Unobserved fall and I feel awful!

Nurses Safety

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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. :(

Thank you. And I know my reaction is way over the top. It isn't productive or practical but I have always been hard in myself like that. Maybe I will find some help with that sometime per your suggestion. Again, thank you all for your input. I do appreciate your time.

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Emery, I think this might help your perspective. A friend was recently hospitalized, quite weak from a critical event. No one answered his call light.. he had to void. went to the BR by himself.. fell... hit his head requiring staples. His room mate also fell... breaking his hip.

This occurred in a well respected hospital! Hmmm.. could be an interesting thread ;)

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I hope they are both ok. But that does make me feel better.

My little old lady was to have an Ortho consult to determine if surgery is needed. The attending consulted one while one of her other MDs changed to another. So no Ortho consult today! Frustrating! But vitals are good and she is sleeping tonight. And yes, thankfully if she had to fall, it wasn't home and we were able to take action quickly.

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And this may need to be another thread, but mechanical dvt prophylactics are a fall risk. Even if a pt is AO. I've heard mixed reviews of whether AT pumps, for example, are effective and worth the fall risk.

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Specializes in critical care/emergency departement.

I agree with SoldierNurse22, I think that it is normal that you feel guilty but it is also true that you can't be everywhere in the same moment.

Unfortunately those things happen, you has done all you can for avoid it but accident happens, therefore, in my opinion, you shouldn't blame yourself.

PS: sorry for my english, i'm italian and i try to learn it :)

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As the others have said, don't be so hard on yourself. It does not sound like you could have done anything to prevent it. Even if you were in the room she could have reached for something and fallen. My husband's grandmother broke her hip in her 80's while standing at the sink washing dishes. She had surgery, healed and went on to live many more very productive years. I work on a floor that receives post-op ortho pt.s and many hip fracture pt.s. While it can be the catalyst for an elderly person's demise, many do recover very well. The elderly are oftentimes tougher and willing to do the rehab more than younger folks. Point is, even if she does need surgery, it is possible she will do just fine. And when she returns, you'll be there to cheer her on and encourage her in her recovery. You sound like a wonderful, caring nurse.

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Specializes in Med-Surg.

I just wanted to say that you aren't alone. Many of us have had a totally ambulatory low fall risk patient unexpectedly fall...

This was not a fall risk patient and you rounded appropriately. I can't think of anything that you could have done differently. She was an ambulatory independent person so applying a bed alarm would not be appropriate. PT had even evaluated her.

Even knowing that, it still sucks to know a patient fell and sustained a serious injury on your shift. As a nurse I have a hard time letting go of the guilt and anxiety.

Just a story... I worked LTC and we had a "walkie talkie" resident fall one night. She was found in the morning, head lacerated, dried blood everywhere, dead. She had hit her head on her dresser when she fell. I was not there but I did assist in packing up hr belongings the next day. I will never forget cleaning off the blood that was crusted on her glasses...

Since she was independent no one checked on her all night. Staff should have rounded of her, no doubt, but no one got in trouble over it.

You rounded on your patient and did everything that was appropriate.

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Thank you, Karou. Sounds like a very difficult time experience with the pt, as well and the LTC. I go back tomorrow and I feel better about facing my pt and another day at work.

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Specializes in PACU, pre/postoperative, ortho.

Pt falls suck! I've only had a couple but the first one really shook me up for a while.

It was my second week on nights, early in the shift & I entered a room to find my fresh c-spine post-op on the floor near the doorway. Blood everywhere! Looked like a horror movie with blood on the bed rails, floor, wall...all from the IV. JP drain & foley intact somehow. No injury, but that room was such a mess, it was easier to move the pt to a clean room & have housekeeping go over the room completely.

I felt awful about it for days & was terrified I would find other pts on the floor. We didn't have bed alarms at that time but having them now help my peace of mind considerably (as long as everyone utilizes them)!

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Specializes in Care Coordination, MDS, med-surg, Peds.

I have been an RN for many years and when I went to a new hospital, still on orientation this happened:

I went to break!!! gosh darn me anyway!!!! AND while on said break, my A&O self amb LOL took herself to the bathroom. On the way back, she fell. Her collarbone was fractured as was her hip. I felt bad, but since I know that many times the hip fractures,THEN the fall occurs, there would have been nothing I could have done, even if I were right there. Except maybe hurt her and me both by trying to catch her!

Give yourself a break, move on and learn from this experience.

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Specializes in retired LTC.

Just to repeat all other posters - you were not at fault.

At my very first job, I had pt fall and I was beating myself up like you. My very wise supervisor told me "You can't sit on top of everyone to stop falls! Made a lot of sense then and now still.

You just do your best to be safe for them.

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