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I had my first clinical experience Tuesday. While I was in the cafeteria of the nursing home with my patient during breakfast, an employee was transferring a patient from his chair at the table back to his geri chair. She lifted him by the waist band of his sweat pants which looked completely uncomfortable for the man. When she went to put him in the geri chair she hadn't locked the wheels so it slid out from under him and he fell. I went over and held the chair still for her to put him in it while another employee helped her lift him, again by his waist band.

In class Thursday I discussed this with some of the students in my group. One of my clinical group members then discussed it with a friend who is an employee of the clinical site who then went to the DON of the clinical site. The DON then called and informed my school that my group member is no longer welcome at their site and our Dean mentioned expelling my friend from the program for discussing the incident with her friend.

So far, I haven't heard of any repercussions for me. I have a couple of questions. First, should I have reported the incident? There were around 6 to 10 employees present when it happened and it just never occurred to me that I needed to. Second, do you think the action of the DON is justified? What about expelling her from the nursing program?

I am having a hard time with it all. I am sure my instructor will have some questions for me Tuesday and I have been wishing all day that I had at least reported the incident to her. Any input you can give will be very appreciated.

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Specializes in Infusion Nursing, Home Health Infusion.

Students do need to discuss and share their clinical experiences in group after clinical. This is how students learn and expand their experience. This is also how nurses in general continue to learn.......I always read about IV therapy related lawsuits so I can learn form them. The BIG mistake here is taking the information outside of your clinical group...that is a BIG NO NO and could violate the pt's rights ..depends upon what was really shared. The aide or nurse transferring that patient clearly needs a class in proper transfer techniques and safety strategies to prevent falls and from dropping patients..what you witnessed was just pure carelessness...how sad! Do I think you did anything wrong.?....not particularly ..BUT you should have reported it to your clinical instructor. The individual that dropped this person should have filled out an incident report and this starts a process of review and remediable action if necessary. The nurse and facility are ultimately accountable and the pts MD should have been notified. In this case the employee needs some training and needs to be counseled for the carelessness. Many moons ago while at Childrens Hospital in Oakland I was in my peds clinical rotation. I witnessed an LVN drop a baby on the floor from a fairly high height (top of the crib rail). She looked at me and gave me the shush sign....and though still a student....I thought NO WAY . I immediately went to my instructor and told her what I just saw and what the LVN in trying to coerce me to be silent. The MD was called and the baby was checked out for injuries. Its always best to do the right thing..that is what I would want someone to do if that was my loved one..that is still how I think....... 28 yrs after that incident.

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Specializes in Hospice / Psych / RNAC.

Ohhhhhh the ridiculous politics of nursing. You should have turned left; no wait it's actually right with a red cherry on top. Sorry (needed to vent). Yes I can see how that poor person is being a pawn in the game of nursing. The hoops; it's all about the hoops and which ones to jump through and how high.

Is it right what happened; no. Should you have reported it; I wouldn't have; but then again I wouldn't have told anyone about it if I wasn't going to report it. Let this be a very big lesson to you. If you see something and you're not going to report it don't go around talking about it. You need to pick your battles carefully because believe me this is only the beginning of seeing things and going oops.

I would have talked with the nurse that the incident happened with when it happened and maybe you could have worked out a compromise about how she would own up to the fall (I know I'm really dreaming here) anyway....so if that didn't work out I would have told my instructor.

It is common practice that I've seen people transferring people literally by the seat of their pants in LTC and in the hospital setting. The ideal situation is to have a transfer belt but that's in that ideal world so people use whatever is close and that includes pants and diapers UGH!

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Specializes in PACU, OR.

I'm not sure what you should do regarding your friend's situation; expelling her sounds totally over the top. However, as I understand it, the whole purpose of placing students in clinical settings is so that they learn the correct way of doing things, and failing to at least put the brakes on the chair is shockingly poor safe practice!

Not only that, but even given the fact that the incident occurred, the proper procedure regarding the incident report should have been carried out as part of your own learning process.

I think this clinical setting needs to be reviewed by your college-they don't seem to be fulfilling their mandate...

