Patient fell and died a few days later, was it my fault?

resumecpr · Aug 1, 2011

Wow. I can see why you're so upset. I would feel horrible as well.

The bottom line is this: You did not follow doctor's orders, and in the end, the patient suffered the most severe consequence.

You are lucky that management has not spoken with you about this matter. Consider it a blessing, and a HUGE lesson learned.

Do not lose faith in nursing. It was not nursing that failed you.

I hope you can find a way to get past this and return to work with a positive attitude.

Best Wishes:nurse:

**RosesrReder, BSN, MSN, RN** · Aug 1, 2011

Wow, I am truly sorry. I can only imagine what you are going through. My T&P's with you. Hugs

JemJ · Aug 1, 2011

Tokyotea, I don't know what else you could have done, to be honest. He was going to get up and do what he wanted to do, whether or not you were there. I know you're feeling scared right now, on so many levels, but keep praying and we will pray for you. Even had you ordered the bedside commode STAT, it's going to take at least an hour to get there, and the minute you turned your back, he would have been up and out of bed.

Hang in there.

SNIXRN · Aug 1, 2011

If the patient had a hard time getting off the toilet, they would have had a hard time getting off the commode as well. Consequently, the patient would have fallen regardless. I am so sorry this happened to you. It can't be easy dealing with this - just learn from your mistakes.

xtxrn, ASN, RN · Aug 1, 2011

It sounds like a catch 22- leave the guy and he gets up and falls REALLY hard, or help him to the BR (against orders).... before he ended up on the floor, your plan sounded like the best option - I can see making that decision.... and being terrified right now. Negligence is based on willful dereliction of duties- you did not willfully do anything to hurt this man. You did choose to take him to the BR, but that was based on what you felt was the LEAST harmful... Hang in there. :)

applewhitern, BSN, RN · Aug 1, 2011

I completely agree that he would have gotten up and fell anyway. He should have had a bed alarm on, but even then he could have easily fell. I would not discuss this with anyone at all, not even your co-workers. By talking about it, you are making yourself sound guilty (even YOU believe you are). You did what you had to do, given the situation. The only other option for a patient who will not listen to you or follow your orders, is restraints, and that is another can of worms. For now, keep your lips together, and only talk to the hospital administrators or their lawyers if you are requested to do so.

sistasoul · Aug 1, 2011

I am so sorry this happened to you. It is a terrible feeling. I had a very confused patient get up out of bed and he fell and broke his hip. I knew as soon as I was told he broke his hip he would not do well in surgery. He ended up dying a week after surgery because he had so many co morbidities. It was during change of shift and somehow his bed alarm was not on. I felt so bad I cried for days into weeks

I wanted to quit nursing too. It was the worst day of my life as a nurse. It was in April of this year. His MD was so nice when I called to tell him that the patient fell. He said the patient had fallen many times at home and this would have happened eventually. It just happened to have occurred in the hospital.

I know what you are feeling well. It is the worst feeling I ever had as a nurse. I think the feeling lessens with time but it never entirely goes away. I am extra-extra-extra... vigilant with alarms and safety now.

Anything could have happened in those 3 days since you had him. If the head CT was negative then chances the fall did not cause the bleed. His low platelets may have been the only cause.

Big hugs to you

WKredz5 · Aug 1, 2011

Yeah, I'd say it was your fault for 1) Allowing the patient to get out of bed (If she got out of bed by her self when you weren't there, you wouldn't be held responsible) and 2) Helping her go to the bathroom by your self when you knew you wouldn't be able to hold her.

I'm sorry if it sounds harsh but its the truth, this is the reason nursing homes must prefer male CNAs?

silentRN · Aug 1, 2011

You shouldn't blame yourself. The CT that was done after he fell was negative, and most likely they did a repeat CT of the head later in the day or night after you had transferred him. There are other possibilities that can cause a brain bleed such as a stroke or aneurysm. Who knows what happened when he transferred to another unit. I'm sure they gave the guy some platelets when he transferred as well. Who knows what comorbidities he had, and you didnt mention what he was in the hospital for except that he had low platelet level. Was he an alcoholic or liver issues? Don't assume responsibility for this.

xtxrn, ASN, RN · Aug 1, 2011

Yeah, I'd say it was your fault for 1) Allowing the patient to get out of bed (If she got out of bed by her self when you weren't there, you wouldn't be held responsible) and 2) Helping her go to the bathroom by your self when you knew you wouldn't be able to hold her.
I'm sorry if it sounds harsh but its the truth, this is the reason nursing homes must prefer male CNAs?

Excuse me? :eek:Some testosterone defies gravity? :eek: I've met a lot of CNAs that could move mountains (and usually did q2h). Some patients are just unsteady unexpectedly. Where are you getting your info about nursing homes preferring male CNAs- they want people that realize that work is a verb, not a destination :)

I've worked with SO many more female CNAs. One of the biggest wusses was a male (granted it was his first death as a CNA, and needed extra help, but his blood flow must have just frozen- he got SO pale. Nursing homes prefer CNAs who WORK :)

Thinking about it, over 19 years working as an RN, and another 7 as a frequent patient with my license still good, I've seen maybe 3-5 % of CNAs that were male.

And the OP was talking about a MALE patient...hmmmm.... wonder if a hard-headed male is more likely to be trouble

Kiwidanni · Aug 1, 2011

Yeah, I'd say it was your fault for 1) Allowing the patient to get out of bed (If she got out of bed by her self when you weren't there, you wouldn't be held responsible) and 2) Helping her go to the bathroom by your self when you knew you wouldn't be able to hold her.
I'm sorry if it sounds harsh but its the truth, this is the reason nursing homes must prefer male CNAs?

What a pile of rubbish. What happens to the patient having their own mind and as health care professionals, our job is to offer the information then support the patient in the decision they make?

The patient decided to get out of bed. The doctors "orders" that the patient isn't to mobilise to the bathroom aren't etched in stone for the patient to obey. They are advice, suggestions, a "this is what I want to see happen" - and if a patient choses to do their own thing, then on their own heads be it.