I shouldn't be a nurse...

[nanae_snow]

I started working again on ltc, but first day on the job on my own I made a horrible horrible mistake. As I write this I am trembling and crying and I feel so sick towards myself that I am nauseous and wanna throw up. What happened was someone was found on the floor by a cna. i had someone's meds and insulin on my hands, I set those on the table because I was gonna help the cna, but then I also thought if i let go of the meds, what if someone comes along and eats up the meds or stick themselves with the insulin. another cna came up so I told her to help the other cna lift the patient up. I went to give the meds. Then i don't know what i did anymore. I think someone started asking me their pain meds or something. My intention was to go give the med then go back to the fall patient to assess, but somehow I forgot. So when I got home I was thinking about my day when it occured to me that I did not go back to the fall pt and assess and do an IR . He was not my pt though, but since i was the one who was there first i think i am supposed to make the IR. Or i could just be a witness. I don't know. But I feel really really bad that I didnt do anything. I am so sick of myself, I deserve to die. I feel that I'm a horrible nurse, even though this is only my 6th day as one, assess and write an IR is a basic thing to do with a fall, and i know that, i know why it is so important, and i know the complications if a fall is not followed through...so i am asking myself where the hell was my mind. I wanna talk to someone but I don't know who to talk to, I am scared to death. I don't know if the nurse who had the pt made an IR...i am praying so hard that she did. I really think I shouldnt be a nurse. This is such a horrible horrible mistake.

[alyx]

You were between a rock and a hard place. ...

On the plus side, you did a good job of delegating appropriately and of preventing someone from grabbing the pill cup.

I totally agree. We can't be all things at all times. Why do you believe that what you did was a "Mistake"? You did the right thing. You would have really been in a pickle if you had left those meds and they had fallen into the wrong hands. That's where your mistake would have been. I think you did a fantastic job ; way to go handling a fall and preventing a med error! Your deep concern is a refelction of your dedication and passion for what you do and should be applauded...perhaps it's your point of view that is the real mistake here...pat yourself on the back. I'd be honored to have you as my nurse!

[rita359]

Please calm down. If this was not your patient you were probably to busy to know what that pts nurse did. The cna should have reported the fall to the pts nurse and she would have taken care of incident report. Surely there was no great harm like fracture or you would probably have been aware of pts transfer to hospital. As others have said, leaving meds where others could have taken them would have been much worse. You are not responsible for everything. Next shift find out if incident report was made. You will probably find all this worrying and lashing with whips you are giving yourself was for nothing.

[SuesquatchRN, BSN, RN]

You deserve to die?

Get a grip, girlfriend! Someone fell. You got flustered. You're new.

Now calm the heck down.

[NursieCutie]

actually, what i believe should have been done is this: the cna found the patient on the floor. you place the meds into your pocket. you go into the room and quickly assess pt. (pain, any bleeding, etc) do not move the pt as yet. have the second cna go and call the nurse. she needs to see how the pt was found, as it is her pt and she will be the one completing the incident report.

once the nurse arrives, you leave, if she and the cna are able to transfer pt on own. preferably the pt nurse should complete the incident report because alot of the questions asked, only the primary nurse would immediately know. ( like what fall precautions was taken to prevent pt fall, was pt previously sedated or were any meds given that would alter level of consciousness, is pt alert and oriented, what could have been done to prevent this. basically the pt nurse is responsible for the safety of this pt, all you know is that this pt is on the floor. that is why you should wait untill the nurse sees the pt before moving. this pt may also have a history of falls and certain precautions were not taken.this is not your fault. i would just let the charge nurse know the next time i go into work. since the pt was moved before the primary nurse could assess him, then you may have to complete the incident report. if the pt is fine without complaints, the charge nurse may simply say let it go, but know better next time. the md may need to be notified. relax, we who are imperfect are required to work perfectly...but it just can't happen. we all make mistakes.

[Butterfliesnroses]

Where I work if a residents falls we get the residents nurse. Unless said nurse is out of the building or something to that effect. The residents nurse deals with the assessment and incident report. The only thing I think you may have done wrong is not assess the resident before telling the CNAs to life them. But the CNAs should have called you on that. As a CNA I NEVER lift a resident that has not been properly assessed. If a nurse tells me to I question it (nicely of course). I wouldn't worry too much though! Everyone makes mistakes. Just this CNAs .

