Patient falls scare me to death

[CBsMommy]

So, in my first semester of nursing school, I was giving an LTC patient a shower who was fully mobile and could ambulate on her own. I was doing the shower with just the resident and myself. I placed a towel on the floor for her to step on(no slip mats were available and the room is all tile), I dried the grab bar and her hands and had her hold on while I was getting the bath chair ready and she slipped! She didn't fall but grabbed the chair, which was right behind her and steadied herself. She gave me the look of DEATH that you never want to see a patient give you! Now I am deathly afraid of anyone falling! I'm really thankful she didn't fall but now whenever I'm getting ready to start a new clinical rotation, I just see that day over and over in my mind, and now I'm scared to death to help give anyone a shower!

I did tell my CI about the incident and she agreed that there were no other precautions that I could've taken. I also told another of my classmates and she just remarked that, "people fall all the time". She didn't say it very nicely either (like I was making a big deal out of nothing).

Do you think that I'm over-reacting? Have any of you had a patient fall while you were still a student? Maybe I need to walk in and volunteer to give everyone a shower the first day of clinical so that I can "get over my fear". Anyone else feel this way?

[healthstar, BSN, RN]

I am scared of patient falls too. I always always hold their arm.

[Moogie]

I think you are being very prudent to be aware of the risks of falls and to be careful. I think you're showing a lot more wisdom than your classmate; I'd be a bit afraid of someone who had a cavalier attitude that "people fall all the time". You're also demonstrating a lot of self-awareness to realize that this is an issue for you and you're smart to realize that you need to get over being scared to death. Being so scared can lead you to second-guess your competence and it can lead to making more errors because you're so wrapped up in your fear of this happening again.

You will make mistakes during your student years and you will make mistakes as a nurse. And no matter how hard you try and how many precautions you take, you will have patients who fall. It's a terrible feeling! You do what you can to prevent the situation but if someone falls, you assess him/her carefully, get help in moving him/her (when it is safe to do so), complete your documentation (including an incident report), and try to understand the root cause of the fall so that you can help prevent it from happening again.

You might want to revisit the incident with your previous clinical instructor and explain that you feel afraid that this will happen again. Maybe she can give you a bit of reassurance that you did the right thing or help you to understand why this has become such a big deal for you. From your post, I gather that this shook your self-confidence and that you're really worried that you did something wrong to cause the near-fall and could do that again. Again, you're human and will make mistakes. Learn from them. Own them. Don't let your mistakes own you.

I agree---it's downright scary to have someone fall or nearly fall and to realize that you are responsible, as a student or a nurse, for someone else's safety. As you gain experience---and confidence---it will become less frightening for you.

Good luck to you and please don't let this become an insurmountable hurdle for you. You will be okay.

[CBsMommy]

Thank you Moogie! You are so wise!

That's exactly what this situation did, it shook my self-confidence! I think the best thing that I can do is get right back on the horse and will offer to give people showers whenever I can so that I can get myself comfortable with that aspect of patient care again.

And you are right about my classmate, she was very cavalier about the entire thing. I asked her if she ever had someone fall and she said that her patients fall ALL THE TIME, like it was no big deal! That kind of attitude just shocks me!

Thanks so much for your reply!

[doublehelix]

Patient falls are ALWAYS a scary thing! The best thing you can do is take a look before doing any patient care (especially showers) to prevent a pt from falling. Showers are always the worst place, especially if the pt is left alone. It seems like you did all that was in your power at the time, but I know, it is scary and it does make us worry!

I'm a nursing student and worked as a HCA for a year before going into school. I had two pts fall in me, but both were assisted falls. My first patient was an elderly lady I was bringing to the washroom, with a known history of falls. She uses a walker, and our hospital has a policy to use belts on all of our patients. If a belt is there, use it! When my patients knees began to give out on her and she started wobbling (this was also at 11:30PM when she was extremely tired) I tried to hold her up, but she was completely unable to bear ANY weight. I slowly let her fall down to the ground and we had to hoyer her back up. My second patient was an extremely obese man who was supposed to use his walker at all times... of course they don't! I was doing rounds and caught him walking to the washroom without his walker, and he was using the doorframe to support himself. Literally right after I walked in he started to fall, and I went from behind him and we slowly slid down to the floor then we used the hoyer to get him back to bed.

There was a family member of bed B in the room that said I handled the situation quite well.. Both pts were not injured, but it's still a scary situation for both the pt and you to be in... I don't remember ever learning what to do in a situation with a pt falling, and we were never taught in hospital orientation. The first time is always the scariest. After my lady fell I remember crying my eyes out in the washroom!

[guiltysins]

Your classmate was right, patients fall all the time, but that doesn't mean they should! LOL I mean to me that's like telling someone they are afraid their patient will die that "patients die all the time". Just because it happens doesn't mean you shouldn't be concerned.

[Intern67]

I also told another of my classmates and she just remarked that, "people fall all the time". She didn't say it very nicely either (like I was making a big deal out of nothing)

You did what you could and doing those things will help keep your patients safe and make you a better nurse.

A lot of fearful hand-wringing and endless obsessing over it will not help keep your patients safe or make you a better nurse.

You choose.

[collegets]

I had a patient yesterday, that fell out of her bed, while her family was in the room arguing with each other, my teacher and the whole staff entered the room and found the familly taking pictures, and picking the patient off the floor, before the nursing staff even had a chance, i smell a lawsuit coming on, oh by the way she has "dysphagia" and "dementia"

[JROregon, ASN, BSN, RN]

When I did my CNA clinicals, that was my biggest fear. I tried to think ahead of the task at hand and limit the amount of time that the patient was standing on his or her own. I would prepare the shower area and chair ahead of time so that we could go right in and the patient could sit down. I don't like that attitude of "stuff happens". It's good to be prepared to know what to do if your patient or resident starts to go down so that you can guide her safely to the floor.

[LocoStrange]

Are you overreacting? Maybe. But is that a bad thing? Never. Patients do fall and, sometimes, there is nothing you can do about it especially when they are confused unless someone is sitting.

I had a patient whom was confused and he couldnt be left alone for 5 minutes. One minute he is sleeping in bed...the next minute, he is side in bed with all side rails up.

Ive had a patient who was able to get out of wrist restraints and poseys.

Ive put patients to the bathroom and then straight into bed to start my shift report... only to have someone call me and ask why my patient is laying on the bathroom floor crying for help.

Things I do to prevent other falls... i will help them into the bathroom and only leave until they are basically squatting down and I will stand right next to the door outside. I will check up on them 5 minutes if I dont hear a peep inside or less depending on their condition. I will visually scan the floor and I will always walk behind them with one arm on the IV pole and the other under one of their arm pits. Always make sure they are wearing the hospital socks