PT fell... Now I'm paralyzed with fear

[mevsmom]

I'm in my final semester of school doing my preceptorship/capstone. I'm on an ortho floor and really enjoying it. I received report on a PT who was not a risk for fall... Later in my shift I went in to check on him and he was getting up. He got up slowly and stumbled to the side and fell. I couldn't do much it all happened so fast, I got to his head and protected it as best as I could. I couldn't stop the fall though my hand was crushed into the wall forcefully. I went to the ED they splinted it, met with an ortho 2 days later and it wasn't broken just a bad crushing injury.

Tonight will be my first day back and I'm paralyzed with fear. I'd do anything before going to my floor tonight... I feel hopeless and extremely fearful.

Both my instructor and preceptor think that I did the right thing, and that it wasn't my fault but I just can't get beyond this. I almost feel like I have PTSD I keep reliving it in my head.

How do I get beyond this?

[EaglesWings21, ASN, RN]

This is brutally honest: You will heal and get over it. I am 99.999% sure you don't have PTSD. I spun out on the highway going 60 MPH and slammed head on into a wall a few months ago. I had flashbacks for a few months and avoided highways when I could but I am mostly over it now.

People who have PTSD have been traumatized. They may have almost lost their life or lost everything they love, they may have been raped repeatedly, they may have been at war and seen their buddies blown to bits and pieces. People whose patient's have a fall at the hospital generally do not develop PTSD.

[Ruby Vee, BSN]

I phrased that wrong, he was a risk for fall... Almost all ortho PTs are a risk for fall, the only ones that aren't a risk are the overflow med surg patients. He wasn't on a 1 to 1 assist for ambulation on he was up and out of bed ambulating well without assistance all day.

I don't understand how all of your Physical Therapists are at a risk for fall.

[Dranger]

To be honest it happens all the time and you cant be in the room 24/7

[jead1]

I don't understand how all of your Physical Therapists are at a risk for fall.

I'm pretty sure pt stands for patient. So what she means is all ortho patients are at risk for falls.

[Ruby Vee, BSN]

I'm pretty sure pt stands for patient. So what she means is all ortho patients are at risk for falls.

PT stands for Physical Therapist. If she meant patient, that's pt.

[jead1]

PT stands for Physical Therapist. If she meant patient, that's pt.

Either way, I'm pretty sure you could infer what she meant. Surely physical therapist aren't a risk for falls. Lol it's all good! Smile! And mevsmom if no one else understood...I did!!!!! :) :)

[jead1]

Ruby Vee, I do understand the importance to decipher medical abbreviations. It is needed! Thanks!

[pinkiepieRN]

If patients didn't fall all the time, we wouldn't have fall protocols and fall assessments and yellow skid-free socks and yellow stars and place high fall risk patients close to the nursing station if possible. I work in LTC and we usually have at least 1-2 falls/week. We have some residents who consistently fall either because they insist on getting OOB by themselves even though there are 2 signs in their room saying, [resident's name]: DO NOT GET UP, YOU WILL FALL! Others are ambulatory but unsteady, confused and impulsive and get out of bed and into the hallway without anyone catching them and wander into someone else's room, to fall on their floor. Still others are in a geri-chair in front of the nursing station for high visibility and the second you go in someone's room, they try to get up and walk down to their room even though they shouldn't be walking unsupervised because their gait is unsteady.

Most of the time when I call a doc s/p fall, they're not surprised. Very few times are injuries noted, and if there are injuries, we deal with them - either by sending them to the ER for evaluation or getting a portable X-ray, etc. Otherwise, you get vitals, and start neuro-checks for 72 hours. Live and learn. This won't be the last person who falls on you. It's not your fault. You can't always stop someone from falling. And plus, do you think anyone thinks your hand injury is from *NOT* trying to prevent the fall or injuries to the patient from falling?

[Ruby Vee, BSN]

Either way, I'm pretty sure you could infer what she meant. Surely physical therapist aren't a risk for falls. Lol it's all good! Smile! And mevsmom if no one else understood...I did!!!!! :) :)

I could infer what she meant, but nursing requires precise communication. Might as well start now.

[Ruby Vee, BSN]

If patients didn't fall all the time, we wouldn't have fall protocols and fall assessments and yellow skid-free socks and yellow stars and place high fall risk patients close to the nursing station if possible. I work in LTC and we usually have at least 1-2 falls/week. We have some residents who consistently fall either because they insist on getting OOB by themselves even though there are 2 signs in their room saying, [resident's name]: DO NOT GET UP, YOU WILL FALL! Others are ambulatory but unsteady, confused and impulsive and get out of bed and into the hallway without anyone catching them and wander into someone else's room, to fall on their floor. Still others are in a geri-chair in front of the nursing station for high visibility and the second you go in someone's room, they try to get up and walk down to their room even though they shouldn't be walking unsupervised because their gait is unsteady.

Most of the time when I call a doc s/p fall, they're not surprised. Very few times are injuries noted, and if there are injuries, we deal with them - either by sending them to the ER for evaluation or getting a portable X-ray, etc. Otherwise, you get vitals, and start neuro-checks for 72 hours. Live and learn. This won't be the last person who falls on you. It's not your fault. You can't always stop someone from falling. And plus, do you think anyone thinks your hand injury is from *NOT* trying to prevent the fall or injuries to the patient from falling?

This!

Mistakes happen -- no one is perfect. If you've done the best you could, then you've done what you should.

[jead1]

I could infer what she meant, but nursing requires precise communication. Might as well start now.

That's true!

[lilredrunner]

One of the things I've realized, going from a CNA to an LPN and finishing my RN, is that all patients are risks for falls. Every darn one of them. Just because they don't fit all the criteria for higher risk, they are still risks, largely for one reason: All are human, most are stubborn, and all of them make mistakes, especially when they're sick. Which they have every right to make as a patient, of course, separate from you and your abilities to care for them.

So try not to beat yourself up. I've had patients fall into me, or found them down when I left for just a minute. Mostly because when I did long-term care, they just fall, and there is only so much you can do or put in place to help them. Sometimes, patients just make randomly bad decisions, and they fall. Best thing you can do for yourself and your patients is be on tour game for the next round.