Hi guys, it's been a while. I've just been sweating buckets about something and wanted to get some opinions.
So, I was at clinical this morning from 0630 to 1400. I had a patient with renal/hepatic problems. He was a stand by assist 1. I answered his call light & he said he wanted to go to the bathroom. I looked around for a gait belt & couldn't locate one. He said that he is fine with just a walker. Now, we're told to always use a gait belt. I messed up and took him to the bathroom without one. Once he was done with his business, I went in to get him off the toilet (he had his walker in front of him & I was helping him to stand up. We locked arms and he was getting up when his right knee buckled and he fell to the side. I held on to him and tried to lower him as far as I could until gravity took over. He fell on his butt and later stated that he had some back pain (he normally has chronic back pain & I guess this aggravated it). I assessed him at the time and called in his primary nurse right away. She told me I should have probably used a gait belt (turns out it was behind the open door, tucked away on top of a table). She did say that it probably wouldn't have mattered anyway considering his knee buckled under him. They called in the doc and he said the same thing & suggested that he be more mobile to strengthen his muscles.
My instructor on the other hand said that she would have to write me up anyway (which I completely understand). The thing is, she told me to meet her tomorrow after our exam to talk it over with the dean of nursing.
I am freaking out about this soooooo much and I can't afford to because of my exam but I can't help it. I'm worried this might cause me to fail my clinical portion (and in turn, the entire semester -- this is my last semester before my NCLEX btw). Thoughts? I feel like I'm overthinking things but its just how I am. I can't get this whole day off my mind. . .
Specializes in Surgical, Home Infusions, HVU, PCU, Neuro.
One thing that you have on your side is that you are taking responsibility for the error on your part and was given some good advice on what to do in order to prevent this from repeating. Best wishes to you
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'm very sorry for the predictable yet unwarranted, irrational and despicable treatment you are being given.
I'm very sorry for the predictable yet unwarranted, irrational and despicable treatment you are being given.
Yeah, I'd be interested to know how a gait belt would have helped in this situation in the first place. He had a walker in front of him. Was she supposed to one-arm a grown man to keep him standing? He didn't get dizzy, his knee buckle for crying out loud. I would have dropped him too.
I'm very sorry for the predictable yet unwarranted, irrational and despicable treatment you are being given.
Indeed. You forgot to add "spineless."
The take-home lesson here is: don't help anyone. At least not without bringing in a team of half a dozen staff members who have signed affidavits in advance that you won't be personally liable for any mishaps. Waiting to go to the bathroom is, of course, a common cause of falls in the hospital. But at least the OP wouldn't be liable if the patient fell on his own and cracked his skull, rather than falling with assistance and bumping his butt.
OP, I've never faced any of this, and this is not legal advice, but I have a couple of thoughts:
1. I would use extreme caution in any further discussions of this. The issue is not that you deliberately and carelessly shrugged on the idea of using a gait belt. It is that, for all intents and purposes, there was no gait belt and so then this became a matter of an ethical "call" that had to be made: A) Do nothing to support the patient's autonomy as far as his idea that he wished to use the walker to move to the toilet to avoid soiling himself, nor support his dignity in attempting not to soil himself or B) Do something to try to maintain his autonomy and dignity - which is what you did.
While you may be faulted for the ethical choice you made, that is a far different argument and discussion than an argument about willfully disregarding rules.
2. Consider legal advice. I'm not the expert about such things; perhaps a lawyer doesn't have much to offer in this situation. Just the same I would take every action to ensure that you aren't simply railroaded.
I've been reading all the responses and I am so glad I'm not the only one who thought it was a bit much to kick me out of the program. I do have good news though: they accepted my appeal and I will soon get a letter officially recognizing my reinstatement. I am just glad I won this part and that I'll be able to graduate come May.
They had a couple of my instructors from my prior semesters sit in on the appeal and they also got to vote. They were all very understanding and simply encouraged me to be more assertive with patients so that I can ensure I have done everything on my part. I do have a sort of red flag/tape all over my records now so one misstep that leads to a breach in a clients safety will get me immediately and completely kicked out.
I am driven to make sure there is no situation that may put me in this place again. I really don't like the fact that I have to tiptoe for the rest of my clinicals but I'll take it.
Thank you all so much -- this thread was a big help believe it or not.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I'm glad you're back in. What they were all really doing is throwing you under the bus in case of a lawsuit. Now that everyone's huffed and puffed and made like they were going to kick you out, they can all rest easy.
You can walk on eggs for 3 months. If you think of it, send us a note when you graduate so we can celebrate with you.
I have just finished clinicals (at a well respected university) and we didn’t put gait belts on people who were stand-by assists! The purpose of “standing by” was to do exactly what you did— jump in and prevent major injury, not to physically keep a person standing up. This was in two different hospitals, too. I know that’s irrelevant to your situation, since you are required to use gait belts, but I am amazed.
Specializes in Clinical Research, Outpt Women's Health.
Glad you made it through ok. That was very harsh. You are a student and this is how students learn. One of those lessons you will never forget. Your intentions were good. You just didn't have the experience yet to make the best decision.
I am driven to make sure there is no situation that may put me in this place again. I really don't like the fact that I have to tiptoe for the rest of my clinicals but I'll take it.
You can do it. In a matter of weeks it will be in the rearview mirror. ??
Kallie3006, ADN
389 Posts
One thing that you have on your side is that you are taking responsibility for the error on your part and was given some good advice on what to do in order to prevent this from repeating. Best wishes to you