Back in the early eighties, it came strongly into focus about patient rights. It was decided by the Joint Commission, now known as JACHO (the accrediting council for hospitals) that it was no longer allowed to physically restrain patients.

You see it used to be a safety practice for confused patients if they were in danger of harming themselves or others we would put what was called a Posey jacket or wrist restraints on there person to keep them safe. A Posey jacket was a little front and back jacket with strings that could be tied to the bottom of the bed. Usually this was enough but sometimes they had to have their wrists restrained because they could get themselves undone with just the jacket. We called these patients Houdini.

Of course, we would include the family in the decision regarding patient rights and ask them to come sit with the patient to prevent this from being necessary. Sometimes they were willing, other times they would give permission for the restraints.

Don’t get me wrong, it was actually quite humane, patients that were confused were constantly pulling out their IV’s or falling out of bed, or pulling out their urinary catheters. All these things are dangerous and painful. So it was all good.

Well, it was to be no more, no restraints! Patient rights ruled over patient safety.

Well this one evening, I had a little 85 year old Alzheimer’s patient that was very very confused and disoriented. I had her bed in the lowest position, but she kept getting out of bed. She was very much in danger of getting hurt, I worried so much about her. Then I got an idea…

I asked her what she used to do when she was younger, she said she took care of her home and family. Well that is all I needed to hear. I told her I also had a family and home to take care of and that I was overwhelmed with how much I had to do and I wondered if she had time, would she like to help me. She was eager to help me.

I left her room and returned with a big box of towels and washcloths and pillow cases, all jumbled up. I told her it was just out of the dryer and needed to get folded. Her face was joyful. She had a purpose. She had something to do. She was somebody again.

She meticulously folded each and every piece and stacked them all up. It took her an hour. She was so proud when she offered her completed project to me. I thanked her profusely, kissed her cheek, went outside the room and messed it all up again.

I stayed gone for a few minutes to give her a little time to recoup and then I brought the next “load” in for her to fold. She looked at me and started folding. She did an excellent job. She finished again in about an hour.

I came in a third time with another “load” and her face looked a little troubled. Then she pushed the basket back to me and said “Honey, I’ve tried to help you, but you are going to have to learn to take care of your own home. I am not always going to be here for you. You need to stand on your own two feet now.” It was great! I tried hard not to smile, really I did. She then told me she was exhausted and she was going to bed.

She went to bed for the entire night, slept like a baby and was never restrained. From then on we just kept her busy with chores and never had to restrain her again. Her patient rights remain intact! What a memory.

Technorati Tags: medical patient, patient health, patient mental, patient rights, patient safety, patient treatment, patients rights, rights

7 Responses to “Patient rights, was patient safety jeopardized?”