someone who has had a brain bleed allowed to fall in hospital toilet smashing his head AIBU

[tallulah07]

I just visited a relative in hospital. He had a brain bleed 24 hours ago and is extremely unsteady on his feet. When I arrived he said he needed the toilet and asked me to pass him his walking stick. I did this and watched with concern as he shuffled one inch at a time. A nurse came in and told him he must ask to be helped if he needs to go to the loo. She took his arm and led him to the toilet which was opposite the ward. I sit on his chair. About 5 minutes later I head an almighty crash and a cry of pain. DH saw that my relative had been left in the toilet and he had fallen and smashed his head very hard against the door! AIBU to think that he should have been placed on the loo and helped back up. When I left he was in pain in his head and waiting for the doctor who had been called. I feel so upset and angry as somebody who has had a brain bleed should be lying still and not left unattended anywhere.

Yes exactly. You started the ball rolling g and sat back and watched. Any reason you couldn't have helped him.to bathroom?

Sorry but this is absolutely not true, unless you were treated in the world of make believe

With all due respect, even though you’ve had the same diagnosis as him, it doesn’t mean your treatments will be the same. Age, lifestyle factors, co-morbid conditions, prognosis etc will all shape the treatment, so you can’t really compare.

You’ve also said you’d expect he was to lie flat for several days but if a nurse hadn’t come you’d have walked him to the toilet.

It’s hard for any of us to comment directly without knowing his case (it seems that most of us commenting are medics/nurses) but I really don’t think there’s blame to assign here.

So why on earth did you help him to get up rather than telling him he should stay in bed?

in the case of the man under the influence of ketamine he would have been deemed not to have capacity temporarily that’s not the same. Capacity is fluid not an absolute and it’s decision based. You can’t assume somebody doesn’t have capacity off the bat.

you can just force anything on somebody because you decide it’s in their best interests if they have capacity. You can safeguard if they’re vulnerable and have capacity but have to take that persons capacity into account. People with capacity are allowed to make bad decisions, you can just decide they’re not going to because you don’t think it’s the right thing to do.

Capacity assessments are made when patients are admitted to hospital on every patient, so I’m not sure what you mean by ‘start asking questions’. They’re already asked.

Excuse me? I am no liar!!!!

The reason is because the nurse came and took his arm - I was literally about to call one upon seeing how badly my relative was walking.

Duh - he got up on his own. I merely passed him his stick, at his request, and moved his table out of the way. He moved around one foot before the nurse came and took him by the arm.

Bucketheadbucketbum - the name kind of sums you up ;-)

You’re lucky he was even taken to the toilet. Nurses told my mum they didn’t have time to take her so she should just piss the bed and they’ll change it later when they have time.

Because naturally I assumed the nursing staff were in charge and they were the other side of the window beside his bed.

I’m a hospital nurse and never heard of patients with brain bleeds being told to be laid flat on bed rest.

We have to respect a patients dignity and right to privacy and barely anyone wants to go to the toilet being watched. If they have capacity, whatever they do is up to them and we have to respect that. If a patient has capacity and an allergy for example and chooses to consume something that could cause them anaphylaxis, I don’t have any power to stop them, I’d advise them not to but have to respect that they have capacity to make that choice. It is unreasonable to be angry at the nurse.

Our ratios are currently awful. On a standard shift I am one nurse to fifteen patients and it’s not possible to stand with every patient going to the toilet, plus we’re promoting independence and mobility and encouraging patients to do as much as they can themselves. We do our best to avoid institutionalising patients and respect their wishes.

@tallulah07 This is probably not the direction you want this to go; but I've been equivocating over these past 4-6 months about whether to quit the NHS. I'm a MR/CT radiographer. 35 years experience. Aged 60. I'm being 'nudged', via 'micro-aggressions' towards 'quit'.

This is one of these.

People have NO ACTUAL IDEA of what a car-crash the NHS is, right now. 5 years ago, my team was 100% Western trained. It's now 10%. Brexit and Tory. It is a disaster. You couldn't make it up.

I hope your complaint addresses how many trained (registered) staff were on duty, versus how many should have been. Be informed the NMC welcomed the government's 'minimal staffing numbers during a strike'- directive; as its way more than are on duty on a normal day.

Complain to your MP.

And, actually, thanks for reminding me why I'm done with the NHS.

