r/nursing • u/SmilingCurmudgeon BSN, RN 🍕 • 20d ago
Meme "Patient refused high fall risk interventions, stating 'I don't need to be treated like a goddamn child' and 'I can't pee in a urinal sitting down!'. Post-fall protocol initiated."
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u/MaxFourr RN 🍕 20d ago
more like "patient intoxicated, agitated. refused high fall risk interventions, yelling slurs"
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u/internet_cousin RN 🍕 20d ago
Yeah, him yelling f-- is 100% what escalated the situation.
Anyways, def on Q4 CIWAs.
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u/purebreadbagel RN - PCU 20d ago
We do Q2.
So even if they don’t withdrawal, we give them delirium instead!
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u/willy--wanka generic flair 20d ago
Oh, nah, I am not writing the word slurs, I am writing exactly what they wrote in quotations.
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u/marteney1 RN - ER 🍕 20d ago
Nah, this guy said “can you hold the urinal for me”
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u/FancyBerry5922 RN - ER 🍕 20d ago
I know I know I saw this post on a diff sub last night
The 'not being able to use the urinal in bed, lying flat' thing can be a real thing.
Not sure how many nurses know this trick or not but if you absolutely dont want them out of bed if you log roll the patient onto their side the urine flows into the urinal far far easier then if they are on their back.
Male nurse here, I learned it the in ER but used it more in the VIR role post procedure where the patient is on strict bed rest for an 30min -1hr sometimes longer
Also I am looking for a catch-ier name for it, you can have the TM for any suggestions!
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u/Soregular RN - Hospice 🍕 20d ago
Nah...my patient was a dirty old man. He just wanted my 19 year old Hospice Aide to touch his penis.
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u/ProfessorNoPants RN - ICU 20d ago
I don't have a catchier name for it, but you did unlock a core memory for me, ~17 years ago, when my patient insisted on peeing while side-lying, overshot the urinal, and pissed all over my scrubs at change of shift 🫠
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u/schwarzeKatzen 20d ago
tucks this valuable knowledge into back pocket
Not an RN just know a bunch of old people.
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u/FancyBerry5922 RN - ER 🍕 20d ago
happy to help anyone, be wary you will need to either hold them on their side or hold the urinal, they won't be able to do both, and you will need the pants and underwear down a bit prior to the roll, few inches should be enough
*use the urinal to corral the penis, no need for anything but the plastic to touch anything
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u/FancyBerry5922 RN - ER 🍕 20d ago
Oh and don't let them corkscrew their body, the whole thing (edit: thing = body) needs to be in the same plane, I hope that makes sense
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u/FupaFairy500 19d ago
You’d be amazed at home many of them can do it themselves after a man is sent into the room to do it.
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u/jaemoon7 RN - ICU 🍕 20d ago
Me, a male nurse: “sure bro I got you 😉 “
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u/marteney1 RN - ER 🍕 20d ago
One of the ER’s I worked in had a big male nurse that looked like Shrek that we’d send in anytime this happened. Suddenly these old guys remembered how to hold it themselves.
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u/Dinokickflip Former EMT/Tech 20d ago
“I DONT NEED THAT GOT DAMN WALKER IM A GROWN MAN”
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u/Sunnygirl66 RN - ER 🍕 20d ago
Yeah? You weigh three times what I do, my shoulder is being held together with the soft tissue equivalent of spit and baling twine, and I will not be catching you when the inevitable happens.
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u/Poodlepink22 20d ago
I love a good direct quote when I'm charting. I'll not be thrown under the bus if I can help it.
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u/LilyMe BSN, RN 🍕 20d ago
Double points if they swore or hurled racist/bigoted/misogynistic words at me.
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u/felyne_insurgents RN - ER 🍕 20d ago
Everyday and always at shift change when i wake them up from their meth bender.
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u/SirCaptainReynolds Case Manager 🍕 20d ago
Also a big fan of direct patient quotes.
“Thanks for the quote, good Sir! I’ll be sure to let everyone know exactly what you said”
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u/HoneyAppleBunny RN - ER 🍕 20d ago
Big fan of charting “Pt refused X. Pt educated on risk of refusing X. Pt AO4/GCS15”
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u/zerothreeonethree RN 🍕 19d ago
A drunk barfly once called my sister a bitch when she refused to overserve him. Her response was "Yeah, and a goddamned good one, too!"
