother, my Dad, and the caregiver (have 24/7 at home for parents). With the UTI and other issues she's been having problems going. She buzzes and an aide comes in and Mom says she wants to try to pee (first time in new room). She's taken to the bathroom, and the aide keeps the door wide open while standing there. I hear my mother request calmly to please crack the door and stand outside, but the aide says it's against hospital policy. So then a few minutes of back and forth with Mom trying desperately to have the door cracked because she can't go with door open. After several minutes Dad decides to get involved. He raises his voice, and drops expletives, normal for him when his blood boils. As words are exchanged more heated the nurse says to my Dad she's ready to call security on him. It could be heard easily on the floor, and within minutes there is the charge nurse, RN, and the aide by the open bathroom door and four more workers outside the door. My mother is trying to explain she's always been able to go with a cracked door, why not now? My Mom was telling everyone she was sitting now, keep the door cracked, and when I'm done I'll tell you so you can come in and get me up. Then the words fall risk comes into play. More arguing, then a male nurse/aide comes in by the door. Poor Mom with all these people, and then a male. FINALLY the charge nurse tells the aide it's OK to crack the door and some semblance of order is restored. Five useless minutes.
I thought it was played poorly by the staff. For one, I do not think it was ever fully explained to Mom what the limitations of a fall risk were. Logically I could not understand why the door had to be wide open. The aide could have made a call based on my Mom's age and other factors and could have just cracked the door and still been within feet of her. I get there is liability, but a patients dignity should also be in play which it didn't seem to me it was. How anyone couldn't see Mom was a low risk to go against her words and lie about the bathroom was ludicrous to me.
My daughter is a nurse in the Army. We discussed the incident. I told her I was debating telling hospital management of what happened. Not sure what that would do to be honest. At this point will probably let it go.
Do you think based on what I've stated that the hospital was correct?
Unfortunately nothing you're describing sounds very unusual for elderly patients.
The best thing you could have done in the situation is for you and your brother (and possibly Dad and caregiver) to offer to wait outside the hospital room while the nurse helped your mom to the bathroom and back. That would have given your mom privacy while still allowing the nurse to follow policy. They're really careful with elderly and bathrooms if they're a fall risk. They were probably going into the restroom with her the other times, and she was uncomfortable with it because you were visiting. You could have acted like you wanted to take your dad to get a soda or for a little stroll through the hallways if he was getting restless, so your mother wouldn't feel like she was putting you out.
The reason they sent the male aide is because your father was getting belligerent. Sometimes that happens with dementia patients and sometimes they can even become physically aggressive. My dad has that problem, which made it difficult to find care for him. When my mom was in the hospital for a septic UTI, my dad and I spent every day there, but he was horribly rude to the male nurses and aides.
Unfortunately nothing you're describing sounds very unusual for elderly patients.
The best thing you could have done in the situation is for you and your brother (and possibly Dad and caregiver) to offer to wait outside the hospital room while the nurse helped your mom to the bathroom and back. That would have given your mom privacy while still allowing the nurse to follow policy. They're really careful with elderly and bathrooms if they're a fall risk. They were probably going into the restroom with her the other times, and she was uncomfortable with it because you were visiting. You could have acted like you wanted to take your dad to get a soda or for a little stroll through the hallways if he was getting restless, so your mother wouldn't feel like she was putting you out.
The reason they sent the male aide is because your father was getting belligerent. Sometimes that happens with dementia patients and sometimes they can even become physically aggressive. My dad has that problem, which made it difficult to find care for him. When my mom was in the hospital for a septic UTI, my dad and I spent every day there, but he was horribly rude to the male nurses and aides.
We were on the far side of the room, nowhere near the bathroom. We couldn't see in at all nor could Mom see us. In just listening to my Mom, her only issue was why in the past she could go with a cracked door with someone outside (and even peeking in if they had to). When she was first admitted, I was in the first room while she was brought in and she went in, the nurse/aide cracked the door and all was good. It was moving to the new room where I believe a lack of education occurred.
Now of course if we were out of the room my Dad probably would have not got involved like he did. My gripe (and my daughter agreed and is a big pet peeve of hers) was patient education. If all of the sudden Mom was a high risk fall patient in the eyes of the hospital, she was not told what that means. It could have been told to her and she forgot, but even in her state I don't think she wold have blanked out like my Dad is.
I can understand how disappointing this experience would be for all you...but the first job of medical staff is to protect the pt at all costs. Perhaps they considered her a fall risk when you might disagree.
If your dad had been able to stay calm instead of inflaming the situation, you could easily have asked for a supervisor whose job it is to negotiate and resolve conflicts...saving everyone a headache and resentful feelings.
I can understand how disappointing this experience would be for all you...but the first job of medical staff is to protect the pt at all costs. Perhaps they considered her a fall risk when you might disagree.
If your dad had been able to stay calm instead of inflaming the situation, you could easily have asked for a supervisor whose job it is to negotiate and resolve conflicts...saving everyone a headache and resentful feelings.
Supervisor came in before I really had a chance to step in. At that point I just kept to the side.
Again, fall risk or not (which I agreed she was), an 84 year old woman already sitting on the potty wasn't a risk at that point. I don't know if "policy" is open or cracked open door, but the supervisor allowed cracked open door and it's been that way since. The aide would have been the same 3' away open or cracked door and could easily have reacted IF my mother started to get up (she said she wouldn't). I think the aide as programmed to do the job, and not trained to assess a particular situation. My Dad made it worst but I couldn't jump in and intervene in time before everyone was in the room.
I just spent some months in rehabs (3) and omg, how understaffed. For 2.5 months I could NOT walk so had to depend on the bedpan...talk about a shock in my life.