I’m a hospital nurse and never heard of patients with brain bleeds being told to be laid flat on bed rest
I did my nurse training in the mid 80s and that was the advice then - but we did loads of things then that don’t happen now like Australian lifts and admitting people with back pain for light traction ! ( and wheeling people outside to smoke )

Nope, that isn’t how intracranial haemorrhages are managed at all.

My nan was given a pad and told to wee in that
No-one to help her in and out of bed.
AWFUL

Well I can only speak for subarachnoid haemorrhages but I also have had a stroke.

So sorry to read your message. I am 50 now and have had excellent treatment by the NHS from the age of 14. I have had reason to complain in the past but I never have done as I realise everyone I have dealt with has had the best of intentions and is up against it. Let's hope the Government plough some money into it to get things resolved although I fear it will be a long time in coming.

It’s tough OP, hope your relative is better soon ❤️

in regards to falls prevention in hospital, it’s so difficult. I personally have been 1:1 with a patient, they had falls alarms etc but it still didn’t stop them falling and banging their head whilst I was in the room with them. I felt awful!

Even if somebody would have been with your relative, they may not have been able to stop the fall anyway and highly unlikely they’d have been able to catch him/guide him down.

Falls prevention is so challenging!

Im sorry your relative fell. There should be an incident investigation which will consider whether the nurse leaving the patient was an acceptable course of action or not.

It is incredibly undignified to watch someone using the loo! It is necessary at times but if the patient has capacity and declines, the nurse would have to step out. Even if the Nurse were in the room, they may not have been able to prevent the fall. Nurses can end up injuring themselves when trying to prevent someone falling as well as risking further injury to the patient. If 1:1 is used, it’s normally for prompting and guidance to stay safe, not always very effective unfortunately.

What should have been considered was use of a commode next to his bed instead of walking to the bathroom if he is that unsteady which it does sound like.

The hospital social care team (social services) should likely be informed, and they will no doubt commence what's called a s42 Safeguarding enquiry. This will ensure that an investigation takes place.

There might also be an issue around mental capacity, in that if your loved one was deemed capacitated by the staff to express that he wanted to be left alone in the toilet despite knowing and accepting the risks, then this might reduce any allegation of neglect by the staff.

I have been a patient who fell trying to take myself to the toilet, also following a brain bleed. Firstly patients and relatives should be expressly told whether the patient is able to get out of bed to go to the toilet. I don't blame staff for my fall. I was not aware that I was not supposed to go without a nurse. However following the fall I was given a bright yellow bracelet saying 'falls risk'. I wasn't deemed one before, going forward this was part of any risk assessment.

If a patient has a walking aid from previous to the current brain injury, it is not necessarily appropriate to use following the bleed. Some other walking aid may be needed.

What must be recognised is that an admission with a brain bleed is going to be an emergency. Prior to this a patient will have been fit and able and will have self respect which means they will wish to take themselves to the toilet, not necessarily noticing that their condition has changed . It is up to nursing staff to risk assess and decide if another form of toileting is appropriate. Being on a very busy and acute ward made me realise all the conflicting demands on nurses on a very intensive and high needs ward. Falls are monitored and have to be extensively reported, so are not taken at all lightly.

I can only see that OP's suggestion that someone should be left to lie flat for several days would hinder recovery (although every patient has different needs). If they truly believe that they should have encouraged the patient to use a bedpan perhaps! However I am not a medical expert in this.

Like others above I can't see that blame can be apportioned. In my experience all ward staff work hard and are dedicated to helping their patients recover.

Are you inquisitor-in-chief?

🙄

Are you? 🤨🫡

So you helped him get up by giving his stick. He could have fallen there and then with you stood right there and you probably would have found it hard to prevent it. You didn’t help the situation and you’re now applying your experience of a similar illness as if that means you’re an expert. It’s very easy to criticise but it’s well possible as PP have suggested that he needed to pull the call bell when done. He is not a prisoner and it sounds like he has capacity. I wouldn’t want someone staring at me using the toilet, I’d hope that where possible I’d have dignity. You’ve said that the nurses were there quickly which suggests that someone was waiting nearby if the number of nurses you quoted were correct. Your suggestion seems to be that
someone has been negligent. Sometimes accidents happen, the NHS isn’t always shit regardless of what you see on here.