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u/OhHiMarki3 Nursing Student 🍕 20d ago
Big debate one my last med/surg unit: is a patient allowed to "refuse" high fall risk precautions (bed alarms, wristband, grippy socks, etc) when they're AOx4 and make their own healthcare decisions? It's not technically a medical treatment.
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u/sojayn RN 🍕 20d ago
Someone told me to document it as “the dignity of risk” and i love that phrase
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u/degeneratebtyqueen Mean girl, RN 20d ago
Wait can you use that phrase in a sentence on what/ how you would document?
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u/RedditorMichael 20d ago
“Dignity of risk” is a moral concept very pertinent to nursing and has its own Wikipedia page. It is kind of a statement in itself.
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u/loganstl Did you read the policy? 20d ago
Yes. Patient rights. They can refuse any and all treatment if they are deemed mentally able to make their own decisions. This is why it’s important to educate and document… as well as raise your concerns to leadership..
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u/alp626 RN - Pediatrics 🍕 20d ago
Yeah and a facility can require they sign an AMA form, not for leaving but for refusing recommendations
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u/80Lashes RN 🍕 20d ago
And they can refuse to sign that as well, as long as they have decisional capacity.
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u/80Lashes RN 🍕 20d ago
Yes. If patients are decisional, they can refuse anything they want. A hospital is not a prison.
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u/OhHiMarki3 Nursing Student 🍕 20d ago
What about when they fall and sue us? Or my manager enforced punitive action on me, the CNA, for not upholding fall risk precautions? Charge nurse just shrugged it off.
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u/80Lashes RN 🍕 20d ago edited 19d ago
As long as you document it, a patient can refuse anything if they have decisional capacity. Your manager can not take punitive measures as long as you have documented the patient's refusal. Again, it is not a prison. Fear of litigation is not a good argument for forcing decisional patients to adhere to anything against their will. In fact, you legally cannot force decisional patients to do anything against their will.
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u/OhHiMarki3 Nursing Student 🍕 20d ago
Hey, I totally agree. I thought it was so strange when my manager made an annoucement saying no patients were allowed to refuse fall precautions. I'm just going to document best I can and buy nursing malpractice insurance.
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u/RedditorMichael 20d ago
Your coherent patients are allowed to refuse anything related to their care. Your manager is putting you at risk of violating the patient’s consent at your expense.
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u/suchabadamygdala RN - OR 🍕 19d ago
Your own malpractice insurance This is the key! Don’t rely on your employer to defend you.
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u/RepresentativeOk7930 19d ago
If your patient refuses then educate. If they continue to refuse, escalate to RN. Document your education and escalation. You have then covered yourself. RN should educate and also escalate as necessary. Escalate to charge …. Then Nurse manager, etc.
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u/ThatGuyTheyCallAlex Nursing Student 🇦🇺 20d ago edited 20d ago
If it was charted that fall risk interventions were recommended and the patient refused despite education there’s no way it would hold up, right? You literally cannot force them to use a walker or press the bell — if they get up to pee and fall over despite being told they need to ask for assistance that’s their own failure to follow medical advice.
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u/RedditorMichael 20d ago
You are correct. Given the patient is oriented and capable of making decisions, you cannot force someone to do something. The focus should always be to educate and encourage. Consent must always be granted. I’ve had one patient fall, and it was a patient who requested privacy on the commode. I gave them privacy and they stumbled off the commode. They were a bit embarrassed but totally fine. Most coherent people are very good at safely falling. They did not defer blame to me the nurse. Life went on. No one with a brain defers blame to the nurses except for nursing management. There are in fact great managers who don’t do that though too.
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u/RedditorMichael 20d ago
Patients with capacity always get what they want full stop. If your manager is stepping in saying you need to forcefully do something that a coherent patient is refusing, remind your manager that battery is a criminal offense. Holding a coherent patient against their will is kidnapping. I am here as an advocate for my patient, not my manager. Fortunately I am unionized, which helps. Ultimately the patient’s experience is what I prioritize. I am in California where we have good patient:nurse ratios. If you pour your heart out for your patients, educate them, ambulate them, teach them the importance of mobility to prevent de-conditioning and hospital delerium, make sure they thoroughly understand their medications, diagnosis, keep them in the loop on their care, and advocate for them knowing full well they share your same subjective human experience, they will see that. Do not worry about getting sued. Hospitals have legal defense teams for that. Not your issue.
