Maybe giving it all up

Specialties Geriatric

Published

Ok. I post here often, but under another name. I need to vent. Last week, I had the worst night ever. I had an elderly gentleman fall out of bed a half hour into my shift. He did not complain of pain, just wanted to go back to bed. Well, we lifted him and returned him to bed. Guess what? Now, he says he has hip pain. I did a quick assessment prior to transferring and there was no obvious injury. + CSM, legs equal , ect. ect. Called MD, said to send him out and guess what? Hip fracture. I wasn't doubting my actions at first, but other nurses were, but I am too now or I wouldn't be posting here. I did not follow my gut and leave him on the floor. He was confused and trying to get up again while on the floor. My thought at that time was keeping him comfortable and safe. We all know that this is a reportable event. I swear that I am so fed up at this time with nursing, LTC and the whole lot of it,that if this becomes more than a rountine investigation, (which I am sure it will) I will just hand my license over to them. :crying2: I haven't slept since this has happened. I already now how my DON and Administrator feel, they feel that I did not use good nursing judgement.

had a similar case, when the emt came they did say "you know, you should have left here on the floor",,,i just smiled and didnt interact......she was so demented and so uncomfortable and contracted there was no way to keep her still on the floor....she was in more potential danger on the floor, wiggling about, then she was from us gently putting her back to bed, where she quieted down......i suspect this is the same with your gent.....hopefully you documented it this way? If not, at least formulate this type of response to any questions....good luck

This is exactly why I felt it was better to get him up. He is so confused. I did have the side of the EMT's. They felt that he did not have any pain during their assessments, and there was no visable injury.

I really am ashamed that I have let my bosses make me second guess myself. I do feel I have alot to bring to a long term care setting, just not this one. I have seen them let to many nurses take blame. I should have smartened up long before this happened! It took this long to open my eyes and see who wold be there to back me up, or at least hear why I did what I did. They feel they may get in trouble, so they are looking to put the blame on someone. I think mostly I feel hurt, this place was my family

Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

He fell- you assessed him. He complained of no pain. You got him up. He complained of pain. You assessed him again, you called everyone you were supposed to, you got him treatment...hummmmm....your co-workers need to get a grip.....

Specializes in Cardiac/Step-Down, MedSurg, LTC.

I think you being so concerned shows that you are indeed an excellent nurse, assessing you patients well and learning from your experience. I work nights in LTC and we don't have as many falls as we used to, but they still happen. With the poor patient/staffing ratios in LTC (my facility, at least, at night) it's bound to happen. No matter how much we alarm people and how many interventions we take to prevent falls, people with poor balance and judgment will continue to think they are still the unstoppable 30 year old when in fact, they're the frail 80-something.

And by the way, I think it's the DON/ADON/Management's job to make you feel like poo on a daily basis. I still see that whole " 'motivation' by intimidation" play on a daily basis. In one ear and out the other, here.

Hey~ I had a fella just like that once. He fell, and before I got to him (was with another patient or at lunch... can't remember now...), but the CNA's just helped him up and put him in bed.

I usually like to check their hips BEFORE they get up to feel if there's a lack of symmetry or the typical one leg longer than the other or outward turning of the foot. By this time, there were none.

He continued to complain of pain, so I called the doc and had him sent out. The EMT's came in and the one smart-alek one says (of course), "I see outward turning" Totally ignoring me....

There was none when I assessed!

But I digress.... the patient HAD broken his hip, and did have to have surgery.... family was NOT upset with me or with any of us....

I documented what I knew and what I saw, and counseled my CNA's to NOT get a patient off the floor until a nurse sees them first.

You hang in there and don't give up. Long Term Care sure ain't for sissies!

Thank you to everyone. I am feeling much better now. I keep going over everything in my head and I know I did the best I could.

Specializes in Gerontology, Med surg, Home Health.

"And by the way, I think it's the DON/ADON/Management's job to make you feel like poo on a daily basis. I still see that whole " 'motivation' by intimidation" play on a daily basis. In one ear and out the other, here."

I am the DON and I do NOT use intimidation to motivate my staff. As far as I'm concerned we're all in this together and I treat them the way I wish MY old DON's had treated me.

As far as residents falling....they always will. I've seen people fall and they have obvious fractures. I've seen people fall and literally jump up off the floor walk around and then days later complain of pain and be diagnosed with a fracture. I've seen people standing still and boom..end up on the floor...hips break and they fall.

Unless you have xray vision, you make the best decision you can at the time.

It would be awesome to have someone like you as our DON. Ours DOES use intimidation... and takes hours away (interestingly enough, all her buddies she brought with her get their hours, and then some!), and makes the schedule purposefully difficult on those who cross her.....

It's scary sometimes....

Specializes in Cardiac/Step-Down, MedSurg, LTC.

I wish I had someone like CapeCodMermaid as well! It's tiring, getting the same spiel day after day, is the point I was trying to make. It's impossible to stop everyone from falling, or getting skin tears/bruises, but boy oh boy, when it happens - I don't appreciate being made to feel like it's all my fault by my higher-ups. It's stressful, doesn't solve the problem, and gives staff "just another reason" to despise their job (from my point of view).

I haven't met our new DON yet, and probably won't until there's a staff meeting (since I'm 11-7), but I sure hope she's the type that's more understanding and willing to discuss rather than barrade :)

Heck, I only saw my DON once when I was interviewing, and once at our staff party before she moved on! Pesky DONs, avoiding me on nights! Haha

If you assessed the pt after the fall, no c/o pain, ROM norm, no immediate s/sx of a fx, assisted the pt back into bed and documented your findings, monitored the pt, etc. I don't think you did anything wrong. You did your part to the best of your ability/judgement it sounds like.

Ok, Thank you to everyone that replied to my above post. I have some questions to ask now. Would it hurt me if I gave my notice and got a new job before the "investigation" is over? The state has not been in for this incident, but I cannot tolerate to work there anymore. In fact, I am still thinking of giving up nursig. I would have already, if I could figure out how to make a decent paycheck without a RN degree! I was hoping maybe it was just this place and not nursing as a whole, that I am done with.

Specializes in LPN.

Did you ever think that your pt already had a hip fracture before the fall? Sometimes these things are spontanous, and happen without anything big happening. Could have been a hairline fx already there, and now he gets up and the leg gives out and he falls? Could be as simple as that.

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