Hello everyone,
I'm a brand new RN. , just passed my NCLEX last week. :)
I have been volunteering at my local hospital as a "patient care companion" since February of this year, just to get that extra experience outside of my clinical curriculum and to increase my marketability as a new grad RN coming on to the workforce. As a companion, I often do 1-to-1's with acutely confused patients who are major fall risks (although, RN's are NOT supposed to assign volunteers to do 1-to-1... however, this occurs very regularly). Today, I had a patient unlike any that I had to deal with as both a volunteer or as a student nurse.
The patient was a middle-aged alcoholic who was admitted in DT's. He was completely delirious, and only oriented to himself. Alcoholics, as many of you know, get very aggressive and agitated in withdrawal. I was assigned to him as a 1-to-1.
All through the day, this highly tolerant gentleman kept trying to get up despite respectable doses of librium and PRN ativan. I haven't been volunteering for a few weeks, so I felt a little timid today, especially with such a patient.
The patient kept getting up, and instead of using an effective amount of force to hold him down and keep him in bed, I was simply following him and redirecting him, asking him to please get back into bed. His gait was extremely unsteady, and in multiple instances I had to prop him back up into alignment so he wouldnt drop down.
In this middle of this day, He aggressively got up and said he had to go somewhere, in his hallucinatory state. I tried redirecting him, but he shoved me aside and marched forward. I was asking the nurse for help as he walked forward. Next thing you know, he was on his hands and knees on the floor.
An incident report was filed. I felt like I should have known better, as a new graduate RN whose sole purpose in life should be the safety of the patient, no matter how many times they tell you to go ".... yourself". It made me question myself and my abilities. I knew what I should have done differently (be more aggressive in demanding he stay in bed), but at the same time I couldn't help but feel that the responsible nurse should have followed a hospital algorithm and put this extremely volatile patient on, at least, 2-point restraints or heavier chemical sedation.
Eventually, a high-level nurse came to interview the responsible RN on the details of the incident. I overheard her say something about "penalizing" someone. I'm not sure if she was referring to me, but I feel like she was (the RN downplayed it and said I wouldn't get in trouble). My stomach churned. At this moment, I felt like these 110 hours of volunteering would go down the drain as I would get terminated. In addition, I felt incompetent and felt like my job or license would be so vulnerable to termination if this had happened to me as a new hire RN.
So what do you guys think? Am I justified in feeling the way I do? Does this happen all the time and is it "no big deal" for the sake of your job security (so long as it doesnt happen in a consitent pattern)? I know falls are HUUUUGE things for hospitals, and they can get in trouble and lose JCAHO money and general prestige. It's really eating me up inside...
Please share your thoughts and advice. Thank you.