One of my patients fell!! Need Advice!!

Virgo_RN, BSN, RN · Jun 21, 2009

I remember my first fall. I was a CNA working noc shift in a SNF. The resident's careplan said she was a one person transfer, and despite it being late at night, the resident insisted on getting OOB to go watch TV in the common room. So, I put the gait belt on and get her standing at the bedside to do a stand-pivot, and over she goes like a log. Her head hit the table on the way down and made an awful sound. The nurse came and assessed her and she was sent to the hospital for sutures to her forehead. I felt horrible. I felt sick to my stomach and I cried. But, I was following the careplan and did nothing wrong, as wrong as it felt at the time. Incident reports were filled out and that was that.

The sad thing was, after the paramedics had taken her away, and I went back into her room to straighten up her bed for when she got back, her roomate said "Can you get me out of here too?".

blondeoverboard · Jun 21, 2009

accidents will happen. we do the best we can with the best of intentions and still, accidents happen. from what you described it sounds like you did what you could to ensure her safety to the best of your ability. it also sounds like you acted quickly to get her the help she needed. in all likelihood you will heap the strongest punishment on yourself by wondering about all the couldashouldawoulda's. as the saying goes, "you can't unring the bell." be gentle with yourself and learn from the experience.

nigerianmalenurse · Jun 21, 2009

My clinical experience as regards to your standards over there can only be measured in "seasons!",by that i mean a sum of movie seasons from dr.house (who knows when season 4 would b out), er ,scrubs and some 'law and order', dis means i cant advise u,i am only replying to cheer u up a bit,i guess u did wat was best to protect your patient. You dont wana know how we do it here, seriously 'a patient falls,you get some aide to help carry him bak to bed,if he is- conscious 'apologise(dont borda cos there are no side rails in our er)',if restless 'restrain'. U r wondering whether theres going to b some legal issues,neva,the guy wld definitely have enough problems to deal with and he/she would sure wouldn't wana add u to his problem list,its cheaper here coughing up your medical bills than going for a lawyer,

UM Review RN, ASN, RN · Jun 21, 2009

Doesn't sound like you did anything wrong. Elderly people can be very frail. I once had a heavy resident whose shoulder was broken even though she was lifted correctly--she had bone cancer. No one knew until that incident.

Maybe your patient's knee just gave out. Who knows? I'm sure your patient will be sent home in a few days feeling better. Since you're a nursing student, I think it's a good sign that you're asking yourself, If there was one thing that you could change about what happened, what would that be?

Perhaps your lifting technique could use a different approach -- you might try using a gait belt if you haven't already. Gait belts tend to take the strain off of the shoulders. Perhaps your positioning of the chair could have been different. Shower chair transfers always make me nervous due to the fact that most of the wheels never lock properly. After a couple of near-misses, I learned to have someone stand by during a transfer to a shower chair.

If you've gone over all of those variables and you come up with nothing that could've been changed, then you need to accept the situation as it is. I'm sure your patient is looking forward to coming home and getting that special TLC that you've been able to provide. I know I would want such a caring and concerned aide for any of my relatives. ((((hugs)))))

Be_Moore · Jun 21, 2009

Law #2. And if Law #2 is disconcerting, please remember to refer to Law #1.

Papercutz · Jun 21, 2009

I know how you feel....it's an awful gut wrenching thing, but sounds like you did everything correctly. I second guess myself a lot in certain situations...but you can only go forward and try to keep learning from every patient interaction or transfer. Yes, anything can go wrong during a transfer, and it's almost impossible to predict every type of scenario. I've been ambulating the most stable of patients (and I have to go on stairs with them as well!!), only one day to have their bp/bs drop suddenly or knee buckle down and bam we're almost both on the floor.

My only advice is if i'm working with a new patient, regardless of what the care plan says, if the patient is large and I even suspect I might have a problem, I get another person. And believe me, i've gotten other people and there can STILL be a problem! Don't beat yourself up sounds like you did the right thing.

bluebird123 · Jun 22, 2009

Thanks for your replies everyone!! And for the kind words Angie :) To the Nigerian nurse....boy am I glad I dont work in your hospital!! :smokin:

bluebird123 · Jun 22, 2009

Oh and just an update....my little sweetie was back at the facility today! She's doing much better. Ended up being a dislocated shoulder. She had some good pain meds and should be better soon :) :yeah:

LEN-RN · Jun 22, 2009

Falls happen. Even when you do everything by the book. And there are some that seek attention and do it on purpose.

I love your compassion and concern. FOR falls my compassion went out the window a long time ago. One of the first things I think of is MORE PAPERWORK. I hear myself say "****."

You will find when its a full moon to call off sick - just kidding - because it brings falls and crazy stuff. You probably know that being a cna.