Many of the really older people and quite sick, I feel had to watched like a hawk and I saw falls while I was in the rehabs....as a friend said in talking about these places, "a necessary evil".... I MAY need a knee replacement BUT dread the rehab issue.
And talk about a stressful place to work, omg and so many I would say "why do you do this as you have so much anger about this work"....and that's truth.
Yes, aides are trained in a specific way...wish the supervisor would have been available early on...
will have to disagree re gmother as a risk.
As a medical professional, have witnessed many patients slip off toilet, fall when getting down or up...some have had strokes or fainted for whatever reason. Patients are hospitalized because they have health problems, plus advanced age in your case....just cannot be too careful.
If she HAD fallen, your anger would be towards staff...
QUOTE=metalmancpa;49518943]Supervisor came in before I really had a chance to step in. At that point I just kept to the side.
Again, fall risk or not (which I agreed she was), an 84 year old woman already sitting on the potty wasn't a risk at that point. I don't know if "policy" is open or cracked open door, but the supervisor allowed cracked open door and it's been that way since. The aide would have been the same 3' away open or cracked door and could easily have reacted IF my mother started to get up (she said she wouldn't). I think the aide as programmed to do the job, and not trained to assess a particular situation. My Dad made it worst but I couldn't jump in and intervene in time before everyone was in the room.[/quote]
Supervisor came in before I really had a chance to step in. At that point I just kept to the side.
Again, fall risk or not (which I agreed she was), an 84 year old woman already sitting on the potty wasn't a risk at that point. I don't know if "policy" is open or cracked open door, but the supervisor allowed cracked open door and it's been that way since. The aide would have been the same 3' away open or cracked door and could easily have reacted IF my mother started to get up (she said she wouldn't). I think the aide as programmed to do the job, and not trained to assess a particular situation. My Dad made it worst but I couldn't jump in and intervene in time before everyone was in the room.
They can definitely fall off the potty. Depending on the layout of the restroom and the size of the patient, they can even get wedged between the toilet and the wall.
My Mom (84) was admitted into the hospital a week ago with a urinary tract infection. She's had a tough time of late. A couple of years go my Dad got a bad blood infection which we believe took early stage dementia into a full-blown case, and now he can't do or remember much of anything. Since Mom relied on him for everything, I took over their finances (I'm a CPA) and got health proxy for him. This year Mom gets lymphoma and recently finished chemo and then needed further radiation. Just the quick back story.
She's been in the hospital before, hooked up to IV on the wheeled tree before. A nurse or aide takes her to the bathroom, cracks the door open and stands outside. All is good. Three days in they move her to another room (nicer/larger). So I'm visiting her in the new room with my brother, my Dad, and the caregiver (have 24/7 at home for parents). With the UTI and other issues she's been having problems going. She buzzes and an aide comes in and Mom says she wants to try to pee (first time in new room). She's taken to the bathroom, and the aide keeps the door wide open while standing there. I hear my mother request calmly to please crack the door and stand outside, but the aide says it's against hospital policy. So then a few minutes of back and forth with Mom trying desperately to have the door cracked because she can't go with door open. After several minutes Dad decides to get involved. He raises his voice, and drops expletives, normal for him when his blood boils. As words are exchanged more heated the nurse says to my Dad she's ready to call security on him. It could be heard easily on the floor, and within minutes there is the charge nurse, RN, and the aide by the open bathroom door and four more workers outside the door. My mother is trying to explain she's always been able to go with a cracked door, why not now? My Mom was telling everyone she was sitting now, keep the door cracked, and when I'm done I'll tell you so you can come in and get me up. Then the words fall risk comes into play. More arguing, then a male nurse/aide comes in by the door. Poor Mom with all these people, and then a male. FINALLY the charge nurse tells the aide it's OK to crack the door and some semblance of order is restored. Five useless minutes.
I thought it was played poorly by the staff. For one, I do not think it was ever fully explained to Mom what the limitations of a fall risk were. Logically I could not understand why the door had to be wide open. The aide could have made a call based on my Mom's age and other factors and could have just cracked the door and still been within feet of her. I get there is liability, but a patients dignity should also be in play which it didn't seem to me it was. How anyone couldn't see Mom was a low risk to go against her words and lie about the bathroom was ludicrous to me.
My daughter is a nurse in the Army. We discussed the incident. I told her I was debating telling hospital management of what happened. Not sure what that would do to be honest. At this point will probably let it go.
Do you think based on what I've stated that the hospital was correct?
Quote:
Originally Posted by greatblueheron
I can understand how disappointing this experience would be for all you...but the first job of medical staff is to protect the pt at all costs. Perhaps they considered her a fall risk when you might disagree.
If your dad had been able to stay calm instead of inflaming the situation, you could easily have asked for a supervisor whose job it is to negotiate and resolve conflicts...saving everyone a headache and resentful feelings.
My partner (who runs hospitals), agrees with the adage that it is the hospital's job to protect patients. However, this must be accomplished within the framework of the patient's personal rights. I would have made it my life's work to have one or both of those nurses fired had they called security on me for getting upset with what sounds like an utter lack of empathy and competence. And I would have gone straight to an ombudsman or the head of patient relations. I don't care how overworked or understaffed hospitals are. I'm quite sure their entire staff isn't composed of male nurses, and they obviously need better training when it comes to providing adequate bathroom privacy for their patients—even those who are considered fall risks.
<snip> Do you think based on what I've stated that the hospital was correct?
(Concerning the liability?) Technically and legally, definitely yes. Socially and morally no!
I hope that's what you're referencing; your mothers, privacy and sense of dignity was certainly compromised and with the huge crowd that was in attendance, the nurse surely could have obliged your mother to crack the door and stand nearby and out of sight.
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