Fall with injury in ltc

[Nrsvn11]

Recently I was put on "suspension pending on-coming investigation following an unwittnessed fall in your fall." My patient was in front of me at nurses station as she is a fall risk because she constantly tried to get up from her chair when she physically can't anymore. I noted she was urinated so I took her to her room and asked the first aide i saw down the hall if she would her resident be changed as she was wet, cna clearly stated "no, I have to do something else." I told the resident give me a few seconds while I get someone to help dont get up, she understands for the most part but does have Hx of cog. Def., I walked out of room yo find my other aides and they were both giving a bed bath, so then I helped the aide that told me no to pass out lunch trays so she can go help resident, then I ended up helping another patient with a complaint on her food. I went to dining room to fix it and a cna went yo get me because my patient was on the floor. I went, supervisor was already there along with another nurse. I got xrays to rule out any fx as she was laying on her side against foot rest. Came back a fx rib that family was saying was old. The incident was reported to state and I was suspended while the aide that told me no is still working. I know I should have just stayed at bedside or changed resident myself, but can someone give me their input. Our administrator doesn't back up the nurse's at all in any which way. Something happens that was out of our control at times and its automatically out fault and nurses get fired. Same incident happened almost exactly similar and the nurse was never suspended nor reprimanded in any way. Im just really scared for my license and job. This isn't fair.

[amoLucia]

By and large, almost every poster has hit the nail on the head re this incident. But there is still the that this pt suffered an unwitnessed fall as a result of a MAJOR cascading errors.

Although painful and seemingly harsh, your suspension for this incident is pretty much what most facilities would do. And it depends on the rest of your employment record if there will be further action, up to & incl BON involvement.

What I think I see is new nurse 'newness' contributing to this incident. Inexperienced decision-making improves with time. You alone are responsible for your actions. And while you meant well, "people do wrong things for the right reasons".

Other people may also be disciplined, but it is NOT Administration's responsibility to notify you. Those things should be kept private.

Good luck.

[Accolay]

Yeah, that sucks. I have sympathy for you, but this post is still going to come off as a little harsh.

Is this your first encounter with Murphy's Law? You left a high fall risk patient, actively attempting to fall on their face alone. What did you think was going to happen? Patient modesty is important but riddle me this: Is it better to keep them in their urine for a few minutes, or have them fall on the floor? It doesn't matter if you stayed four hours after your shift or updated the family. It matters that the patient fell on your watch. It happens, but you gotta do your best to keep it from happening. You were doing this when the patient was in front of the nursing station but you stopped when you moved them to their room to be by themselves. Stuff can come at you quick. A few seconds is all it takes. That's the lapse in judgement. You failed to prioritize and that patient was not safe.

What if you are the type of employee that doesn't learn from mistakes? What if the next fall results in serious injury or death? That's what your employer is thinking about, so keep that in mind during any disciplinary review. Do not get defensive. Accept the blame for this. Show how you will correct any future lapses in judgement.

[rkitty198, BSN, RN]

Thank you so much for your answer. I pray my administrator sees this point of view. I do my best to provide the best care I possibly can. As one of the others said, I should've changed the patient myself; I have done that many times. In my experience in that facility, myself and one of the managers are the ONLY ones that don't mind getting our hands dirty. I change, give showers and bed bathes all the time to help my aides. Once a CNA always a CNA, and I don't mind the work. I just wish administrator backed me up to understand that I had only good intentions for my patient. My intention was not to allow her to fall even though that is what happened. Family backs me up and still THANKS me for taking care of it right away. I stayed 4 hours after my shift to get xrays done and waited for results yo come in to keep family updated. I would be caring if I just left my shift wether patient was taken care of after or no. Again, thank you for your response.

I would sum up why you are a valuable asset to the team. I love what you wrote. I can't imagine you going to work and saying "oh I hope a patient falls today" it is obvious by your actions you want to help everybody, to the point where it wears you thin.

Keep your head up. You are valuable. If not to your current workplace your next workplace will have a stronger smarter nurse because of this experience.

Keep us updated.

Wishing you luck and hugs.

[heron, ASN, RN]

Details in the OP are sporifice, as they should be. I suspect that the difference is that the fall resulted in injury - many of which, like fx, are statereportable in my state. Suspension has more to do with administrative CYA than anything else.

For future consideration, when I have a resident who needs to be kept in line of sight for safety, I take ‘em with me if I have to leave the vicinity.

[southern rn]

Thank you so much for your answer. I pray my administrator sees this point of view. I do my best to provide the best care I possibly can. As one of the others said, I should've changed the patient myself; I have done that many times. In my experience in that facility, myself and one of the managers are the ONLY ones that don't mind getting our hands dirty. I change, give showers and bed bathes all the time to help my aides. Once a CNA always a CNA, and I don't mind the work. I just wish administrator backed me up to understand that I had only good intentions for my patient. My intention was not to allow her to fall even though that is what happened. Family backs me up and still THANKS me for taking care of it right away. I stayed 4 hours after my shift to get xrays done and waited for results yo come in to keep family updated. I would be caring if I just left my shift wether patient was taken care of after or no. Again, thank you for your response.

You may not mind providing personal care, but your original post doesn't sound like it, and if events were described to management the same way, they possibly think the same thing.

You stated you took the resident to her room because she was wet, left her alone to look for an aide, then proceeded to help the aide pass out trays so she would have time to change the resident, while also taking care of dietary complaints.

Honestly, every decision you made from the time you removed the resident to her room was a poor one.

[Workitinurfava, BSN, RN]

Well if you are short staffed you have to go with the safest option. You should not have walked away unless you knew someone would be watching her and helping her. You may have to do it yourself. Cover your but at the end of the day. I know you were trying to help her and I am not judging you, I am just telling you, sometimes the cards are stacked against you so be aware of that and be very careful.

[Ambersmom, BSN, RN]

I would suggest, just in case you write everything down before you forget details on who said what, etc.

[Orion81RN]

Yeah you're correct... As soon as you saw she was wet, you should of just changed her yourself since all the other aides were busy. Helping pass out trays can wait. A food complaint can definitely wait.

I realize this was a task that could be delegated if you were too busy doing other nursing duties. However, you had time to look for aides and help with meals.

In the time it took you to go look for an aide to change her, you could of done it on your own. Lesson learned.

A lot of times when a resident is soiled and uncomfortable, they will get up and that leads to a fall. Would she have fallen regardless? Maybe.

I don't know that there is anything you can do now, except take this experience and learn from it.

I second this. Plus, its exactly what CNAs complain about with nurses. This doesn't help our case as nurses that we really are too busy much of the time to toilet patients.

Anyway, your nursing priorities were off, sorry to say. Quoted poster commented my thoughts exactly.

[NightNurse704]

So sorry this happened to you. I agree with putting on the call light and starting a task myself; the CNAs usually see the light, come to the room and take over. Also agree that if there were such harsh outcomes for nurses regarding unwitnessed falls, there would be very, very few of us. Hopefully it won't go to your BON. If it does, I would see about getting an attorney and keeping this incident from impacting my license. Sounds like understaffing is a bit of an issue where you work (as it is in most LTC facilities). Good luck to you!!!