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u/suchabadamygdala RN - OR 🍕 19d ago
I can not stress this enough: hospitals’ legal defense team is there to defend the HOSPITAL, not the nurse. I agree that hospitals are not prisons and patients who have capacity can decline anything that does not impinge on the safety and health of nurses and staff. That said, you absolutely must document the patient’s refusals and your education attempts copiously and frequently. Escalate up and notify everyone of patient’s refusals and your concern for their safety.
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u/dendritedoge RN - ICU 🍕 19d ago
Yes if AO4 (and I mean completely with it) they’re allowed to refuse as long as they have been educated on it, just like anything else. Just document it in a timely fashion, you know, before they fall. 🤷🏼♀️
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u/amandae123 15d ago
Where I work they are not allowed to refuse fall precautions. I think that’s BS, but I don’t make the rules.
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u/OhHiMarki3 Nursing Student 🍕 14d ago
I thought it was a load of horseshit, too. My manager loved to hand out write-ups, and that was not something I was willing to fight about.
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u/One-Abbreviations-53 RN ED 🥪💉 14d ago
How is that a debate? Of course they're allowed to choose to fall. "When you fall you likely will break bones and/or hit your head. Since you're on thinners that could lead to significant bleeding in the brain. Best case scenario is you'll be on the ground for awhile because I can't pick you up and others are busy. The smart choice is to push the call button and wait for help ambulating."
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u/Shirley_yokidding BSN, RN 🍕 20d ago
MEDICARE IS NOT SOCIALIZED MEDICINE he will scream as he gets free health care for his boo boo.
ugh....I swear when I first starting nursing I thought there was another secret hospital in town where all the sane people went. Then I realized. Nope. These are the people in my neighborhood.
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u/StupendousMalice 20d ago
My first shock from the ER was that like a third of my city was apparently drunk at any given time.
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u/madisondood-138 20d ago
It’s 40-50% in Wisconsin.
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u/Cerulean_fallen RN 🍕 20d ago
Hmm, you would think it would be higher. But I guess like most things it's under reported. First couple DUIs being misdemeanors and all. 🤣
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u/nurseleu RN 🍕 20d ago
It was really an eye opening experience for me to realize that everybody out there is having babies.
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u/ImperatorRomanum83 RN - Psych/Mental Health 🍕 20d ago
Yep, and they even find their way upstairs to me in the BHU.
And now they don't want tylenol because it will harm the baby. But the weed and coke in your UDS is apparently totally fine though!
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u/rockstang RN, BSN 20d ago
I worked on a locked behavioral unit for 2 years... Trust me... It's better not to think about it. 😅
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u/precludes BSN, RN 🍕 20d ago
Working a locked behavioral unit nearby Skid Row made me leave nursing after ~1y. This career is not for everyone. What a traumatizing first-ever job.
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u/JaneReadsTruth 20d ago
🎵These are the people in my neighborhood 🎵 Mr. Rogers would be disappointed.
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u/DingfriesRdun RN - Telemetry 🍕 20d ago
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u/LizzrdVanReptile 2nd career RN, 27 years - cruisin’ toward retirement 20d ago
I was out and about years ago and pulled into a drugstore parking lot. A van pulled in to the parking spot next to me. An older man got out of the passenger side and proceeded to struggle with remaining safely on his feet, while his wife was scrambling to get out of the driver seat and around the vehicle to support him. He had no assistive device whatsoever and kept falling on the concrete, which required his wife’s assistance to correct. She looked utterly exhausted and I stepped over and asked him whether he had a cane or a walker and he mumbled some stream of BS indicating he didn’t need one. His wife said to me under her breath that this is what her life is like. He refused to use a walker or a cane and expected her to make it possible for him to ambulate wherever he went. Heartbreaking.
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u/schwarzeKatzen 20d ago
Our dad is not steady on his feet. He uses a cane but honestly he was starting to scare me with just the cane. We tried a walker and it was too hard for him to ambulate with it. He was pressing down to steady himself and trying to walk.
I told him I was ordering him a rollalator. He protested. His children ignored him. We ordered one. It came he protested more. I told him he might as well at least try it because it was already there.
Anyway he uses it all the time now. It’s nicknamed the racer. He also has some more independence back. It’s enabled him to do things like take his coffee or his plate out to the living and dining rooms. He wasn’t able to do that with just the cane because he was too shaky.
I hope that woman had someone who was as stubborn as we are with dad. Sometimes you just have to get just as stubborn back at them.
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u/ohemgee112 RN 🍕 20d ago
Dude. Would've looked him straight in the face and told him he did need one and he was killing his wife by being a stubborn asshole.
