Published Aug 28, 2014
EmeryRN
18 Posts
I am a nurse of 2 yrs. and yesterday around shift change my little elderly lady was found on the floor. I had round on her about 1800ish and she was laying in bed with her book, didn't need anything. She had been ambulating with a walker to and from the bathroom by herself AND changing her own brief. Not only that, but she would ambulate the halls, often unassisted (however on my shift, I'd always walk with her).
She couldn't help herself up and I knew instantly a hip fx, which later a xray confirmed. The call bell was in reach, she had her footies on. According to her she was sitting on the edge of her bed, which she does during meals, went to reach for something and lost balance.
She had already been seen by PT and like I said, ambulating. Ortho has been consulted to decide surgery or no. I feel completely sick over this. She is AO and so sweet. I don't know why I'm posting. I don't know what else to do but I've already cried and now I'm back to doubting if nursing is for me. And I am to start a 2nd job PRN soon! I can't move forward. I'm scared for my patient and for myself. I can't even blame it on ratios because I had discharges before that.
I need a time machine... And maybe a Xanax.
SoldierNurse22, BSN, RN
4 Articles; 2,058 Posts
You can't be present everywhere all the time. You cannot blame yourself for this. Accidents really do happen, even to the most alert and astute nurses. It's normal to feel guilty, especially if this is your first patient fall, but there is nothing you can do now--aside from finding that time machine, of course.
I had a patient fall on me a few years ago right between my hourly rounds. Myself and a corpsman found her on the floor with a pool of blood (IV had pulled out) nearby. I also struggled with blaming myself. I had a low patient load that night and I told myself I should've been rounding every half hour, fifteen minutes--what have you. I decided I should've somehow sensed that she was going to fall based on my assessment. You name it--I blamed myself.
You can think up a million excuses, but sometimes these things just happen. In the end, you must pick yourself up, firmly tell yourself that it really isn't your fault, and move on.
SoldierNurse22: Thank you. But I can't shake it. It's not my first fall, sad to say. But I round and make sure the call bell is in place, bed alarm, etc, and still falls happen. And I ALWAYS blame myself. Even though my Charge RN and other nurses say I've done everything I should. But it doesn't matter. I still think something could have been different. And when I have a fall, I feel like I'm having too many and I'm a bad nurse. It's so early in my career and I'm afraid of losing my license and not being to handle things.
LadyFree28, BSN, LPN, RN
8,429 Posts
Probably a Xanax...
Like SoldierNurse has explained, you can't we everywhere...things happen, even to the most highly functional AO person; it has NO bearing on our nursing practice.
Decompress and move on; the pt is still ok, despite the fracture. Today is a new day. :)
doctorwhofan
61 Posts
Look at it this way-you did round on her, you did answer her call for help, you didn't ignore her hip pain, you got the ortho team involved, and truthfully she could have fallen at home and not been found for hours. Unfortunately patients fall in the hospital. The important thing to remember is that you took appropriate action after the fact. You'll be fine!
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HappyWife77, BSN, RN
739 Posts
It is not your fault. No one wants to see an injury or accident to our patients.
It's ok to grieve about it....but try to feel what you feel, and move on with Peace my friend. Iam sure your sweet lil lady would tell you as well its not your fault.
I've seen lil o ladies recover from many things. I pray she is ok and you are not too hard on yourself. God bless.
(((Hugs)))
anh06005, MSN, APRN, NP
1 Article; 769 Posts
The only way you could have prevented it was to be in the room the one second that she decided to reach over for whatever she was reaching to grab. She may have asked you to get it instead. Maybe not. Statistically that's a very small window of preventing the incident.
It is known that all of the stuff you DID do will decrease the risk of falls (non skid socks, frequent rounding, etc.). Notice the word is DECREASE and not ELIMINATE. Things are going to happen unfortunately. My first patient death was a sweet little lady I had rounded on within the last hour and the cardiologist had seen within the last 30-40 minutes and I had actually given lasix a few minutes after cardio saw per his order. She was a DNR but a family member asked if I could check on her. When I walked in family was around the bed crying. I was dumbfounded and started crying with the family. They didn't blame me or anything. Actually gave ME a hug. Things happen for no obvious reason.
Go by whatever room she is in now and check on her. I do home health now and do that often when a special patient of mine winds up in the hospital. They really appreciate it and don't blame you for their misfortune. They appreciate your kindness and care.
The only way you could have prevented it was to be in the room the one second that she decided to reach over for whatever she was reaching to grab. She may have asked you to get it instead. Maybe not. Statistically that's a very small window of preventing the incident. It is known that all of the stuff you DID do will decrease the risk of falls (non skid socks, frequent rounding, etc.). Notice the word is DECREASE and not ELIMINATE. Things are going to happen unfortunately. My first patient death was a sweet little lady I had rounded on within the last hour and the cardiologist had seen within the last 30-40 minutes and I had actually given lasix a few minutes after cardio saw per his order. She was a DNR but a family member asked if I could check on her. When I walked in family was around the bed crying. I was dumbfounded and started crying with the family. They didn't blame me or anything. Actually gave ME a hug. Things happen for no obvious reason. Go by whatever room she is in now and check on her. I do home health now and do that often when a special patient of mine winds up in the hospital. They really appreciate it and don't blame you for their misfortune. They appreciate your kindness and care.
It is a comfort to know I'm not alone. I'm trying to breathe easy but I'm still having trouble. Thanks all. This is helping me blame myself a little bit less.
As with any sort if "traumatic experience" it will take a little time to work through it mentally. You were following the best practice but unfortunately it can't eliminate every event.
Your head knows you did what you could. It's that dang heart that's getting in the way. But our hearts are why many of us went into nursing anyway.
toomuchbaloney
14,940 Posts
So, as you have beaten yourself up over this I wonder what you have determined you might have done differently to prevent this fall?
I am asking because from your post it would seem that the AO elderly lady is responsible, not you.
Been there,done that, ASN, RN
7,241 Posts
People fall, people die, people get even sicker... no matter what we do.
You instituted and followed the correct precautions. Accidents happen.
Your reaction.. to now doubt your career choice is way out of line.
Please consult your EAP and get assistance regarding this reaction.
wanderlustnurse88, RN
198 Posts
As other have said, it was not your fault. Unless we place our pts in a bubble, they will fall.
Please don't beat yourself up over this.