Published Sep 1, 2014
Purple_roses
1,763 Posts
Hi all, I'm a home care CNA and I've been working with an elderly patient who lives in a nursing home. Today I caused a skin tear while putting his shirt on and I feel so horrible. I just kept staring at the tear wondering how I managed to do that with a shirt.
I of course reported this to the nurse. I then cleaned it with saline, applied bacitracin, and bandaged it. Is there anything more I should do?
The nurse keeps telling me it's not a big deal, but I feel so guilty. I'm dreading telling the patient's daughter that I caused that.
She believed she could, so she did.
RN403, BSN, RN
1 Article; 1,068 Posts
Don't be too hard on yourself. It was an accident. Accidents happen. You were right to report it and handled the situation correctly.
Truth is, a lot of elderly have thin and fragile skin. Tears do happen. I think at this point there is really nothing else to do, but, forgive yourself. *hugs*
TriciaJ, RN
4,328 Posts
I was working in LTC when a CNA caused a skin tear while putting TED hose on a pt. That pt's skin was so fragile, and she did not have edema, so I thought the TED hose did more harm than good. But that was the order. The CNA was being so careful, and I can still hear her gasp when the skin tore. It truly wasn't her fault, and it wasn't yours. Fragile old skin is fragile old skin. All you can do is be as careful as you can and hope for the best. Stuff happens.
brownbook
3,413 Posts
I know how you feel. I still shudder when I remember tearing a patients skin. And I an a RN in out patient surgery, healthy patients in for same day surgery!
I was removing the IV/tape (which I do 100's of times a month) and the patients skin just came off with the tape! He was older, but not fragile. It just happens. You handled it perfectly, unfortunately it will probably happen again.
Karou
700 Posts
I was going to say I have seen a patient get a skin tear from tape.
Also socks, bed sheets, shirts, ect...
In elderly patients, especially those with fragile skin, it happens. Chronic steroid users are the worst! Their skin can be like thin crispy paper.
duskyjewel
1,335 Posts
Unfortunately, with some people there is no preventing it. I've seen people cause their own skin tear just turning over in bed. Don't feel bad. It wasn't your fault.
Step_981
20 Posts
You shouldn't be so hard with yourself, I can understand as you feel, you feel guilty but don't forget that accidents happen and, sometimes, happen even if we do all for avoid it!
So, don't worry... "keep calm and carry on" :)
(PS: excuse me for possible grammar and writing mistakes)
Here.I.Stand, BSN, RN
5,047 Posts
Some people's skin is like paper. I never would have believed it before seeing it...seriously in my CNA class back in the day I wondered "Skin tear? How does that happen?" (Same thing with pressure ulcers.) Then I worked with a couple elderly, malnourished, steroid-taking elders. I was SO so careful, and the same thing happened to my residents; their skin tore while undressing. I'm sure you were gentle with him, and you clearly sound like you care about him and your work. These things really do just happen. Hugs!!
loriangel14, RN
6,931 Posts
Don't beat yourself up. Their skin can be like tissue paper. These things happen.
RubberDuckieLove
163 Posts
Sounds like you handled it professionally and provided proper first aid. Thats all you can really do.