To make a complaint to the hospital?

[Questionablmouse]

My dad was taken into hospital last week with a suspected heart block that was causing confusion and low heart rate. They found out he'd had a minor heart attack and put him on blood thinners. I got a call last night at 7pm saying he was confused and they were worried about hospital delirium but would monitor him.

He went to the toilet by himself at 8am this morning and fell, banging his head. He's had a CT scan which shows some bleeding and he's in quite a bad way.

Aibu in thinking that considering he was confused and on blood thinners he should have has something with him he he couldn't just wander around the ward? I feel like making a complaint because he should have been safe in hospital and now there's a chance he might not come home at all.

Are you actually at work in a hospital on Mumsnet?

What do they do, sit on the patients?

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.

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.

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 🤷‍♀️.

No, like normal people my colleagues and I are quite friendly out of work too. She is also a mother at my children’s school so we know each other quite well. have sent her screenshots and a link to the thread. She isn’t on Mumsnet.

We don't use any form of mechanical or drug restraint unless it's the only alternative to keep someone safe after full assessments and all other methods are explored, senior medical and nursing staff are involved, patients and their representatives are involved, it's used for the shortest time possible, staff must be fully trained, families are not expected to assist. How do restrained patients eat, drink, move, use the toilet, change position if they are tied up. In 25 years of general nursing I've never seen a patient restrained this way, even to use padded soft mits to stop people harming themselves needs full assessment and permission. Do you use low beds, crash mats, 1.1 nursing?

Please tell me you're not a nurse yourself! Bed rails should NEVER be used to restrain someone in bed. That is far more dangerous than not having them. Not too mention absolutely unlawful regardless of what the family think unless the patient has capacity to choose and has asked for them to be used.

They can't stop someone taking themselves to the toilet. It's just not doable without having 1-1 supervision, which is extremely restrictive and, also, unlawful without a mental capacity assessment and the full deprivation of liberty safeguards put in place. This is not the hospital's fault as long as they have completed a full risk assessment and implemented any advised interventions as a result of the risk assessment.

1:1 is simply not an option here, I can’t imagine it even being considered. If I were to bring it up in a meeting I’m sure I’d be asked to leave! I might suggest it just for a laugh. Restraints would be used if family can’t or won’t stay with the patient. Bedrails are used for those considered not mobile enough or unlikely to try and climb over them but who might otherwise fall out of bed. I haven’t ever seen crash mats used here.

The restraints are adjustable to an extent and only patients who are a danger to themselves and others would have them on to the point that they can’t move themselves around. In other cases, such as a patient who seemed fine in the day and had visitors then but at night would be disorientated and kept trying to get up, they were put on with enough arm movement to be able to take a drink but he wasn’t able to get out of bed. A call button is always available.

I’m not saying it’s a better system. It’s done for safety only and in the absence of other options. I have noticed that if a patient is unable to feed themselves and doesn’t have family visiting to feed them, I don’t think it even gets noticed soon enough and the nurses highly object to having to step in and help feed them.

However I haven’t seen anyone come out particularly traumatised when the use of restraints has been necessary. Pissed off, yes, but usually accepting of the reasons.

And no, I’m not a nurse. I work for a charity advocating for patients here.

Not unlawful here. Standard practice.

Whether it's standard practice or not, if the person hasn't given consent or isn't able to, then it's unlawful without a DoLS.

If you are working in healthcare, please, please go and re-educate yourself on the Mental Capacity Act 2005.

I'm not sure why you would refuse to believe that a different country does things differently. If the choice is between restraining a patient and them getting seriously injured falling in a country where it is expected that a family member will sit with a patient likely to have a fall then why is that so unreasonable.

Nurses highly objecting to help a restrained patient eat and drink is abuse and neglect, are relatives trained and insured to use restraints.

There are plenty of articles online about the use of bedrails and restraint in Spain and the general consensus seems to be it's overused, needs full assessments and should be reviewed by the health authorities .

Because it’s not safe, it’s depriving someone of their liberty and it increases distress. It’s much better for the patient to be prescribed a light sedative to calm them down if they’re very anxious and unsettled. My DF had this when he had spent some time in intensive care following a major life saving surgery. He was extremely agitated, continually taking out his drips and catheter and trying to climb out of bed despite not being able to walk. He was given a sedative and became very calm very quickly - not so much that he was out of it, but enough to settle him and reduce his anxiety. Strapping him to a bed would have been horrific!

Because it’s barbaric.

Have a read of this research
https://pmc.ncbi.nlm.nih.gov/articles/PMC5251344/

I do remember being in hospital a few years ago and there was an elderly woman who kept on wandering and taking her clothes off and staff would have to come in and redress her and get her back to bed. She was in as had fallen at home. This went on all night. I really don’t there’s any system in place to keep people in bed, cant sedate, can’t restrain. You just have to urge them back to bed. Deal with any injuries as you go.

I feel really uncomfortable with the idea of elderly folk being restrained. I suspect the answer is more cottage hospitals set up like care homes. A bed length ways along a wall, lowered as far as it goes. Alarm systems that alert staff as soon as patients have gotten out of bed. I don’t think there is the money though.

You can’t just stop someone from getting up - it’s call deprivation of liberty and it would be a form of restraint. Even putting cot sides up against someone’s wishes to stop them getting out of bed is not allowed

Sorry, I should have been clearer - that’s any patient, restraints or not. The dining room staff deliver and collect the meals. They do not note who has and who hasn’t eaten and the nurses are not involved in that. Unless family supervise and help I find a patient who is physically unable to feed themselves for whatever reason goes far too long without food before someone notices and does something about it as strictly it’s not part of the nurses’ job here.

Yes, well until the authorities start putting a LOT more money into that project it’s not going to change. They’re more likely to go back to open wards to allow for easier supervision and I personally far prefer the private rooms and bathrooms albeit with that issue included.

It is unlawful here - it’s deprivation of liberty.

That’s actually illegal

How is it nanny state? It common sense to risk assess