Duty to catch 'em?

[Music in My Heart]

I was just reading another post about a nurse who had a patient fall on her with a resultant serious back injury. It got me to thinking about something which I often debate with myself. Do we, as nurses, have a responsibility to attempt to break the fall of a toppling patient?

My general feeling is, "no." Honestly, even for a very, very small patient, the risk that I would cause myself permanent, disabling injury is very significant, especially since I couldn't possibly maintain good mechanics as someone's going over. It seems like the best I could manage is to perhaps try to shield their head from whacking something but if they're going to fall, I'm not likely to prevent it and I am likely to get hurt in the process. Neither of us wins by me getting injured. It's analogous to my lifeguard training in which it was drilled into my head that we should only attempt a rescue if we can do so safely.

What do you think? Do nurses have a responsibility to try to catch the falling patient or just pick up the pieces afterward (and of course, to minimize the probability of a fall to begin with)?

[Asystole RN]

Every place I worked had a No Catch policy. Lower slowly if possible but if they are actively falling and you would have to catch, you just let them fall.

Too many career ending injuries.

Nursing should not be more dangerous than underground mining and heavy construction combined, but it is.

[Benedina]

I'm a CNA, not a nurse. Even though I agree with the OP's lifeguard analogy, I had a patient start to fall--and tried to catch without a second thought. (I was beyond lucky: I hurt my back, but it's healed up fine.) My instincts and my brain don't necessarily move in sync. My takeaway lesson was the need to decide for myself what feels safe/unsafe, and be willing to ask for help or say "no." These are not easy skiills for me, but it's *very* easy for me to see how essential these skills are for a nurse or CNA.

In a blast-from-the-past, this situation was the setup of the major plot line of the first Sue Barton book. (These books were written by a genuine MGH nurse, the very interesting Helen Dore Boylston.) Heroine Sue Barton worries that she's not a real nurse, but finds out that she is when she instinctively risks her life for her patient.

Just reporting, not recommending!

Dina

[Music in My Heart]

I actually had a bed-ridden patient who was a former CNA trying to tell me that we had a duty to try to cushion patients' falls - even though she herself had been injured in just such a case. I didn't directly contradict her but in my mind I'd already resolved, "If she goes, I'm not stepping in her way."

Her analogy was with an infant. I'm thinking, "Sure, I'll catch the 15-lb infant, just not the 200-lb lady laying in front of me."

[rainstorm83]

I've been taught that in my state - Ohio - you are not supposed to catch a falling patient. Instead, we are taught a method of guiding the fall. When we are able, we are supposed to help them fall slowly with less injury. Supposedly, it's safer for us and for the patient. (I've never had to use it as almost everybody where I'm working is wheelchair bound - aside from people who are entirely bedridden.) The rational is that if the patient falls you can help them or get help but if you are seriously injured trying to catch someone, nobody is helping either of you which is worse.

[rainstorm83]

I should have clarified that this is when they are walking a normal sized person with a safety belt, like when getting a newly deliverd PP Mom up to the bathroom the first time who may faint. I also emphasize not doing anything to risk hurting themselves, and to only use it when things are under control. Otherwise, yell for someone to get a wheelchair, and don't risk it when the fall cannot be controlled or prevented, or if the client is huge or combative.

That's very different from what I was picturing. There is a reason they are wearing that belt and someone is assisting them. Even if they start to fall, you should already be in control of the situation.

I don't see how this would happen with a normal sized person wearing a gait belt but if for some reason they are going down and you'd have to abruptly catch them, it's still probably safer for both of you to slow the fall and lower them instead of catching them. A new mom's stitches could tear, really hurting her and increasing risk of infection. Besides if you tried to help, the patient still goes down, and you get seriously hurt there's no one there able to help or get help. Now the patient is injured on a cold hospital floor. When the patient is too big for you to safely ambulate on your own, you really should have help although I know when a place is understaffed it's hard to find someone.

[Zookeeper3]

I thought the right to fall was one of the patient rights??

Nope, never ever.. ever will 'catch' a patient. Doing a controlled "slide" to the floor is different than a surprise catch. The first can be career ending, the second not.