Patient Falls

[Bee2008]

I need input/info please.

One of my pts had an episode of the "shakes"...thought it was a seizure but md was at bedside during the "attack" & said it was not. No injury occurred from this. MD informed of the pt's family over the phone. They said that they will be by later to talk to md. An hour after that, the same pt was found on the floor by another rn next to his bed with blood coming from a cut from his nose. All staff nurses & md on call were at the scene in literally 2 seconds. Pt was assessed & seemed fine, other than the cut on his nose. VS taken, tests ordered stat, pt assessed, & all were documented. This pt was at fall risk & fall precautions were already in effect prior to the fall. But pt did not have a sitter & bed does not have alarm. I charted that pt was taught to stay in bed, use call light, etc. throughout the day with a translator. Pt stayed in bed throughout the shift other than that time. Pt is on diaper but was changed q 2-3hrs. Although pt is >89yo, pt is alert/oriented, responds appropriately to questions & follows commands (even after the fall). Family came 1hr after incident & md informed them of what had happened. During one of my checking-in-on-the-pt, i saw the pt's son taking a picture of the pt's face/nose after the dressing was removed. I have informed the other rns in my ward about this & they said "lawsuit". I charted as much as i can & even had a senior rn review my charting & was told it was pretty good. Has anyone been through similar events? What happens next? What could i have done differently? What can i do to prevent this in the future?

I've only been working as a nurse for 2 months & had just finished preceptorship. I'm really worried. Please help.

Thanks in advance.

[spider11]

Sounds to me like you did quite a bit. Sometimes these things happen. Last night I had a pt fall, he had 2 bed exits on (one built into the bed and one stuck under the pad) 4 bed rails up. Pt still climbed out of bed, urinated on the floor, slipped and fell. We found him naked on the floor within seconds of the bed exits going off. I charted..charted...charted. Notified Dr, supervisor, and family. He continued to climb all night long. Sometimes you do everything you can. Believe it or not...I work in the CICU. I think I had every confused pt there was last night. lol

[Miami NightNurse]

Bee2008 Sounds like you did everyhing you can do. Don't worry about it people fall all the time, we do the best to prevent it, that is all you can do. Alot of people are sue happy and it will probally never go to court because the hospital will usually do something to satisfy the family, like void the hospital bill. You just chart well to CYA and its sounds like you did that.

[Blee O'Myacin, BSN, RN]

I need input/info please.

One of my pts had an episode of the "shakes"...thought it was a seizure but md was at bedside during the "attack" & said it was not. No injury occurred from this. MD informed of the pt's family over the phone. They said that they will be by later to talk to md. An hour after that, the same pt was found on the floor by another rn next to his bed with blood coming from a cut from his nose. All staff nurses & md on call were at the scene in literally 2 seconds. Pt was assessed & seemed fine, other than the cut on his nose. VS taken, tests ordered stat, pt assessed, & all were documented. This pt was at fall risk & fall precautions were already in effect prior to the fall. But pt did not have a sitter & bed does not have alarm. I charted that pt was taught to stay in bed, use call light, etc. throughout the day with a translator. Pt stayed in bed throughout the shift other than that time. Pt is on diaper but was changed q 2-3hrs. Although pt is >89yo, pt is alert/oriented, responds appropriately to questions & follows commands (even after the fall). Family came 1hr after incident & md informed them of what had happened. During one of my checking-in-on-the-pt, i saw the pt's son taking a picture of the pt's face/nose after the dressing was removed. I have informed the other rns in my ward about this & they said "lawsuit". I charted as much as i can & even had a senior rn review my charting & was told it was pretty good. Has anyone been through similar events? What happens next? What could i have done differently? What can i do to prevent this in the future?

I've only been working as a nurse for 2 months & had just finished preceptorship. I'm really worried. Please help.

Thanks in advance.

Patients fall. As long as you did all that you said that you did, and charted it as such, what more can the family expect? If they want private duty, they have to arrange for it and pay.

I really don't think that you should worry about the status of your license. He was checked on frequently and stated that he understood through the translator. The family was aware of the first fall as well.

These things happen to the most conscientious of us - sort of like a right of passage. I'm glad that the patient wasn't injured beyond the superficial.

Hang in there -

Blee