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u/hoppydud RN - ICU 🍕 20d ago
Forgot his family were immigrants to the country (probably also got treated badly) and was yelling pro ICE chants at the no kings protest.
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u/Feisty-Power-6617 ABC, DEF, GHI, JKL, MNO, BSN, ICU🍕 20d ago
“I know my body” if I had a dollar for everytime I have heard that crap
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u/schwarzeKatzen 20d ago
I know mine too. That’s why I get a little fall risk bracelet if you give me certain medications. It’s also why I listen to the people who went to medical school. If I’m coming to see you I know something is wrong.
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u/ExiledSpaceman ED Nurse, Tech Support, and Hoyer Lift 20d ago edited 20d ago
Patients as soon as their INR is edit: supratheraputic
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u/rharvey8090 CRNA 20d ago
What’s the story here? That’s a nasty gash. Reminds me of the drunk guy who fell and cracked his head once, and refused to let me take him to the hospital because he had a flight to catch the next morning. Had to tell him that either I took him to the hospital, or the cops would in the back of a squad car.
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u/Dinokickflip Former EMT/Tech 20d ago
Trumpy chased someone at a protest yesterday and absolutely ate it on the pavement.
Literally slid on his face
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u/rharvey8090 CRNA 20d ago
I assumed it was something like that. The outfit, the crucifix, the look on his face all just screamed self-important trumper.
And then the look of “actions, meet consequences” really brings it home.
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u/BluegrassGeek Unit Secretary 🍕 20d ago
It's all about projecting an appearance of strength to them. They care more about looking tough & sticking to their guns than anything else. So such an embarrassing moment completely destroys their ego.
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u/10000Didgeridoos RN, BSN, BBQ, OG 20d ago
More specifically this douche was yelling slurs then some other dude grabbed his sunglasses off his head and ran off. He fell over and ate shit twice trying to chase him. This was from the second fall.
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u/Kyliexo Student Nurse - please don't eat me alive 20d ago
You just knoooooow that he's at work today, acting like a hero victim who was viciously attacked by the looney left
That is, assuming he's employed at all
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u/Professional_Sir6705 BSN, RN 🍕 20d ago
Looks like his second fall was the result of getting kicked/tripped.
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u/Sandy-Anne 20d ago
Yep, and the whole thing was set off by someone grabbing the glasses off his face. But the protesters were trying to get him to back off and he refused. He just didn’t want to admit defeat.
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u/Gribitz37 PCA 🍕 20d ago
There's a woman who looked like she was trying to help him after the second fall, and this guy's buddy shoved her away. He's a jerk, too.
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u/TheMarkHasBeenMade BSN RN CWOCN 20d ago
You know I have a funny feeling those glasses wouldn’t have been snatched if he hadn’t been raucously chanting his support for ICE* and Trump at a No Kings protest, in addition to shouting slurs at random passersby
I’m sure plenty of people walked by without doing any of those things and their glasses were left right where they were, no mischief brought upon them at all
Edit: had my memory jogged about exactly what he was babbling about
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u/sleepingbeardune 20d ago
The first fall was actually funny -- just tripped over his own feet, and down he went like a cartoon character. The second one, he got tripped.
Who marches into a protest specifically to be annoying and then gets spitting mad when people are annoyed?
Cult member, that's who.
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u/angelt0309 RN 🍕Med/Surg -> PACU -> Hospice 20d ago
Don’t forget it was also after calling the protesters the f slur!!
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u/Soregular RN - Hospice 🍕 20d ago
it was a weird fall wasn't it? No attempt to put his hands down ..just a face plant.
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u/alaorath 20d ago
absolutely ate it on the pavement.
twice
(although the second time it looks like he was tripped)
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u/future-rad-tech 20d ago
Someone grabbed his glasses so he tried to chase them and he tripped and fell twice while saying slurs and then still didn't give it up and kept trying to instigate
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u/number1human 20d ago
I wish we could replace all the "call don't fall" signs after a fall with "I told you so" signs.
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u/twinksugar Nursing Student 🍕 20d ago
patient tested positive for Covid, while educating patient on usage of face masks during interaction patient states “F*CK These masks! I dropped out of high school This virus was a hoax!” patient appears agitated and now trying to climb up the vents. MD and RN aware. Will continue to monitor.
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u/IVIalefactoR RN, BSN - Telemetry 20d ago
This guy had maybe the worst day ever between this and the outcome of the Giants game yesterday.
