To make a complaint to the hospital?

I already explained that they use padded straps around the wrists, ankles and if necessary the waist. I find it hard to believe they don’t do it in the UK 🤷‍♀️.

Speak to PALS and be prepared to complain. It is a reasonable expectation that vulnerable patients are kept safe and not made worse by their time in hospital where this is preventable. Yes, dealing with complaints takes time but should be about learning and noone learns when we all refuse to make a fuss because we should be grateful for the NHS. A relative of mine has had absolutely appalling treatment recently, everyone has been kind and respectful, for which I am grateful, but the shitty systems and practices that they all go along with have caused untold harm. Too many staff in the NHS are completely institutionalised and when things go wrong they are far too quick to shrug and say there's nothing we could have done instead of reflecting on how things could have been different. Sadly I suspect a complaint won't make any difference but what else can us ordinary people do? I'm really sorry to hear about your Dad and I hope he makes a better recovery than you fear.

It may be a British thing. I seem to be one of the few posters here that is not "horrified" that a patient who is confused and at risk of trying to get up when they're not able to are restrained. In fact, if I was in hospital, confused and at risk of a fall, I would expect to be restrained while these conditions lasted to prevent me from getting hurt.

Can anyone explain to me why the idea of this is so abhorrent? Genuine question.

What do they do, sit on the patients?

Are you actually at work in a hospital on Mumsnet?

Patients are NOT physically restrained. Do you really expect us to believe that they tie patients to their beds?

It’s not good practice to keep the sides up on beds now as it doesn’t stop people with confusion from trying to get up, it just means they are even more likely to fall and injure themselves when they do try.

Yes. It did sound like you were talking about her rather than to her:

‘But everyone, including the OP, needs to sit back, do their due diligence and work out the value of a complaint before leaping in.’

My comment was a direct response to someone who was suggesting the best way to improve the NHS is to complain. I quoted that comment, I wasn't talking to the OP.

im sorry to hear about your dads fall. I hope he makes a quick recovery. Depending on the circumstances it’s up to you if you want to complain but to give a nurses perspective and maybe some insight into how these things can happen….

most general medical/surgery wards run with a desired ratio of 1:8 nurses to patients. However this is rarely the case due to short staff. When I was working in a gen med ward it was much more like 1:10 or even 1:14. Nurses simple CAN NOT be everywhere at the same time.

most patients in hospital are elderly, we have an aging population and for obvious reasons they are the highest population group in hospitals, they are also more likely to become delirious, coupled with short staff this is a recipe for disaster.

most hospitals are old, and over the years more and more bed have been added making ward layouts awkward and most of the bays unobservable so often nurses cant physically see patients climbing out of bed or other risk taking behaviours until it’s too late and they hear a bang. Newer hospitals are even worse as they have more and more single rooms, great for younger patients and infection control, not so great for older delirious patients. I worked in a fully single room hospital and there wasn’t a single shift that went by were I wasn’t completing incident forms for falls.

lots of pp have mentioned risk assessments yes this “should” have been completed and you can absolutely ask if it was. There should also be a pressure area risk assessment, a bed rails assessment form, a nutritional assessment form, obs charts, medication forms, cannulation forms, catheter forms, care plans etc etc etc on top of the daily notes, which the nurse has to complete for ALL 10-14 of her patients while you know, actually caring for the patients and doing ward rounds, drug rounds, updating relatives, answer phones, planning discharges, cleaning rooms to welcome new patients etc so as you can see it can be easy to maybe miss a box or two to be ticked.

a few pp have mentioned bed rails and to find out if they were used to prevent him getting up. Part of the assessment is NOT to use bed rails if someone is a falls risk as they are just more likely to climb over them, making the height of the fall higher.

complaining isn’t a bad idea, people SHOULD be upset these things are happening but go easy on the staff on the ward, they will be upset by this, it’s not what they want and you can already be sure they will be dragged through the coals for it.

I’m really sorry to hear about your Dad. I do hope he makes a full recovery.

Unfortunately, falls in hospital are not uncommon, and they often involve fractures and bleeds. The floors are so hard and I think there should be more grab rails etc. It would be great if the magic ‘falls assessment’ delivered all the recommendations it suggests upon completion, but tbh it just doesn’t. 1 nurse and 1 HCA for 12+ patients just doesn’t cut it when they are confused. You can try and get extra staff to 1:1 patients but these days due to cuts there just is not enough staff. The budget in my hugely strapped trust doesn’t allow for ‘extra’ staff on shift. I think it will be common practice soon to ask family for more support.