As for the lifting technique, it's been an awfully long time since I worked in a ward or geriatric care facility, and I'd never even heard of a transfer belt until joining AN :D.

We used to lift patients the old fashioned way, under the armpits, bend knees, back straight, lift using the strength of the legs and upsy daisy! Sigh-it's probably why I now have chronic back problems....:uhoh3:

I agree with you, lifting by the belt must be very uncomfortable for the patient.

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Thank you for taking the time to respond. I am praying that this is just a bump in the road for all of my group that we learn a lot from. I know that I have learned that I will not be discussing anything with my group that I haven't already discussed with my instructor, supervisor in the future, etc.

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OP, if I were a student, and if I was in any way involved like you were post event, I would have reported it to my clinical instructor privately and immediately. This so you can get a little advice, clarification of what to do, as well as make sure your instructor knows you were not involved in any facility accident. Best not to discuss with other students or facility staff. Let your clinical instructor deal with the facility!!!! Your instructor also would not appreciate finding out through a third or more party that one of her students might/not have been involved in something. If you don't make her aware, she cannot do any damage control and it's pretty hard to stand up for you guys so far after the fact.

Remember you don't have "friends" in nursing. This is a huge lesson as others have said. If you have obligation to report, then do it through the proper channels.

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You've gotten some good advice so far. I just wanted to add to please tread carefully around this incident. If they are threatening your group member with expulsion (which seems harsh for a first-time offense), don't throw yourself in with her, assume any kind of guilt, or generally get mixed up in it.

You did not make a mistake - you discussed a clinical experience with another student. She presumably violated HIPAA by then sharing that information with someone outside of the academic setting. (Whether or not this seems like a capital offense is another topic ... sheesh). However she COULD be in major trouble for this, it's not your fault, so do try to distance yourself until it blows over. :twocents:

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You are all right and I really appreciate the guidance and feedback. I have learned so much by reading the threads on this site and knew I could count on some of you to help me see what I did wrong and how to avoid making the same mistake again. Nursing has such a steep learning curve!

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Specializes in ER, ICU.

Just be sure you know your chain of command for incidents like this in the future. For your friend it is important to know if any patient identifiers were shared, this could be a privacy issue. Being expelled for trying to do the right thing seems ridiculous, although this whole incident is not funny at all. Not to be glib, but I'm sure you learned a great lesson in how not to move a patient. Good luck.

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In our nursing program, it is a HUGE no no to discuss any patient outside of our clinical group, and even then we are not to discuss names or verifiers. Its considered a HIPAA violation and we will be expelled. No exceptions. I feel very bad for your friend, but honestly, she definitely should have read her nursing handbook. In there it states the actions to take to report things like this. It should have been reported to your clinical instructor first. It would then be the responsibility of your instructor to take it to the DON (usually). Since you didn't take it outside of your clinical group, then you shouldn't have anything to worry about. The DON has every right to refuse her to come back since she broke HIPAA, and the director has every right to expel her unfortunately, but its a very serious that she did that. She broke federal regulations!!! Your clinical instructor may question that you didn't bring it to her. Be honest with her and explain you "assumed" it would be reported by someone else.... I already know what she will say. You cannot assume anything and it is your responsibility to bring it to HER attention. Then everything else is up to her. If she decides to report it to the DON she will keep your ID unknown so no repercussions would be taken out on you from the facility.

This does happen very often unfortunately in the LTC setting. Its wrong for sure. But I also know that half the time you can't find transfer aids in LTC for patients. Its a catch 22 for the aids. I mean, either they waste an hour looking for something they won't find anyway and get ridiculously behind and reamed out for it, or they just "get it done". They don't have time to look for anything. They don't have adequate time to do anything the right way, and it sucks but its not thier fault. Look at how long it takes you to do what you do with your patients, then imagine having to do it in a certain time frame with atleast 19 other patients. I know I wouldn't be able to do it. It truly sucks that she forgot to lock the wheels on the chair. I'm not saying she shouldn't have created a report herself, she definitely should have. But who's to say she didn't?? Maybe she was new and in was in such a rush it was an honest mistake. There are time frames in facilities to create incident reports, and I'm sure she wasn't going over the intercom to announce it.

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