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?

[canuck-nurse]

When your instructor and preceptor provided you feedback that it was an unforeseen event, then trust that it was not your fault and you acted safely and efficiently to keep you and your patient safe. All I can say is that a post-conference and/or a briefing would help talk about your concerns. Nursing students and general nursing life are anything but ordinary, do not expect to be a superhero just take it easy and do not let this experience hold you back.

[emcadams]

Use this as a learning experience. All patients are fall risks. Every single one. My unit is not Ortho, but we have a policy to bed alarm all patients, unless verbally refused, and then we chart "refused" every time we chart safety rounds. I had a patient that was very restless and confused, thought his denture paste was in a drawer in the "other room" and thought I was a fool for not getting it for him (there was no denture paste in his room, and we didn't carry it on the floor). I wanted him to scoot up in the bed, so I put the walker in front of him, and asked him to stand and move to his left and sit down again on the bed. Well, the patient stood up, and proceeded to walk with the walker right out the door of his room. And fell. There was nothing I could do to stop it. And this gentleman had been ambulating with walker and PT all day. Things like this happen. Know your floors protocols and policies, and follow them. Even when other co-workers don't.

[Amistad, RN]

I had an experience similar to SoldierNurse when I had my first patient fall... It was very traumatic for me to find my patient, who was not designated as a "fall risk" lying in a pool of blood. I took that experience as an opportunity to be more diligent preventing patients from falling, even ones who have ambulated with a stable gait in front of my own eyes. Be aware of your surroundings. Is the room cluttered? Are they wearing treaded socks? Are they hooked up to IV fluids? Be aware of medications that can increase risk of falls. Help out your coworkers as well and keep an eye on their fall-risk patients. If you hear a bed alarm going off, answer it even if its not your patient. Hopefully your coworkers will return that favor.

[catebsn25]

the exact same thing happened to me in my last semester! 6 week s/p BKA, A&Ox3... sitting on the edge of the bed. I asked him to wait a moment while I turned the bed alarm off, he said okay, and then he decided to try to stand on his own. He lost his balance and fell, luckily no injury but it shook me up so bad. No matter how many nurses told me it wasn't my fault, I kept thinking how could I have prevented this?

The answer was: I couldn't have. Accidents happen, patients aren't always compliant. It took a while but I shook it off. I will never forget that moment. You will be okay and shake it off as well.

[loriangel14, RN]

Everyone is at risk for falling.Patients fall. Nurses fall. Don't blame yourself.It happens to everyone.

[redhead_NURSE98!, ADN, BSN]

I'm confused as to whether you're so upset that the patient fell, or that you injured your hand.

[Ruby Vee, BSN]

Everyone is at risk for falling.Patients fall. Nurses fall. Don't blame yourself.It happens to everyone.

I've seen some spectacular nurse falls -- including one broken ankle. (OK, that was a physician, but the point was anyone can fall.) You do the best you can to prevent it, and if you've done your best and they fall anyway, it's not your fault.

[mevsmom]

I could infer what she meant but nursing requires precise communication. Might as well start now.[/quote']

Good thing I won't be communicating via my tiny iPhone keyboard or message board while nursing. ;-)

[mevsmom]

I'm confused as to whether you're so upset that the patient fell or that you injured your hand.[/quote']

I don't really know... I'm not upset about my hand anymore, slightly embarrassed especially infront of the RNs on my floor and the nurse manager.

I'm scared of another patient falling and hurting them self... I'm scared of appearing to be incompetent too.

[icemanof92]

Your first fall is always traumatic. All patients are fall risks to some extent. One word of advice, while some may not agree, years of experience has taught me this: Do everything you can to stop a patient from falling, except catching them. You are going to get injured if you try to stop them mid fall. If they fall despite whatever fall prevention measures you have taken thus far, it is to late to safely stop them.

[nurseprnRN, BSN, RN]

Telling yourself that you are terrified and paralyzed is no way to go through life. You have had a great many experienced people tell you that this was not a bad event, that you didn't do anything wrong, and that you should get on with it.

I say this in all charity (and I have had a pt or two fall on me, too, though thankfully not a PT, because those folks tend to be heavy and muscular): It is not mocking or minimizing your initial feelings to tell you to get a grip and move the heck past this. If you are worried what other people think about you, the immortal Dr. Phil has a bon mot for that too. He says most people would be shocked if they knew how little other people thought about them at all. :)

Go forth and sin no more, live your life, and be free.