Keeping a patient from falling

bklynborn · Feb 1, 2005

On January 19th, 2 hours away from the end of my shift I was assisting a bariatric patient to transfer from edge of bed to wheelchair with her primary caregiver in attendence. The woman decide NOT to bear any weight and went down on her knees straining my back in the process. Her ambulation status was immediatley changed to black....meaning mechanical lift only.......I am now on light duty and in pain.....she has since recovered and gone home. Moral of the story prevent injury to yourself and others by reviewing and changing ambulation status as needed.

Ms.Hobbes · Feb 1, 2005

Most definitely don't risk your back. If they are insisting she be ambulated then insist another person follows behind with a wheelchair. If at all possible when she dicides to go down don't try to hold her up just let her slide to the floor using your legs as a wall of sorts. It must be a frustrating situation for you but learn now to stand up for yourself because back injuries can leave you with a life time of problems.

Town & Country · Feb 1, 2005

Okay, I have a problem. Twice this weekend I had a 200 pound (at least) woman using a walker decided to sit down while I was leading her to her bed. This would have been all fine and well if she had waited until there was a chair or the bed underneath her. Instead she just sat with nothing but me behind her, and it was all I could do to lower her to the ground.

Is this lady alert and oriented? Can she hear well?

The first time it happened, I called for my coworker to help me get her back in bed, but she left me feeling like there was more I could have done.

What was this mysterious "something?" She should have told you what it was. Ask her....

I'm still fairly new to the medical profession (I just got my CNA a few months ago and have only been working that long), and think that I did all I could, but my coworker has years of experience, and made me feel stupid for not doing more.

Don't allow anyone to make you feel like that. Everybody was new at one time or another.

The second time (the next night I worked) the same resident decided to sit herself on the floor again, and did so before I could get a wheelchair fully underneath her. I think that the lady in question should be a two-person assist, but no one else has reported any trouble with her that I know of. Is it just my problem? Is there something else I could have done besides lowering her to the ground?

It doesn't matter if anyone else has or has not reported trouble with her - she is giving YOU trouble, and you need to tell somebody.

I can't say what the real problem is, not knowing the lady, but you cannot allow this to continue because you will wind up being injured.

No, it isn't just "your" problem.

Maybe no one else has reported problems with her because they gifted you with her, LOL.

You need to have a quick conference with this more experienced CNA, and/or one of the nurses.

Tell her what's going on and they something needs to be done. If you don't you are going to wind up on a walker, yourself.

Good luck, you sound like a great CNA.

Alicia18 · Feb 1, 2005

Thanks, everyone, for the stories and advice. I needed them, and hopefully next time I go to work, I'll find that the lady's status has been changes to two-person assist. Even if it hasn't, I'll say something to a coworker to make sure I get the help I need.

Thanks all of you (esp. SunStreak) for the vote of confidence! :icon_hug:

CoffeeRTC, BSN, RN · Feb 1, 2005

I would make her a two person transfer or ambulation. For these type of pts I alway make sure I have a wc or chair behind them while guiding them with their walker. If she is A&O I would tell her that it isn't acceptable. If she feels week or needs to sit she needs to let you know. How about asking if therapy is working with her?

LPN1974, LPN · Feb 1, 2005

Does this lady have all of her mental faculties?

I, personally, do not see that you could have done more than what you did.

Please! One person cannot catch and hold up 200lbs.

I work in MR/DDS and just the other night I was standing by one of our people served, to check out a complaint he had of his hip hurting. While I was standing there, getting ready to lower his sweatpants to see the hip, he started to have a seizure and fell. I reached and tried to grab him but he went down anyway, as I could not catch and assist him. He had on his helmet and his head actually hit the corner of a wall, but thankfully the helmet was well padded, so NO injury occured to him, thank goodness.

When people decide to sit down like your resident did, or fall like mine did, they fall HARD. It is sudden and hard. Not much you can do, but assist afterwards.

loriangel14, RN · Feb 2, 2005

If this patient had not been previously doing this to people when they were ambulating her then her status should be changed. I would refuse to tranfer her alone. No one should have to take such a risk with their own safety or a patients safety.

Don't blame yourself for what happened. You did your best and it has happened to most of us at one time or another. I work for a homecare agency and we are given the right to refuse anything we think is unsafe.

RN4NICU, LPN, LVN · Feb 2, 2005

Helping the falling patient to the floor is the safest action for both the provider and the patient. To try to keep the patient from falling (trying to catch her, for example) risks sudden muscle or connective tissue injury. The body's natural response to sudden pain is the "OUCH" response, during which you drop (or lose your grip on) whatever you were holding - thus allowing the patient to crash to the floor with a resounding THUD, rather than being eased to the floor and then assisted back to bed or chair safely, once the troops are rallied. That situation could easily lead to injured worker AND injured patient. Always look out for your own safety and well-being first. (No one else is going to do it for you). If this seems too harsh to you, consider how will you care for your OTHER patients (and your FUTURE patients, and yourself, and your family...) if you injure yourself trying to break/prevent the fall of one patient, who may wind up hitting the floor anyway - despite your best efforts.

TracyB,RN, RN · Feb 2, 2005

Ok.... as a nurse for the last 13 years, plus CNA before that, I can tell you, you did the right thing. You protected the patient the best you could from injury & you are still way too fresh in this profession to subject yourself to back problems. I just had back surgery recently & may not be able to return to acutal hands on patient care, b/c of trying to be the hero, too many times. So, take this issue up with the nurse in charge of this patient, the rehab/restorative staff/ & if necessary allllll the way up the ladder to the DON & administrator. This pt needs to be a 2 person assist, even if just being followed by another staff member with the wheelchair. Regardless of this woman's hearing, or mental status, for some reason she is weak & one person cannot possibly be expected to "catch a falling 200 pound pt." That is sooo ridiculous, it makes me want to puke. Your coworker needs a lesson in the "teamwork concept" & also maybe some lessons in proper body mechanics & safe patient transfers. Good luck to you & always remember to protect your back. You are the only one who will give a rat's butt about yourself & try dealing with worker's comp if injured on the job. Some places are good, but others will blame you for not speaking up when you needed help. Protect your back, your future in healthcare, AND your patients. I am only 34 & have a lot of years left to work, & the thought of not being able to do hands on care is just about killing me.... I learned the hard way, please don't do the same. CNA's are usually the first ones to notice a change in patient condition & you definitely sound like you will be one of the good ones. Just don't injure yourself in the process. You only have one back & once it's jacked up, it pretty much stays jacked up. Good luck & don't back down on this one......

Alicia18 · Feb 2, 2005

Can I ever thank you guys enough for the stories and advice? :thankya: This board is just wonderful! I shall certainly put into practice your suggestions. TacyB, your story especially incorporates a terrible result that could happen if I don't learn to stand up for myself here. Thank you so much for sharing! I hope that you're wrong and that you'll be able to return to hands-on-work like you want to.

TracyB,RN, RN · Feb 3, 2005

Alicia, I hope I can return also.... I will find out in the morning. My appointment is at 10:15, so we shall see.....

Like I said before, you have to protect yourself & please don't take this the wrong way, but learning to stand up for yourself as a CNA, will certainly help once you continue your education (if that is your plan) & it will help develop that thick skin needed when docs are screaming at you for questioning their orders...

Good luck. You sound like a very caring & sincere person & I welcome you to the healthcare profession. It has its good & bad, but from your post, I think you tend to see things more in a positive light, & that in itself makes a world of difference :)