Just a bad day...

[tobi1007]

It's been a month that I began working at a facility and still in orientation period. I have two more weeks before I'm assigned to a floor to be alone. I am very nervous about when I think about it. However, I have such a great mentor. I really learned a lot from her. As days go by, I start to believe I am capable working by myself. And also earned a good trust from other nurses and cna. But you know, when you began to think all that positive things and be happy for yourself....all of sudden, a bad day ruins everything.

I was at the end of my shift. Almost finished my med pass, tx, and progress notes. Then one of my patient decided to call for help to use the commode. I know her quite well and she is able to transfer with one assist, which I helped her couple of times before. However, this time things turned out bad. She was doing so well transferring from chair to commode. Then when she was ready to go back to chair, her knee gave up and she went down on the floor. She just sat down on her butt...aka pt fell!!! She began to scream for HELP!!! when I'm in front of her face. Oh no...she was also quite big lady. So I went to get help from my cna and brought her back to chair. I checked her VS, pain level, and etc. She was fine. Now this becomes my very first incident report. I began collecting forms and writing them down...also waiting for my mentor if I miss anything out. Also contact the doc. But as I know, this isn't the first time for this pt. She will not let you know if she is going down on the floor. I don't blame her. She has bad knee. Anyhow, then director passes by as I'm writing the report. Of course, at the facility "FALL" is big thing and something that does not want to happen. She began asking me questions...I explain everything. Then she began yelling/lecturing me that I didn't check her care plan or look up her MAR....to the point where I said "sorry" to her. She made me feel terrible for doing this. Oh and also that I did not contact my unit manager right away....that part it was my fault that I did forget. Anyway, so everyone eyes' on me and telling me that she is 2 assists and blah blah blah. I know but everyone has been doing 1 assist and she was fine (as I think in my mind). Then I realize tomorrow I will be in the morning meeting and this issue will be brought up. I am scared as hell, how they will shoot me with their words....and also I'm a NEW ORIENTEE!!! I just gave them a bad impression from this incident. I was doing so well then now it's all ruined. My mentor told me not to worry too much, because this isn't really the first time and she is okay. W/E everything is known by tomorrow morning....

And one more thing, as I try to report to manager, mentor, doc, and etc. The pt decided to complain for pain. I know she has bad knee and I asked her if she needs pain med. She refused pain med, patch, or anything else. And she told me "You I fall, and pain on my leg". I shouldn't think this way, but I think she kind of using this incident as her having the pain. I'm pretty sure her standing up from the floor aggrevated the pain on her knee. But what can I do at this point when she refuses everything? I really wanted to as her, "what do you want then, what do you want from me?" She's not mean to get me in trouble for doing this, but she already complained pain at my unit manager. The pain she had since the morning and the pain that doc can't do anything but giving her scheduled pain med. OMG...I hope I'm not in trouble tomorrow. I won't get a good sleep tonight. I already feel bad that I have done this to the pt and I told her sorry for not getting extra help.

But you know, anything that happens to the pt is mostly nurses fault. Not sure if everyone agrees to it, but that's how I got the impression working as a nurse.

[NoviceRN10]

Take a deep breath :). It sounds like more of a "slide to the floor" than an actual fall. I mean, I think of a fall as something that happens when patients are not being assisted at all and try to ambulate. You probably actually kept her from "falling," if you think about it. Hope your meeting went better than you expected. Falls happen, and people are human and not always perfect. You are on orientation and still learning, and this woman doesn't seem to be any more worse for the wear.

[OnlybyHisgraceRN, ASN, RN]

Take a deep breath :). It sounds like more of a "slide to the floor" than an actual fall. I mean, I think of a fall as something that happens when patients are not being assisted at all and try to ambulate. You probably actually kept her from "falling," if you think about it. Hope your meeting went better than you expected. Falls happen, and people are human and not always perfect. You are on orientation and still learning, and this woman doesn't seem to be any more worse for the wear.

This nurse seems as though she works in LTC. Any time a patient is on the floor whether assisted or not it is considered a fall. "sliding down to the floor" is a fall and has to be documented as such.

To the OP: I don't think the patient is using the incident to c/o pain. Pain is whatever the patient says it is. I also don't think she is trying to get you in trouble either. Chop this up as a lesson learned and always review the plan of care for transferring. Many times in LTC nurses/aides will not follow the POC and get themselves in trouble. I for one have learned this. I don't transfer any resident without knowing for sure what transfer they are, either one or two. The may be able to transfer with less assistance but if its' not documented then I'm going there. Hang in there. Hope it gets better for you.

[wwwyzzy]

Hang in there... There are any number of things that can come crashing down at any given point in this field that you CANNOT be too hard on yourself. Use this as a lesson learned and it can only make you a better nurse! I'm hoping that they weren't too hard on you in meeting. Just remember all of them were new at some point and all of them have made mistakes. This will pass and something else will be the topic of discussion.

Good luck!!