[nerdtonurse?, BSN, RN]

The first time you have a pt fall, yours or someone else's, it's traumatic, and you feel like the world's worst nurse. Everyone's had a pt fall (well, maybe not those in the NICU, hope not...), and for the most part, they are fine. That first fall is harder on you than it is on them, probably. What probably happened was the CNA got the pt's nurse, they did the assessment and the IR. Even if I was in your shoes, I'd have told the CNAs to leave the pt in place, got the pt's nurse down there, and did a fast neuro/physical check -- you don't know if the person's on blood thinners and is going to need a scan if they hit their head, or if they routinely sit down in the floor and fake a fall. What if the person normally had a dilated pupil--you wouldn't know that, and would think the worst, that's why you get that pt's nurse. You didn't see anything that alarmed you right off -- no obvious bleeding, vomiting, broken bones, screaming in pain -- so take a deep breath. If that's the worst thing that happens, you will have a blessed career.

[Bugaloo]

actually, what i believe should have been done is this: the cna found the patient on the floor. you place the meds into your pocket. you go into the room and quickly assess pt. (pain, any bleeding, etc) do not move the pt as yet. have the second cna go and call the nurse. she needs to see how the pt was found, as it is her pt and she will be the one completing the incident report.

once the nurse arrives, you leave, if she and the cna are able to transfer pt on own. preferably the pt nurse should complete the incident report because alot of the questions asked, only the primary nurse would immediately know. ( like what fall precautions was taken to prevent pt fall, was pt previously sedated or were any meds given that would alter level of consciousness, is pt alert and oriented, what could have been done to prevent this. basically the pt nurse is responsible for the safety of this pt, all you know is that this pt is on the floor. that is why you should wait untill the nurse sees the pt before moving. this pt may also have a history of falls and certain precautions were not taken.this is not your fault. i would just let the charge nurse know the next time i go into work. since the pt was moved before the primary nurse could assess him, then you may have to complete the incident report. if the pt is fine without complaints, the charge nurse may simply say let it go, but know better next time. the md may need to be notified. relax, we who are imperfect are required to work perfectly...but it just can't happen. we all make mistakes.

:yeahthat: could not have said it any better myself!

[medsurgrnco, BSN, RN]

Surely the CNAs got the pt's nurse and she followed through with VS, neuro check, assessment, calling MD and any new orders, and incident report. In your situation, I would have asked a CNA to get the pt's nurse and stayed in the room until the other nurse showed up. Then I would have asked if the other nurse needed help before leaving to give the meds. Just my suggestion on what to do in the future. New nurses easily get overwhelmed, agree with others that you should stop beating yourself up over this.

[Melinurse]

Okay first off, you are human and we all make mistakes...I don't know one nurse that hasn't made some kind of mistake in the past.

The best thing you can do, is use this experience as a learning experience. Your a new nurse...don't beat yourself up over this!

Also, if it is still worrying you you can always call the nurse who is caring for the patient now and ask if the other nurse assessed after the fall, etc.

We all make mistakes.

[leosasha]

I noted that your stated that you started working LTC again. It seems that you may have already known how anxiety provoking this environment can be. Sounds like you became overwhelmed and " shut down". It's a coping mechanism. When I went to LTC they gave me 2 days orientation. I was supposed to have more but got thrown to the wolves as they say. Just recently while working at a hospital I ran across the nurse that oriented me at this facility. It's been 7 years. The poor thing is a burnt out wreck. Quit beating yourself up. Lord help us all! Tell your DON what happened. If she does'nt help you rectify it shes a fat cow:grpwlcm:

[Vito Andolini]

So where do things stand now?

Fat cow? I don't know whether to laugh or cry.

LOL

[lovingtheunloved, ASN, RN]

It was a mistake. You're new. The patient will not die because you didn't do an incident report. You will make more mistakes over the years. This one was not that big of a deal. Save the nausea and tears for something that warrants it. You'll be fine.