Free Fallin'

The rule on my floor is 7 pm, the bed alarms come on. Falling is a big deal on our floor. We have a lot of confused and/or unsteady people. When the alarms are on and someone tries to make a break for it without calling – a loud, annoying bell goes off and, at night, it is usually followed by the sound of running down the hall as we try to stop the offender before anything bad happens.

Don’t get me wrong – we let people get out of bed. We just want to be with them when they do so. Falls are also tracked closely by the hospital. We get all sorts of reports about which units have had falls, how long you have been without a fall, etc. Our unit tends to be on the upper end on falls for the hospital but, in our defense, I don’t think it is so much a lack of diligence but a higher percentage of confused patients.

All this to say…I had my first patient fall this weekend. It was awful. Really awful. The patient is okay – honestly it didn’t seem to impact him at all. Four days later, I still feel sick about it and can’t quite shake it. I didn’t peg him for confused. He was alert and oriented just very, very weak. He couldn’t physically get out of bed on his own and he assured me he would call first and not try. He didn’t. And that trusty bed alarm…it didn’t go off either. I am not quite sure what happened on that end. I know I turned it on when he arrived on the floor but when he fell, it wasn’t on. Maybe in repositioning him in the night I turned it off and didn’t put it back on…I just know it didn’t make it’s awful, annoying sound. I may not have gotten to him in time anyhow but I would have liked the chance. I was always neurotic about checking the alarms before and since the fall I am borderline OCD about it.

My coworkers are amazing. They were all in the room helping within minutes. Together we got the patient back to bed and checked him out. He was in the same shape as he had been before the fall. They all assured me that it was okay – that I am not a terrible nurse and those things happen. I love the team I work with at night. My charge nurse was amazing. In the interest of privacy and in honor of the Olympic Trials, we will call her Lolo. I don’t know if she can hurdle but I have seen her running down the halls...and she is fast. Lolo was my preceptor when I started. She is kind, thorough and encouraging. The night my patient fell, she made sure the patient was okay and then helped me through the whole process. She totally had my back. 

I have realized over the past several months that despite the best of intentions, bad things are going to happen. Being a nurse doesn’t mean making everyone well. Really, I don’t make anyone well. I am just with them on their journey and sometimes the journey involves healing and living more independently. But, sometimes, the journey means going home on hospice or taking a turn for the worse before things get better. Hard lesson. Just like I want all my patients to like me (hasn’t happened yet), I want them to all get better. The realization that I can’t make that happen is a bummer but I think the hard stuff – like the dreadful fall – will make me a better nurse in the end. When I can embrace doing my best and walking with them instead of being frustrated at what doesn’t go right, I can be more present. I think it is going to take awhile.

I went back to work the next night. The patient seemed the same but had been moved to really low bed. My floor wasn’t that busy so they floated me to a surgical floor. The patients I was assigned weren’t confused at all and they don’t have the same rule of bed alarms at night on this floor. It was VERY hard not to bed alarm them anyway. I am sure they would have thought I was crazy if they had been walking around their entire hospital stay and then this new nurse comes and demands they all be on super sensitive bed alarms. Through gritted teeth I resisted the urge and decided not to inflict my own neuroses on them. But, when I get back to my own floor tomorrow night, I am wearing my running shoes.