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I think as fellow nurses we should support the OP. Don't you remember the situation recently where a nurse committed suicide following a mistake that lead to the death of her patient. Mistakes happen everyday. I am so sorry you are having to go through this. Find someone supportive that you can talk to about this.
Everything cannot be prevented. Don't beat yourself up too bad. You learn from mistakes and go forward. You worked too hard to become a nurse to just throw it all away.
When the policies were being changed (mostly in LTC, then moved on to hospitals) re: restraints, the line we always got was "the patient has the right to fall" . It stinks, but it's true.
They also can eat all of the salt they want even if on a NAS diet- I couldn't give it to them, but if they find it, there's nothing I could do. They can eat all of the candy bars they want, even if their blood sugars are never below 200mg/dl.
They can walk on a new ORIF of the hip before they're supposed to have full weight bearing. Yadda, yadda, yadda.... Patients have the right to not follow orders.
If a nurse can help someone not be as injured by the refusal to follow orders, she's still acting in the best interest in the patient. :)
Tokyotea, I am very sorry you are going through this. Nurses are expected to have superpowers and we are only human. The patient had a whole lifetime of issues that played into the reason he was in your facility, and the facility had a whole lifetime of issues that played into that patient outcome. You were one person standing in the middle of all of that, trying to do the best you could. You did what you thought was right for your patient at the time.
Sometimes we just do the best we can. Remember though, that there are decisions we make that have the opposite outcome, that change the patient's life for the better, that save lives. I'm sure you have made more than your fair share of wonderful decisions.
As for all the nonesense about how this is your responsibility because you didn't do this that or the other,
It's not the responsibility of the nurse to get a comode. Every single thing that happens in a health care facility is not the responsibility of the nurse. Because, while she was running down to central supply, that patient could have gotten out of bed and fallen, and she would be blamed for not being there, or another patient could have crashed, and it would be her fault for leaving the floor becuase IT IS NOT HER JOB to run and get supplies from central.
Unfortunately, the reality is that in this screwed up system, the nurse is held responsible no matter what happens because it's her patient. She could be home sleeping and someone would find a way to make it her fault. Because it's for damn sure that the facility doesn't want any responsibility.
Some posters sound so clueless and ignorant that their words scream that they have not a single second of experience in healthcare.
Life is too short. It's not even worth arguing.
I personally have had that PITA patient the refuses to follow the rules and I have chosen to assist them to the bathroom because I know the minute I turn my back.....the will do it on their own. Obstinate/strong willed.......Pig-headed/foolish.......they do what they want because, of course they know better.......and will get hurt in the process. I have had patients lose their balance and have assisted them to the floor as gently as possible and soften the injury as much as possible. If that patient is alert, you can't stop them. What would someone do restrain the patient???
I don't think so. The prudent thing to do would be to stay and assist the patient who insisted on ambulating tot he bathroom instead of leaving them to fend for themselves. Events unravel quickly and I can see how there would not be a ton of time to call for help....but as the patient is falling your job is to ease the fall and SCREAM for help.... (
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Originally Posted by RoyalPrince
Actually I'm male so I don't tend to spout "feminist nonsense". I am just of the opinion that "orders" should not come from professional's working on the same team, there should be respect and understanding of each other's role. I am an independent practitioner in my own right and would not take "orders" from anyone, nor would I give them to others.
Okay , so what do the call the order's written by doctors? "patient requests"?!
When the policies were being changed (mostly in LTC, then moved on to hospitals) re: restraints, the line we always got was "the patient has the right to fall" . It stinks, but it's true.They also can eat all of the salt they want even if on a NAS diet- I couldn't give it to them, but if they find it, there's nothing I could do. They can eat all of the candy bars they want, even if their blood sugars are never below 200mg/dl.
They can walk on a new ORIF of the hip before they're supposed to have full weight bearing. Yadda, yadda, yadda.... Patients have the right to not follow orders.
If a nurse can help someone not be as injured by the refusal to follow orders, she's still acting in the best interest in the patient. :)
All you said are right and I concur. The only dicey part in the OP's story was her presence with the patient. People can skew that in several different ways.
Patient fell when no one was present, yup good. Patient fell with ou helping him.. much more dicey. It's one person's word against the patient who sadly is no longer around to state his side. That is the dicey part.
Actually I'm male so I don't tend to spout "feminist nonsense". I am just of the opinion that "orders" should not come from professional's working on the same team, there should be respect and understanding of each other's role. I am an independent practitioner in my own right and would not take "orders" from anyone, nor would I give them to others.
Serious questions (not sarcastic :)).... as a NP, how are you a totally independent practitioner ?? Do NPs in the UK have the same scope of practice as MDs? Don't you need a supervising MD? Did you ever work as an RN who had to follow MD orders? :)
Um, activity orders are part of the basic admission orders. And how would you think that docs DON'T write orders that nurses are legally obligated to follow (unless there's a question of safety). RNs are not totally independent practitioners (not including NPs- and they must have an MD supervisor).I'm guessing as a NP in the NICU, you don't write a lot of ambulation orders
Serious question: Did you think that nurses just go to work and do what they want with the patients? :) Some units have protocols, but the doc still writes the order for that protocol. Nurses don't just do it w/o the order.
I'm kinda feeling 'unreal' that someone thinks nurses are completely autonomous :) No offense- just mind boggling :)
Apparently poster is an "independent practitioner". But if he has "BSN", anywhere in his credentials, independence my foot:D
xtxrn, ASN, RN
4,267 Posts
I hear ya w/JodieMay's post.... :) IMHO, it's more a statement of inexperience- not necessarily feminism (there are a significant number of female docs giving orders, too)