Falls Risk.
Recently, I was unfortunately poorly enough to see life from the other end of the hospital bed. I was poorly with sepsis but due to my pre-existing condition (POTS) I was automatically a "falls risk". POTS means I am more prone to fainting than your average 22 year old, even more so when I'm poorly. However, being categorised as a falls risk would possibly have been hugely detrimental to my recovery had I not been very well educated abut autonomic dysfunction and how quickly I would become deconditioned. During my 8 days on the ward, I had plenty of time to mull over attitudes to inpatient falls.
Where I work falls are seen as a very bad thing. Our morning meeting involves a reminder of how many days since our last fall and how many we've had that month. As HCA's we've had various training sessions on falls prevention and are given frequent reminders to declutter bed spaces and make sure we're doing all we can to prevent falls. We often have bays where someone must be present AT ALL TIMES because of the falls risks. There is an element of fear among the staff about having a patient fall and I'm not ashamed to admit, that in the past, I have been reluctant to help certain patients mobilise for fear that they may fall on my watch. I have only ever worked on one ward...so I don't know how things are elsewhere...but the grapevine suggests that we're somewhat more at the extreme end of fear over patients falling.
Don't get me wrong, I agree that we should be trying to prevent patient falls, particularly for our elderly and frailer patients. For this demographic I believe there is a greater risk of life altering injury that may prolong their hospital stay or ultimately lead to their death. However, the fear of a patient falling can mean they leave us less mobile than when they arrived. We know some patients fall over - often it is the reason for multiple admissions for elderly patients - are there circumstances where we should be accepting this and educating these patients in how to fall in a way that may be less likely to cause them damage? Yes, provide them with aids to prevent falls, but equally the knowledge to accept when a fall is occurring and how to protect themselves as much as possible.
For me, I was a falls risk. This meant that for my first four days in hospital I wasn't really allowed to do more than stand and transfer onto a chair/commode and only then with direct supervision from the staff. Unfortunately patients with autonomic dysfunction become increasingly worse, the longer they spend in bed. This is known as "deconditioning". The less I stood and walked, the less I would be able to stand and walk without falling. The risk of this deconditioning (which would be a massive decline in my overall health) was far greater than the likelihood a fall would greatly injure me. As it happens I did "fall" twice on this admission. Both times were faints and would be viewed as avoidable despite the fact that they are an inevitable part of my illness. I gained a mild concussion. But emotionally and physically I *needed* to keep mobile. That was far more important than a few bruises.
I realise that this is a somewhat rambling post and a bit of a brain splurge...but being a falls risk has been playing on my mind this past week. Maybe once I'm studying again I could look into the more scientific side of things...but for now this shall do!
Where I work falls are seen as a very bad thing. Our morning meeting involves a reminder of how many days since our last fall and how many we've had that month. As HCA's we've had various training sessions on falls prevention and are given frequent reminders to declutter bed spaces and make sure we're doing all we can to prevent falls. We often have bays where someone must be present AT ALL TIMES because of the falls risks. There is an element of fear among the staff about having a patient fall and I'm not ashamed to admit, that in the past, I have been reluctant to help certain patients mobilise for fear that they may fall on my watch. I have only ever worked on one ward...so I don't know how things are elsewhere...but the grapevine suggests that we're somewhat more at the extreme end of fear over patients falling.
Don't get me wrong, I agree that we should be trying to prevent patient falls, particularly for our elderly and frailer patients. For this demographic I believe there is a greater risk of life altering injury that may prolong their hospital stay or ultimately lead to their death. However, the fear of a patient falling can mean they leave us less mobile than when they arrived. We know some patients fall over - often it is the reason for multiple admissions for elderly patients - are there circumstances where we should be accepting this and educating these patients in how to fall in a way that may be less likely to cause them damage? Yes, provide them with aids to prevent falls, but equally the knowledge to accept when a fall is occurring and how to protect themselves as much as possible.
For me, I was a falls risk. This meant that for my first four days in hospital I wasn't really allowed to do more than stand and transfer onto a chair/commode and only then with direct supervision from the staff. Unfortunately patients with autonomic dysfunction become increasingly worse, the longer they spend in bed. This is known as "deconditioning". The less I stood and walked, the less I would be able to stand and walk without falling. The risk of this deconditioning (which would be a massive decline in my overall health) was far greater than the likelihood a fall would greatly injure me. As it happens I did "fall" twice on this admission. Both times were faints and would be viewed as avoidable despite the fact that they are an inevitable part of my illness. I gained a mild concussion. But emotionally and physically I *needed* to keep mobile. That was far more important than a few bruises.
I realise that this is a somewhat rambling post and a bit of a brain splurge...but being a falls risk has been playing on my mind this past week. Maybe once I'm studying again I could look into the more scientific side of things...but for now this shall do!
Comments
Post a Comment