Submitted by alexandergunther t3_115ot75 in tifu

This happened 2 days ago.

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Background: I'm a registered nurse working toward my psych NP and I'm taking a break from school for multiple reasons. I just got a new job in homecare and landed a pretty sweet gig with this nice family who has a kid in a wheelchair, immobile and nonverbal with a seizure disorder. The idea is that I take the kid to school and help facilitate activities that are within his capabilities. He can move his arms around and has some basic ways of communicating, but it's essentially stuff you'd do with a baby (funny noises, putting blocks in a box, stuff like that). Both parents are also LPNs so they did a good job of teaching me how to take care of him. Like I said, pretty simple work for great pay, and I've been with them for about a month.

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We take the kid into the bathroom about every 2 hours to change him. He's a 2 person assist so the special ed teacher and I will both go in, get him on the changing table, clean him up, and get him back in the chair. Recently we've been letting him hang out on the table for a while to offload pressure, so we put a thick blanket underneath him to help make him more comfortable. Also important, this changing table is not exactly built for a kid his size. He barely fits on it, there are no guard rails, and it's right up against the wall, so it can be difficult to maneuver him on and off.

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Now the fuck up.

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The special ed teacher is out of the bathroom so I call for him. I place a Hoyer pad (basically a sheet with handles) underneath the kid and step a few feet away from the table for a few seconds to lock the wheelchair. When I look up, I see something that makes my heart drop instantly: This kid is midway through a fall, headfirst, directly into the hard bathroom floor. Everything goes in slow motion as I watch this completely immobile child bonk his head, and the rest of his body crumble after him. I run over to him: He's clearly in pain and my heart is pounding out of my chest. My one job is to take care of this kid and I fucking failed. I'm about to break down into tears but I hold it together and begin the process of checking for injury. No signs of bleeding or fractures, thank God. The only thing I notice while palpating him is a large lump on the top of his head where he hit. I look at the changing table and notice the culprit: The thick blanket he'd been laying on had slid away from the wall and toward the edge of the table. While I'm freaking out, the special ed instructor finally enters the room and I explain what happened as best I can. He tells me to calm down and that it looks like the kid is okay, but I know that I'm in for it. This kid's parents are understandably protective of him and they're not gonna be happy. Nonetheless, I do what I have to do and begrudgingly call the mom to tell her what happened. She sounds neutral over the phone and says she'll be right over.

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The teacher and I put the kid back into his chair and he's using body language to tell us he's in pain. I check his pupillary response for a concussion (no signs of one) and begin rubbing his head, thinking the pressure will help ease the pain. Mom and Dad both show up and begin asking questions (also Dad tells me to stop rubbing his head as it probably hurts, which makes me feel like an idiot). I answer as calmly as I can and they begin gathering the kid's and my belonging's to get him loaded into their handicap van and drive to the doctor. I take a walk of shame out with them and awkwardly drive back with them to their house, which thankfully wasn't far. Unfortunately, my coffee spilled while driving back and created yet another mess for them to clean. They drop me off and let me get my lunch out of their fridge (which I had forgotten to take with me to the school). They tell me to clock out and then they drive the kid to the doctor. I went shamefully to my car and cried while driving home.

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When I got there, I lied in bed for an hour, not moving at all, just hating the fact that my day wasn't even halfway over and I had been sent home for a mistake that could've been fatal and shouldn't have happened. Finally, I get up the nerve to call my brother (who's also a nurse) and explain what happened, and he told me that it's not a big deal, that the kid is probably fine, and that these things happen. It helped me feel better but I still felt terrible. Afterwards, I finished my paperwork for the day, called my work to explain what happened, and they also assured me that I did everything right and that I had nothing to worry about.

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I also received a notification from the family that the kid was okay: no broken bones, no concussion. Just a bruise on the head. Thank God. They also told me that they would keep me as their nurse "with caution" and not send the kid back to school until they improved the changing table situation. This told me that they had at least considered letting me go, which I suppose I can understand.

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The next day I receive a call from the dad, who wanted to ask about the day prior. He asked me specifics, like whether I had laid the kid too close to the edge, and exactly how he fell over. "Do you think he rolled?" he asked. "I mean he must have or something," I said. He replied, "Well, [Client] can't actually roll, so..." I won't get too far into how I read this, but suffice it to say I can feel he's suspicious of something. He then reveals that the kid now has a bruise on his right shoulder and we're uncertain of how that got there. They kept asking questions and all I could do was be honest: "I have no idea how that bruise could have gotten there." They had mentioned that they're just trying to get a consistent story and asked whether it had happened during the transfer from the floor back to the wheelchair, or if it had happened earlier in the day, and all I could say was, "I don't know."

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I still don't know how the bruise got onto his shoulder or why the dad tried to fake me out with asking whether the kid had rolled off the table. It was clear to all of us that the changing table situation was not optimal but we went ahead with it anyway, knowing full well that we were taking risks with it. I have taken full responsibility for the fall and even admitted that it's completely possible I placed him too close to the edge of the table. Additionally, someone should have been standing right beside him while he was on the table at all times, and even though I was only a few feet away, I was not close enough to stop him from falling. That's on me as his nurse. But I can't fight the feeling that they no longer trust me, and they've even stated they want to give me "additional training" within the home before sending me back to school with him.

