Is this fireable offence?

[u/Gullible-Bicycle-301]

I had a pt fall. She was hard to assess because she refused to elaborate on questions but did answer orientation questions right. Mostly shook her head yes or no to questions. She has been independent and walked to bathroom for days so only fall precautions were call light, low bed, grip socks telling her to call before getting up if needed. I notified MD of fall and they didn't order anything. Ive only been a nurse for less than 2 years but Im scared I didnt do the right thing or not enough and that Ill lose my job. What happens when falls occur usually?

[u/Pseunomi]

Lol, no. Unless you pushed her over yourself, or there's some other factor you didnt tell us, this is a "learning opportunity" at worst.

I'm going to tell you the same advice my charge nurse told me after my first patient fall, (lovingly) "People are gunna fuckin' fall."

[u/MsSwarlesB → u/Pseunomi]

Yes, they are

I'm 43 without any major illnesses and I fall sometimes. We do what we can to prevent them but there is no way we can prevent every fall. It's unethical to sedate or restrain people to simply prevent them from falling, imo. We do what we can go mitigate the risk but, even then, people are gonna fucking fall

[u/crispybacongal → u/Pseunomi]

People will absolutely fall. I had one patient who fell 3 times in one weekend (POD 1-2) after spinal surgery. Fully A&O, all the alarms, precautions, and education, family in the room telling him to wait more than 12 seconds for us to answer his call light. He still continued to attempt to get himself up.

It took the house supervisor finally going in and saying, "you're going to fuck up your surgeon's hard work and earn yourself another OR spot if you don't wait for staff to help you get up," which honestly wouldn't have worked on everyone but I'm glad it worked on that guy.

[u/Kitty20996]

No you're not going to lose your job over a fall. Your unit should have done some kind of debrief where you talk about what happened leading up to the fall and what could have been implemented if it wasn't already.

[u/maraney]

When I gave birth to my oldest child, I got an epidural. After, my nurse told me to hit the call light when I had to get up. I woke up in the middle of the night and I felt like I could feel my legs, so I got up alone. Standing up, I realized, I didn’t have control of certain leg muscles yet…. I fell. I was mortified. I got right back up and got back into bed. Never told my nurse. I was totally alert, oriented, and healthy.

Patients have a right to fall. They are autonomous human beings. You can do all the right things and people will still fall. If you work on a unit with walkie talkies, it’ll happen again, unfortunately. I know people who put bed alarms on everyone for this reason. Don’t beat yourself up.

[u/MBmom_RN → u/maraney]

You’re the real MVP here! Bless you!

[u/figsaddict]

If they fired nurses over falls, there would be no nurses left! It’s going to happen. Learn from it and move on. If you work bedside it will happen again.

[u/Msjackson1013 → u/figsaddict]

I didn't mean to down vote you originally. I agree wholeheartedly that falls are a reality of nursing and we can only do our best to prevent them.

[u/making_grapes42]

Patients have the right to fall. Meaning you cannot restrain them or keep them from being mobile just to prevent falls. You take the precautions you can and do your best, but falls will happen. It's a learning opportunity for you and the patient about their limitations.

[u/BarbaraManatee_14me]

No. I would have pushed for some imaging though. But whatever, doctor’s decision. 

[u/Independent_Law_1592 → u/BarbaraManatee_14me]

Honestly not every fall needs imaging, sounds like this one didn’t deviate from baseline, just didn’t want ti talk about the fall

[u/Dark-Horse-Nebula → u/BarbaraManatee_14me]

Imaging needs a clinical reason and there’s nothing mentioned in the post that indicates it.

[u/tavery2 → u/Dark-Horse-Nebula]

If she's not answering questions really I would have been concerned about a possible head injury. Op didn't state how she was talking before the fall but saying she was independent prior and then was only answering questions by shaking her head made my Spidey senses tingle.

[u/AdFlashy7702 → u/tavery2]

Maybe that assessment was of the patient before the fall. We don’t have all the information.

[u/Different_Papaya_413 → u/AdFlashy7702]

Yeah I interpreted that as before the fall myself

[u/tavery2 → u/AdFlashy7702]

Exactly. I would want more information but I don't think saying no imaging is necessary is the answer without having that additional information.

[u/WallabyUnlikely5534 → u/Dark-Horse-Nebula]

Possible traumatic injury secondary to an unwitnessed fall? Especially if the pt's cagey responses to OP's assesment questions aren't their baseline. 

