Accidental skin tear, now I'm worried!

yousoldtheworld · Mar 26, 2011

I think almost EVERYONE has had something like this happen! The elderly are frail, and skin tears and bruises happen all the time. As long as you reported it to your nurse and did your incident report, you should be fine. Especially if this woman is often combative, odds are you aren't the first one something like this has happened to.

I don't work with the elderly anymore, but even with disabled kids, we find skin tears and bruises all the time, and it's usually pretty clear how/why it happened and that it's not abuse. I have never seen someone lose their job for an accidental skin tear. Don't worry yourself too much. :)

CoffeemateCNA · Mar 27, 2011

I have accidently caused multiple skin tears over the years. Nobody has ever blamed me for them, and in fact, beyond telling the nurse so that an incident report could be filled out, I've never heard a single word about them. Yousoldtheworld is right, they happen ALL THE TIME. Sometimes, no matter how careful you are, they will still happen. You don't necessary have to have a sharp object like an earring or a siderail to cause a skin tear. Sometimes, the pressure on their arm while they are being turned is enough to split the skin right down the middle. Not that tears are totally okay, but having a combative resident like that makes it all the more understandable.

You did a good thing reporting it right away. Always CYA. The only times I have ever seen a skin tear become a problem are when a CNA thinks "Oh, I better not say anything about the skin tear or I'll get in trouble" and then management has to start investigating. Better to be up front about them rather than try to sweep them under the rug.

You don't have to worry about being accused of abuse. There would have to be far more evidence to support that kind of accusation, such as suspicious bruising, or continual patterns of skin tears.

As you get more experience, you'll discover what does and what doesn't cause skin tears and then figure out how to prevent them. Take this as one of those learning experiences and apply this knowledge to future situations.

interceptinglight, CNA · Mar 27, 2011

I was putting a lady to bed one evening after giving her a shower, and I suddenly noticed blood on the sheet by her feet. As I had slid her legs into bed I ended up rubbing the backs of her heels on the bed causing very large blisters which burst.....she was diabetic and didn't even feel anything. Immediately I 'floated' her heels off the bed and had the nurse come look so she could apply sterile dressings. It turned out those heels never fully healed. I felt terrible about it at first, but I realized that it's part of the job, the elderly have very fragile thin skin. That same lady a few months later passed away when she took off her tabs alarm so she could get herself out of bed without assistance and re-broke her hip.

These are the kinds of things you will be dealing with if you work in long-term care. Even if you always do the best you can, bad things still happen If you work with people who have dementia, such as your combative resident seems to, just remember that these people fight and give you a hard time even when you are trying to help them because dementia robs them of rationality. There's no reason for them to protest and resist so much, yet they just can't help it.

Furthermore, because you take responsibility for your actions and are very conscientious about the job you do, there's no way you're going to get fired even if this kind of thing happens again. Don't sweat it.

nurse2b013 · Mar 27, 2011

Thank you all so much! You made me feel much better!