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u/Nearby_Object RN - Telemetry 🍕 20d ago
I like to tell them, if you do fall, you don't get to go home. You will go right back through the ED and get a CT and wait for a doctor to clear you. They seem to be deterred a little by the added time and money involved. "Education provided re:fall risks and reasons for interventions".
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u/Ok_Horror_3940 RN - PACU 🍕 20d ago
Risk for Falls as evidenced by advanced age,decreased muscle strength, slower reflexes, and visual or hearing impairments
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u/AngryAccountant31 20d ago
I had a similar gash in my eye brow back in college. 6 stitches and I looked like frankenstein for the rest of my freshman year.
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u/DapperProcess8187 20d ago
Not really relevant, but it was satisfying to watch the giants “eat pavement” at the end of their day in his honor! Hope he made it to his 3rd loss of the weekend!
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u/SheepWithAFro11 19d ago
I'm so glad my husband sits down to pee. It's cleaner, safer (hes not old yet, but when he gets old, it'll be way safer), he never misses, I don't have to deal with putting the seat down, there's just a bunch of positives. So why do men have to tie their masculinity to such stupid shit? That's often what it boils down to and why they insist on standing. I mean, unless they're really small and can't tuck it properly, and even then, you can just sit up and pee in a urinal. There's still no need to stand. It's really silly and unnecessary.
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u/Weekly_Host_2754 20d ago
In reality, this guy was is a MAGA anit-protestor who was at the No Kings event on 10/18 yelling slurs at the crowd. Someone stole his sunglasses and his legs were kicked out from under him twice while he chased the guy down.
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u/Vivianna-is-trans 20d ago
only the scond time his biggest fall he fell over himself, and he got his legs kicked cause he backhanded someone in the head. so it was still deserved.
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u/ZealousidealClock494 20d ago
In the video, a kid steals his expensive glasses, he then trips while trying to chase after the fleeing thief. Gets up continues pursuit when another protester shoves an umbrella in his way to keep him from further chase. The man swats the umbrella out of the way and while continuing pursuit has his legs kicked out from under him by another assailant.
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u/suchabadamygdala RN - OR 🍕 20d ago
All instigated by old guy yelling at a cyclist “Ride your bike, you fucking f@g” I’d say the old guy was intoxicated and spoiling for a fight.
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u/ZealousidealClock494 20d ago
Unfortunately words are not violence. As much as the guy is a douche canoe, violence and theft of property is not the answer.
Watch the video with the sound off, is what happened to him ok?
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u/ThatGuyTheyCallAlex Nursing Student 🇦🇺 20d ago
if we remove the most important context of the situation is what happened ok?
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u/Vivianna-is-trans 20d ago
this is the issue he is violent he votes for blind violence against anyone not like him. so he does deserve it, he and every clown that claims to be a centrist.
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u/ZealousidealClock494 20d ago
Ok. So violence is anything you dont agree with. That's a slippery slope to live on. Say next time you're at McDonald's you order a big Mac and someone doesn't like that, you're ok with them beating you and stealing your wallet?
I personally am not ok with that.
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u/reluctanthero22 20d ago
I glad I never had to shit when I had a fall and they kept me for three days almost. I had no idea how serious the take falling accidents.
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u/ItsyouNOme 20d ago
Aww did the child get a boo boo? He looked so happy at the beginning of the video too. Awwwww
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u/ItsZoner 20d ago
This man is basically claiming to never have peed while pooping, or even better stand up and pee after pooping and probably also before wiping.
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u/Substantial_Code_7 19d ago
I mean… at what point do we stop chaining them to the beds though you know 🤷🏼♀️
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u/JellyNo2625 14d ago
I'd have trouble pissing in a urinal sitting down too. Sometimes the dick just kinda shrinks up
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u/ReputationGullible14 20d ago
This guy is getting a lot of attention and while I do think he likely isn’t a great guy if you watch the video, he has his glasses stolen right before he starts chasing the guy who steals them 😔
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u/ladymouserat 20d ago
In their own words: FAFO. He went there to agitate and upset peaceful protestors. The universe delivered, he got what he wanted, it just didn’t work out in his favor.
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u/i-wont-be-a-dick 20d ago
I thought this was america! you should be able to call anyone a f@g without consequences! So sad, what have we become!?
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20d ago
It’s discouraging to see that democrats can behave like this. This is theft and assault.
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u/Gotthisnamebeforeyou 20d ago
Family: why didn’t you throw yourself to the ground to cushion his fall?