I would speak to PALS. It should and must be investigated. As a nurse, I welcome fact finding investigations when things have gone wrong. These are people’s lives and questions should always be asked. Nothing will ever change if the conditions for both patients AND staff are not challenged. The nurse will be devastated.

Gov,UK produce clear guidelines on the use of bedrails

Common sense isn't enought, there are policies in place for bedrooms in all health settings.

Wow. I just showed that to my colleague and she snorted and said that "here we just use common sense". I raised my eyebrows because I can't fully agree with her on that statement but it does sound a bit over the top to me, a bit over officious or 'Nanny state'.

‘Sorry to hear about your dad though, OP’

My Nan was actually dropped by staff when she was in hospital several years ago being moved from her chair back to bed. She skinned both her shins and bruised her arm badly, the staff put dressings on her legs but didn’t tell any of the family.

When my aunt went to visit the next day, she asked Nan about her bruises and was told what had happened. Nan had no cognitive issues and was only in for observation following a bad nosebleed that wouldn’t stop. When asking the staff, my aunt was told ‘oh yes, there was an accident yesterday evening’ but nobody bothered to tell the family.

When a complaint was raised via PALS, the hospital send Nan away for ‘rehabilitation’ at a centre over an hour away which was really difficult for family to visit. Said rehab consisted of 15 minutes of physio twice a week and she was there for 26 weeks!

She went in a fully mobile 85 year old who could look after herself and came out unable to walk and needing carers four times a day.

Lessons would be learned from the incident apparently 🤔

I expect people quite often find your advice unwelcome, it might be worth thinking about why.

Bedrails can only be used with consent, either at a patients request or in their best interest if they cannot consent. A full bedrail, capacity, falls risk, mobility risk and safety plan have to be in place as they are a form of restraint.

I personally wouldn’t complain,just ask questions and see how the hospital responds. My late mum would get bad hospital induced delirium and she would have 24 hour 1 to 1 care. I used to try and spend as much time with her as I could and never saw the worst behaviour which was things like taking her feeding tube out and trying to get out of bed.

Once she was home she would be back to normal within a couple of days. I think the delirium is a coping mechanism in a weird way. But once I realised it wasn’t a permanent change it was easier to cope with.

Well yes - rails work for those who aren't mobile enough to climg over them but could fall out of bed otherwise and who are compliant. We don't know what the case was with OP's father.

I’m not aware of bed rails used to restrain patients. I did some fall falls training this week and bed rails are advised to be used with caution to stop people falling out of bed, but not if they are confused and can independently mobilise. This is to avoid people trying to climb over them. Agree with pp to ask to see how he was assessed re falls risk and what was put in place, eg cohort observation perhaps. I hope he gets better soon.

Indeed but when they arrived she was shown the sofabed for her use and the sheets provided for it and she was repeatedly asked to stay so...

Anyway, clearly restraint is seen as unacceptable over there but falls risk assessments can be difficult. We don't know yet from the OP just how mobile her father is or what sort of assessment was done or what, if anything, was put in place to prevent falls. It is also possible, as someone else suggested, that the bleed precipitated the fall rather than caused it. I have seen this happen before too. How is your father now, @Questionablmouse and what has the attitude of the hospital been towards the fall?

for folk based in the UK who have rellies with complex cognitive needs who are in hospital, it's worth looking up John's Campaign. Most hospitals are receptive to the idea of extended visiting for patients with additional needs these days.

It is worth remembering thought that where an elderly person is in hospital, quite often the nearest relative who can or wants to visit is equally elderly and they do need to be able to rest themselves so they don't become ill too.

I agree with this. Visiting is quite strictly enforced in our local hospital but I was allowed to go outside because of her being so difficult and in a side room. I was asked to keep out of the way when the bell went so others wouldn’t ask questions. Because my son was small, I used to put him to bed and then go and visit mum. I usually arrived around the end of visiting and would stay an hour or so. She was in hospital for 3 months and on 1:1 care probably for 2 of those.

Definitely this as every patient should have one. Take it from there.