Crutches and Clinicals

[RookieRoo]

Ugghhhhhhhh so with two weeks to go, I fell today and hurt myself. I fell right outside of the nursing building, in the middle of the street, on my way home from a day of studying for a med surg test. JOY!

Ended up in the ER and found out that while my ankle is NOT broken, it is very badly sprained. I can't bear weight on it and I am on crutches and in an air cast. This is bad because I have two weeks of class left this semester and along with those, I have clinicals. You would think I wouldn't have too many clinicals left, but I actually have 6 from tomorrow through next thursday. Insert freak-out here.

I already had to bow out of my clinical tomorrow. I'm not sure what the rest of the week will bring but I know there's no way I can be on up on my ankle for 8 hours tomorrow. I can't even put a shoe on, at this point. The problem is, we're so close to the end of the semester, there's not really any time to do make-ups... especially since my schedule is jam-packed with other clinicals. So, my intructor is looking into a few things but she said it may come down to me taking an "unsatifactory" for clinical tomorrow, just as a matter of standard procedure. She said it won't reflect badly on me and she'll put why I was unable to attend, but it still makes me really upset because I have worked hard to be an excellent student in clinicals, and I have never received an unsatisfactory EVER. To have to do so because of an injury I cannot help... Ugh, so frustrating. And then there's the matter of what to do about the rest of my clinicals... I'm going to try to make them, if only to not have to reschedule them, I guess. I'm not sure what else to do. So stressed out now, my ankle hurts and it just seems like these things always happen right when they're most inconvenient. :(

[mrsboots87]

There is a very real possibility that you will not be aloud to attend clinical with crutches and/or the air cast. That totally sucks, but it is a liability for both the school and the hospital you are placed at. We had a student who was in a severe MVC that left her with pins and a cast on one of her legs and pretty beat up all over. This was 4 weeks before the end of her second semester. She was doing very well in class and clinical and only had I think one or two clinicals left. Since she very obviously couldnt attend her last clinicals she failed the course. She was then placed in my second semester class in the fall of this year. She still had a boot for her injured leg. She was not aloud to wear the boot to clinical. She toughed it out and just pushed through at clinical. But still, it was very crappy that she had to.

Basically, if you can't even weight bear on that ankle, then you may not be able to attend any of the clinicals. This may or may not affect your ability to pass this semester. So you may want to speak to your instructor about what your options are as far as even competing the semester. Whatever happens, good luck. This is a cruddy situation all around. Sorry.

[Red Kryptonite]

She still had a boot for her injured leg. She was not aloud to wear the boot to clinical. She toughed it out and just pushed through at clinical. But still, it was very crappy that she had to.

First, "allowed."

Second, how does her wearing a boot hurt anything? I get crutches, that's extra equipment getting in the way, but the boot is an assistive device contained in the body space of the person wearing it. I'm not usually this person, but I think it might have been worth her while to complain and suggest there might be an Americans with Disabilities Act violation.

[203bravo, MSN, APRN]

sucks yet --- had a classmate in a similar situation and she was allowed to take an incomplete (at least did not fail) for the clinical and redo the clinical component of the following semester.

[JustBeachyNurse, LPN]

Often splints and boots are only permitted in clinical settings if a workers comp related injuries. It's a liability unless a permanent splint which would be covered under ADA

[JustBeachyNurse, LPN]

First, "allowed."

Second, how does her wearing a boot hurt anything? I get crutches, that's extra equipment getting in the way, but the boot is an assistive device contained in the body space of the person wearing it. I'm not usually this person, but I think it might have been worth her while to complain and suggest there might be an Americans with Disabilities Act violation.

ADA generally does not apply to a temporary disability.

[KatieMI, BSN, MSN, RN]

Only one reasonable idea in this situation is to contact the Dean immediately, state facts and develop a plan of action. In this plan, your health and your safety must come first, therefore you should not be put in situations when oxygen tank could be accidentally dropped on your foot (happened with me, couple of times). If you are in good standing, they should allow you to go on medical leave and re-join the next class. You will most probably lose some time and graduate later than your friends but that will be it. I bet you won't be the first and only student going through that.

[RNsRWe, ASN, RN]

Second, how does her wearing a boot hurt anything? I get crutches, that's extra equipment getting in the way, but the boot is an assistive device contained in the body space of the person wearing it. I'm not usually this person, but I think it might have been worth her while to complain and suggest there might be an Americans with Disabilities Act violation.

Our facility doesn't allow anyone to wear a boot to protect an injury while in a nursing or nursing-related job, period, and that includes students who use our site for their program clinicals. There is a risk to both the person wearing the boot (as in something that causes an even greater harm to the injured ankle) and the person the wearer might be working with. The person who has the injury could become further injured BECAUSE of the weakened state of the part of the body in the cast/boot, and then it gets messy: how much of the injury was related to the "old" injury, how much is the "new" injury? Whose insurance (the individual's or the hospital's) is tapped for what part of treatment and recovery?

Then what of the patient who is being assisted by the person with the cast/boot? If the wearer were to become off-balanced and do ANYTHING that even MARGINALLY hurts the patient (or if the patient THINKS they were hurt, or MIGHT HAVE been hurt---you get the idea) then the hospital will own that lovely bit of liability as well.

The answer is to Just Say No to such devices in clinical sites. Could there be facilities that do it differently? You bet. But then they haven't faced the above scenarios, so haven't fixed that part of their policy yet.

And the ADA doesn't apply, as has been mentioned. It's not considered a permanent disability requiring livelihood protection, it's a temporary medical condition for which there is an expected and short-term recovery period.

[nurseprnRN, BSN, RN]

I got lucky once with a walking cast for an ankle avulsion fracture because I wore long scrub pants and a woollen sock over my toe that was the same color as my other shoe. Nobody noticed at all. But if they had, there was a policy that nobody got to do that, because it was considered a liability issue for the hospital, and I would have been out of work (without pay, prn staff) for 8 weeks.

[CamillusRN, BSN]

This is just off the cuff . . .

What if your instructor had you do chart audits, lab reviews, order verifications, patient admission/discharge flowsheets, and other RN-level administrative work instead of direct bedside care? I realize this may not be a possibility depending on the facility, but there's no harm in asking, right?

[mrsboots87]

First, "allowed."

Second, how does her wearing a boot hurt anything? I get crutches, that's extra equipment getting in the way, but the boot is an assistive device contained in the body space of the person wearing it. I'm not usually this person, but I think it might have been worth her while to complain and suggest there might be an Americans with Disabilities Act violation.

Im typing on my phone and don't proof read. I fail to see how rudely pointing out a spelling error in any way gets your point across or pertains to this conversation. But I guess if it makes you feel better then whatevs.

It was deemed a liability by the school due to a slip and fall risk while wearing the boot and some other reason I don't remember. She was not disabled, only injured in a severe car crash,so there is no ADA protection. She is currently doing well in third block with my class, but it was definitely a bummer.

Also so my point in pointing out not being aloud to wear the boot was to show that some programs may have a problem with using crutches at clinical and that it was very difficult for her to get through clinicals without it.

[HammockBound]

My school had a policy that if you can't perform with no restrictions, you need to withdraw and take the class when you are at full ability. That's just how it is. We wouldn't be allowed in with a boot or crutches.