Pt fainted on me while standing up

[anon456, BSN, RN]

I'm a student and this is the first experience I have had with this-- we watched some videos on the subject though.

I had a patient who was not labeled a fall risk. She had to use the bathroom and me and an RN were helping her to use the toilet. Upon standing up, the patient started to sway and I knew she was going down. I told the RN "she's going down!" as the patient leaned into my body. I had a door jam behind me. I put my arms around the patient and we both leaned towards the door jam. It was controlled fall. Then I lowered us both down to the floor together, sliding down the door jam. Within a minute the patient had come around again and was able to be assisted to a chair, and then to the bed. The RN said I did great. I was not sore or anything.

However my instructor, who first commended me for keeping the patient safe, later said never to let a patient sit on me like that, and to make a choice between myself and my patient when it came to injury and safety. I really thought I had done a smooth job keeping us both safe, but at the same time I can see her point. I would not want to throw my back out, and if that door jam was not behind me to lean on I'm not sure how I would have saved the patient from being hurt without hurting myself. And if the patient had been any bigger I might have been squashed.

[brownbook]

OK instructor, why doesn't she give her students an inservice on assisting pt's from chair to standing, or walking along side pt's and what to do if they faint! No one can perfectly catch or control a pt. who "suddenly" faints. Ask your instructor for that inservice then let the rest of us know how to do it the right way! I remember an inservice once on how to assist pt's as you walked along side them if they might be a fall risk but for the life of me can't remember the details of it!!!!! I think you did the best you could in an impossible situation!

[mustlovepoodles, RN]

I think you did a great job. Way to think on your feet! What did your instructor expect you to do, stand aside and let her crash to the floor? I can just imagine the Press-Ganey on that one.

I have had this happen to me twice. Yes, me personally. I fainted when I gave my first shot. I have no idea who caught me, but I woke up in the next bed without a head injury. And fainted after surgery my first time out of bed. I remember saying "I'm gonna be sick" and the nurse pushing me backwards to the bed, where I flopped across the bed and threw up on the floor.:barf01:

I think I would ask the instructor to give your class an inservice on what she feels is the proper way to handle a fainter. Because this won't be your last one. And remember, in an emergency all bets are off. You can be prepared with all the book knowledge in the world, but when it happens you just need to do the best you can to keep your patient safe AND not injure yourself.

[April, RN, BSN, RN]

I think you did great, also. I'm sure that patient is very thankful that you saved her from slamming her head or breaking her nose and teeth.

[Faeriewand, ASN, RN]

I'm so afraid my patients will faint on me when they stand up that I'm constantly asking them how they feel, do they feel steady on their feet, let me know if your feeling lightheaded etc etc. LOL! Some look at me like I'm crazy because I ask them several of the same type of questions just to be sure! LOL! I even tell them what to hold on to. Hold that rail! Put your hand here!

well you know how patients are. I've asked, "so any medical history?" no just diabetes. Are you on any medications? No just ----- And I've already marked no because that's what they answered. Now I ask "Any medical history SUCH AS..... LOL

[canoehead, BSN, RN]

For heavens sake, your instructor would complain about a sunny day.

You handled the situation without injury to anyone, good job. Keep in mind that you don't have to catch the patient, just break their fall for them. You can do that with heavy patients even if you are tiny- if you stay aware of your limits, and keep a straight back.

[talaxandra]

Your first (and second) instinct is to catch falling things, whether that's a needle-tipped syringe or a person. It takes practice not to try, which is why my ward instituted a safe sharps routine that includes purposely dropping, and not catching, objects until that instinct is dampened.

That's harder when it comes to people! Ideally fallers should be assisted to the ground in a semi-controlled way. If you're able to, you should focus on injury reduction, particularly the head, followed by equipment and invasive technology protection (pumps, IDC's, CVC's etc).

But none of that's something you get any way except experience or practice. I agree with those members who suggest talking with your instructor about techniques and practicing. Wll done :)

[BreeLPN2RN]

You did GREAT!!

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

There be no expectation for you to do any better under the circumstances. Playing "what if" may help prepare you and give you a chance to learn from what happened, but in any mergency like that, you have to play the cards your dealt. Good job, bad instructor. Bad, bad.

[bagladyrn, RN]

You did well.

It's not unusual to have patients faint first time out of bed in my dept - L&D and although I'm a short 55 yr old I've managed to break their falls in a similar way with no injury to myself or patient. My usual technique is to get my arms under theirs either from behind or in front, and as they go down go to a squat, kneel and then sit. This slows and controls the direction of their fall at the same time without at any time attempting to support their whole weight. The trick is to go straight down, not twist or lean.

[SlightlyMental_RN]

I've had a few people faint on me, and I'm not a spring chicken, nor very big. I just go with the notion that I'm there to pad their fall, and perhaps control it a bit.

[AmericanChai]

Thanks for your feedback. :-) I pretty much did exactly what some of you described-- padded the fall and eased her to the ground in a somewhat controlled way.

My instructor is a nice person and I learn a LOT from her. She makes me think deeply about things . . . and probably she was just really concerned about my safety. I guess the nature of the job is to help people and oftentimes we put our safety behind our pt safety automatically.