"I'm in absolute state of panic" UPDATE

Hi folks!

This past Wednesday morning I made a post about my TOTAL state of despair after a horrendous incident at work that morning, and the fact that I wanted to quit my job, RIGHT THEN. You guys gave me LOTS of great advice regarding my post, and I really thank you all!!!

Just wanted to post an update and let you all know I am feeling a LOT better. I have decided to actually keep doing what I am doing, because overall I really do love being a nurse. I love using the knowledge that I have to help my patients, and also educate them. I love HAVING all of the knowledge that I keep accumulating every day. Also, I have learned that I really need to take steps to reduce the stress that I let myself feel OUTSIDE of work, and that means, for me, letting my husband know, loud and clear, that he needs to help out around this house. (I'm going to start making lists of errands that he can run for me, on days that I need to sleep!) Also, that means not worrying so much about things that are really kinda petty, like home repairs and such. Plus, I'm going to look into maybe doing some agency work, to make more money. That will help with our financial situation and ease THOSE worries a bit. I know, agency can be VERY stressful and agency nurses can get the crap end of the stick sometimes. But, I've learned to embrace the stress of my job, and then LEAVE it there.

Also... I wanted to share with you all exactly WHAT happened that morning to make me so upset. Some of you may read this and say "Uh yeah, you screwed up pretty bad, hope you learned from it", and some of you may say "Is that ALL??"

Anyway... my hospital has, in the past couple of months, implemented a tighter "fall risk" protocol. In addition to putting orange bracelets on "fall risk" patients, putting up little "leaf" signs outside their doors, bed alarms for some, and checking on them regularly... we NOW have q 30 minute checks on all of them. We have a piece of paper that hangs just inside their rooms that we have to fill out every thirty minutes. Anyway, in order to be considered a definate "fall risk", the patients are supposed to meet certain criteria.

When I came on shift at 7pm, I was going to have five patients with no tech. Okay, fine. Would RATHER have a tech, but I can usually handle five with no tech, fairly well. The nurse that I was taking over for, had also not had a tech, had had admissions, and had been VERY busy. She therefore had not been able to hang signs, put bracelets on, or really fully and accurately chart Fall Risk assessments. When she gave me report she basically said "Oh ALL these people need to be fall risks!" But, in my opinion, two of them were somewhat iffy. One of them was a 35 year old who was currently getting up and down pretty well. The other one was an 81 year old who, to the best of my knowledge, had been getting up and down by herself all day, was perfectly "with it", and had not fallen any time in the recent past, if at all. HOWEVER, the woman did have a high INR. So maybe the high INR should have made her a fall risk ALONE, and I did consider that. But she was very steady on her feet, or had been. At 11pm, we actually got one tech for the floor; she was going to have 15 patients all by herself. Of my five patients I decided that three of them were definate fall risks, and the two did not need to be, including the one with high INR.

WELL..... guess who decided to get up and go to the bathroom, go wash her hands at the sink... and FALL, and hit her HEAD on the SINK. You guessed it.
The 81 year old, with the high INR. Well actually, it had been high the day before, but she had gotten FFP, and that morning it apparently was much better because the lab had not called me with a critical INR on her.

Still... I was VERY VERY upset for several reasons. 1) Even though she had been steady on her feet, I feel like I should have went ahead and made her a fall risk for the high INR ALONE. 2) I know that I didn't accurately and completely chart that the reason I didn't make her a Fall Risk was because she was steady on her feet, or even that she had BEEN steady on her feet. My charting is usually pretty good, so why in the world I dropped the ball so badly there, I really don't know. 3) Today was this WOMAN"S BIRTHDAY.

Oh, and this happened when I had a grand total of 10 minutes left in my shift.
And I DID do everything that I was supposed to do afterwards. I called the supervisor, called the family, called the doctor, assessed the lady (she appeared to have a nice bump on her head but that was it; we put ice on it), and did the appropriate charting. I really hoped that I would come back to work and find out that she ended up being fine. I did however find out that she had went to ICU, but it supposedly had nothing to do with the fall or a bleed or anything like that; someone said it was cardiac related.

So.... I guess from now on, when in doubt, make them a fall risk. But it's frustrating because MOST of our patients are fall risks, and we have to do so much extra charting and paperwork. And, I guess maybe I was trying to make things a little easier on my tech or something, since she had fifteen patients. But it isn't like I couldn't have helped her WATCH this one patient.

*sigh* This incident was just a huge wake up call. I need to work harder, accept the fact that my job is hard work and a LOT of stress, WATCH my charting more carefully... AND, take care of myself at HOME so that I can do my job more effectively.

Thanks for listening!