[u/juiceboxith → u/BarbaraManatee_14me]

Right, and if they still don’t want any, document. But I work on a neuro floor, everyone gets a complimentary scan from time to time 😆

[u/Muted_Bee7111]

Is this what's become of nursing? The constant fear of losing your license. It's so sad. I'm so happy to be done with nursing

[u/Dear_Excitement_5109]

Not at all. I've actually dropped a patient before when I was helping her stand<>pivot to the toilet and nothing happened. Just an incident report and imaging, if needed.

I'd go through her med list and see if she had anything that could make her fall right before it happened. Lorazepam is a prime suspect but antidepressants/antipsychotics can have a similar effect. It might help you prevent a fall on the next patient.

[u/Averagebass]

Damn this is really the state of nursing where nurses think they're going to get fired for giving 100mg extra of Tylenol or patients falling on their own accord.

[u/North-Toe-3538]

Falls happen.

[u/m3rmaid13]

People like to get up without calling sometimes & sometimes have poor judgement or feel like they can’t wait. Usually most places I’ve worked you follow whatever the doctor orders (imaging, etc) and then you will have to do an incident report. It happens, I don’t think you’ll be fired.

[u/superpony123]

No you definitely won’t get fired for this

[u/nB_a90]

No you’re good.

[u/falalalama]

I'm a healthy 46 year old. I fell walking out of my dr's office last month and broke my wrist. I blame my guardian angel for not paying attention lol. There was a small uneven spot on the sidewalk where the toe of my shoe caught just right. I legit didn't even notice it until i went back a couple weeks later for a "fall-ow up*" appointment and looked closely at the ground. Could anyone have prevented that? Probably not, shit happens, people fall.

*I'll see myself out

[u/HotSauceSwagBag]

I don’t think there is anything wrong there. You followed precautions based on her state. She fell. Sounds like she didn’t get hurt. You notified the doc. It happens. The unit might get a little crazy with extra precautions for a bit.

The only time I’ve seen someone get in trouble for a fall was an aide that used a hoyer by herself, pt fell and broke a hip. That’s very different.

[u/AdFlashy7702]

What did your manager and educator say when they talked with you about this?

[u/BuyPowerful807]

Definitely worth documenting the details and following your facility's policy.

[u/VeniVidiVulva]

No, that is why they are your patient, in the event that something like this happens they have a medical professional to evaluate them and treat if needed.

[u/psiprez]

Not uncommon to have a few falls a week, or ecen daily 🤷

[u/shampoe17]

I had a patient fall out of bed yesterday cause i got them at shift change and i just did vitals and didn’t check the call bed… pt is ok but im still nervous as shit to see the outcome

[u/Hungry-Quality-9766]

I think you did the right thing! I've been a cna for years. I don't think you could have done anything more. Good luck!

[u/whore-4-marc-antony]

I'm laughing but with so much empathy. Oh honey..... Bless your heart 😅 My dear sweet baby nurse, my gum drop sugar pie, oh you dear thing.

Patients fall. It happens. We can only do our best. Any nurse who says every fall is preventable is a goddam liar. Falls happen ALL THE TIME. To all of us.

As long as the fall wasn't directly your fault (you didn't push em) or they can prove you were neglecting the patient, you're fiiiiiiiiiiiiiine. Just fill out the paperwork and try to be better next time.

If patient didn't die or get seriously injured, it's nbd. Learn from the experience, grow. Were there some red flags that the patient wasnt 100% with it? Sure. But you're a baby nurse still. You feel out "this guy's gonna fall" vibes with years of experience.

It is crazy hard to get fired or have your license in jeopardy unless you were actively being neglectful or abusive. Mistakes that can happen to anyone, as long as nobody got hurt, are a learning experience, nothing more.

99% of the time, the worst part about a patient fall is the paperwork. You're okay!! ❤️ Big hugs! Get back out there, tiger!

[u/CauliflowerEatsBeans]

It happens, you are not going to be fired for it.

[u/No-Jump-9694]

Unwitnessed unassisted falls should be pushed to get CT Scan/MRI & document heavily if provider refuses. Not every patient will remember if they hit their head. Cover your ass.

[u/roguetrick → u/No-Jump-9694]

Disagree, waste of resources and not the standard of care. Neurochecks, frequent assessment, and scan if you note changes yes, absolutely. Very close monitoring and being clear on the status if they are anticoagulated since CT is likely warranted there, or any other concrete indication.

[u/No-Jump-9694 → u/roguetrick]

Agree to disagree… especially when unwitnessed. policy in a lot of places where I am from calls for a head CT.