Freaking out over a patient fall!!

bsyrn, ASN, RN · Mar 6, 2019

You know you messed up so you certainly don't need anyone harping on that. Unfortunately, patient safety is taken extremely seriously so there could be some dire consequences. I would go in totally prepared with what you learned and how this will never happen again. It really doesn't matter what the doctor or nurse said, bottom line is the gait belt should have been used. I am hoping for the best outcome for you!

Persephone Paige, ADN · Mar 6, 2019

Don't know what to say about this situation except, 'sorry.' I no longer 'get someone up' to the bathroom alone anymore unless I know them. I'll call the aide and we can do it together. I used to let the patient's urgency to not have an accident cause me to feel compelled to get them up, 'right now!' Not anymore, I'll get help. If he has an accident, we'll clean him up. I'm old too. I didn't sign up to blow out my back either.

C_M_L_R18 · Mar 6, 2019

I was so anxious about having this happen to me, that I actually bought a gait belt off of amazon. - I know how busy things can get and things might not be where I think they are or where I need them to be.... unless I have it right in my pocket. * maybe when you meet with the dean, tell them as part of your plan to make sure this never happens again- that you’re going to buy your own so you always have it on hand.

a lot of times folks don’t know their own limitations- (i mean don’t we all?!) I’d rather use a belt and it not be necessary than something bad happen

good luck tomorrow. I hope it’s just a “let’s talk about this CI and how to prevent it”

* ok it’s not just the gait belt, I literally have an entire orificenal of stuff , pulse ox, bp cuff.... planning on getting a temporal thermometer too at some point heh.....

Cowboyardee · Mar 6, 2019

Take a few minutes and write down (really, write em down) a few things you can think of that may have contributed to this fall. From the beginning of the situation to the end, both your own errors and other factors present that might have contributed.

- Was there a common place to put gait belts so that staff would know where to find them? Was the toilet seat the right height for him? Were there bars on the wall of the bathroom the patient could use to assist himself? Should you have asked for a second RN/student to assist you? Was a second RN/student available if you had? Is using a gait belt the policy at this institution? Would a gait belt have kept him from falling or simply pulled you down with him? What medications was he on?

Go in to the interview with a thoughtful analysis of the situation and without trying to avoid blame personally. Having a list will let you feel (and be) prepared. And once you're prepared, do your best to forget about it until the interview happens, and focus on other things.

Zenndaya · Mar 6, 2019

Thank you guys soooooo much. I have probably released enough tears to fill a bathtub. The meeting was actually not a meeting. They just told me that I needed to recognize what happened and that they had to kick me out of the program. I got kicked out today and I have an appeal set for tomorrow. My instructor told me that i have a very clean record and that I know what I did wrong and what I will never repeat again. She told me to use this. I was also told that there is a possibility that the school can get sued and (me in turn). These posts have really helped me clear my head and prepare myself.

Honestly though, I’m so thankful for your guys’ input bc you guys don’t know me and I tried to give all the facts — I’m killing myself thinking how much I should’ve just stepped out of the room and asked for a gait belt (one was hidden in the room and yes it’s supposed to be hanging by the door). I just wanted people who would give it to me straight.

Anyway, I can’t change what’s happened but I just REALLY can’t imagine not being a nurse or even restarting the semester. I’ve alreafy prepared for graduation and even reached out to a couple of job positions. God willing, it’ll go well and I’ll be able to continue. Thanks again xx I’m going to go prepare and pray for the best

Zenndaya · Mar 6, 2019

3 hours ago, Persephone Paige said:
Don't know what to say about this situation except, 'sorry.' I no longer 'get someone up' to the bathroom alone anymore unless I know them. I'll call the aide and we can do it together. I used to let the patient's urgency to not have an accident cause me to feel compelled to get them up, 'right now!' Not anymore, I'll get help. If he has an accident, we'll clean him up. I'm old too. I didn't sign up to blow out my back either.

This was exactly the situation. He was on lactulose and was 50 so he really didn’t want to “go” on the bed. I slipped his grip socks on first and complied when he said he was fine with the walker. It says in the hospital report/documentation that his right knee tends to buckle. My instructor included that in her report too (it was not in his chart). It was all just a mess from the beginning but I felt cornered and felt that it was emergent. It’s true though, I would have rather just cleaned him up. I will definitely take that into account from now on though. If i don’t know the patient, i will get an aide or someone to help me

Sour Lemon · Mar 6, 2019

44 minutes ago, Zara9897 said:
Thank you guys soooooo much. I have probably released enough tears to fill a bathtub. The meeting was actually not a meeting. They just told me that I needed to recognize what happened and that they had to kick me out of the program. I got kicked out today and I have an appeal set for tomorrow.

You have got to be kidding??? Good luck with your appeal. I can't believe they kicked you out for this with no prior issues.

Persephone Paige, ADN · Mar 7, 2019

3 hours ago, Zara9897 said:
This was exactly the situation. He was on lactulose and was 50 so he really didn’t want to “go” on the bed. I slipped his grip socks on first and complied when he said he was fine with the walker. It says in the hospital report/documentation that his right knee tends to buckle. My instructor included that in her report too (it was not in his chart). It was all just a mess from the beginning but I felt cornered and felt that it was emergent. It’s true though, I would have rather just cleaned him up. I will definitely take that into account from now on though. If i don’t know the patient, i will get an aide or someone to help me

It happens often on our floor. Almost everyone is on Lactulose and they all want to make it to the bathroom with their dignity in tact. We are a 1:6 nurse/patient and a 1:12 aide/patient ratio, I tell 'em to sit tight. If we have to clean up, we will. We simply cannot be everywhere AND be safe. Also, a bedside commode. Put it right next to his bed... Then it's just a pivot transfer.

TriciaJ, RN · Mar 7, 2019

Hopefully by now you've had your talk with the dean of nursing and it went ok. (I think that was a bit of overkill for a typical rookie mistake.) The big reason everyone gets in a tizzy over a fall is because if the patient is injured enough to require additional hospitalization, Medicare won't pay and the hospital eats it. It's a money thing.

Not that falls should be taken lightly. They can cause serious injuries regardless who is paying the tab. I think the doctor and primary nurse were probably right: a deconditioned patient with a bum knee probably wouldn't have been saved by a gait belt. It's just better CYA on the incident form when you can say one was in use.

Please stop freaking out. The patient is as fine as he was going to be and your school just wants to put the Fear of God into you. Which you obviously already have. Do something nice for yourself when you get the chance and try to put this behind you.

TriciaJ, RN · Mar 7, 2019

1 hour ago by TriciaJ, RN

TriciaJ has 35 years experience as a RN and works as a Retired.

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Hopefully by now you've had your talk with the dean of nursing and it went ok. (I think that was a bit of overkill for a typical rookie mistake.) The big reason everyone gets in a tizzy over a fall is because if the patient is injured enough to require additional hospitalization, Medicare won't pay and the hospital eats it. It's a money thing.

Not that falls should be taken lightly. They can cause serious injuries regardless who is paying the tab. I think the doctor and primary nurse were probably right: a deconditioned patient with a bum knee probably wouldn't have been saved by a gait belt. It's just better CYA on the incident form when you can say one was in use.

Reposted from original thread.

Edited to add: I can't believe they kicked you out of the program for that. Sending you good thoughts for your appeal.

KJoRN81, RN · Mar 7, 2019

Update?