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Anyway, I didn't think I would write this much, but the whole thing has me extremely anxious. I feel like I did my absolute best and I'm not being given the benefit of the doubt. I have no clue how that bruise got on his shoulder, and if I did I would be honest about it. I have to go back on Tuesday and I don't know how well I'm gonna do facing his parents again. I keep going over and over the situation in my head just blaming myself and wishing it hadn't happened. I guess I'm just writing this to try and vent since I can't get my mind off of it.

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Tl;dr, I'm the nurse in charge of an immobile child with a seizure disorder, kid fell off the changing table while I was only a few feet away, parents are very upset and questioning the situation while reluctantly keeping me as their nurse. Also I'm an anxious mess.

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Comments

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Safe_Fast_Hella t1_j92zygu wrote

The kid is ok, and the parents are understandably freaked out over the situation, I don't think they're trying to get you in trouble, or 'catch you out', they just want to make sure they understand everything that happened.

If you get anything from this, at least next time you'll make sure you stay close to every other patient and can campaign to install adult changing tables.

It sounds like a genuine accident, so try not to blame yourself

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alexandergunther OP t1_j930zd0 wrote

Yeah I know the parents' reaction is understandable. They're very protective of him and rightfully so; they have cameras in the house because of the horror stories they've heard of home nurses, including a friend of theirs whose kid was abused pretty badly by one. tbh I wish a camera had been on me at the time so that this situation would've been completely clear.

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I just can't get over that the dad asked me if the kid had rolled knowing full well the kid can't roll. That's what gets me. It seemed like a disingenuous question.

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Safe_Fast_Hella t1_j932jd0 wrote

Maybe the parents are trying to cover any base in case there is an investigation at the school, or if they need to know for insurance purposes (Not sure if that's relevant in your case)

From how you write it sounds like you genuinely care about the kid and were not negligent so I'm sure it'll be absolutely fine

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alexandergunther OP t1_j933zqf wrote

I care very deeply about this kid. I would've understood and moved on if the parents decided to drop me as their nurse; I would've never been able to live with myself if something serious had happened.

Maybe I'm reading into it too much. If they truly didn't trust me then they would've dropped me as their nurse. It's just gonna take some time to get past this I guess.

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Safe_Fast_Hella t1_j935qzk wrote

You've got this! Sounds like you've got the compassion to be an excellent nurse <3

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ladybirdstar02 t1_j92xfg4 wrote

Please don’t be so hard on yourself it was obviously an accident and you took full responsibility for it 💐🤗xx

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alexandergunther OP t1_j92zom7 wrote

Thank you, I'm trying to approach this rationally and constructively but I'm so fucking anxious about it.

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unknowngodess t1_j93ajum wrote

These situations always suck, even if it happens with a mobile child.

When a traumatic event happens in front of you; your brain will continue to process it, in wierd ways sometimes.

It is possible that his shoulder also took some of the impact. Unless he made contact with anything else, such as the foot rest of his wheelchair; that would be my assumption. Simple physics.

Even if he hits the top of his head; there's going to be impact bruises on where the body took the hit too.

It is unfortunate that you were left alone with him in a vulnerable place. I will remind you that even swinging arms will cause some movement to the upper body. Place the body on a ledge and then momentum can take over.

I'm sorry that you have to go through this. It sounds like you do really care about the well being of this child and did the best you could.

You generally apply a ice pack or cold compress to bumps in order to minimize swelling. Rubbing is not recommended as that would definitely increase the blood flow to the bump.

Note: bumps and bruises are a normal part of childhood. The parents know that.

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alexandergunther OP t1_j93bflw wrote

The angle at which he fell is what's causing the confusion as to where the bruise came from. He was on his back with his left side closest to the floor, and from what I recall he hit the top of his head, came down onto the floor, and ended up facing about the same direction he was when he was lying down, meaning his right shoulder shouldn't have made contact. We simply don't have an answer for why it's there and that's what's causing them distress.

I know this ultimately isn't as big a deal as I'm making it out in my head but I just feel embarrassed and ashamed. It'll take some time to get over it. Thank you.

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ProzacTheGiggleFairy t1_j99542p wrote

I have been reading your post and it reminds me of an incident that happened with my own son who has severe cerebral palsy when he was 5 years old. He had recently been supplied with a specialist sleep system for his bed to keep him supported properly as he is immobile too but the sleep system was too big for the wooden surround of his cabin bed to fit back on, so we left it off.

One morning we heard a thud & a scream which was him falling head first off a 4ft high bed onto the floor. He has strong muscle spasms in his legs, which allowed him to push himself to the edge of the bed and when he fell he could not put his arms out to save himself. We rushed him to the hospital where they x-rayed him and thankfully there were no fractures but he had concussion.

We managed to get the wooden surround put back on the bed temporarily until a hospital bed was supplied for him. He still has a visible bump on his forehead where he hit and he shows signs of PTSD from it. He is now 23 years old and with (slightly) limited speech he will talk about it.

OP - Try not to be too hard on yourself over this, as there were other factors that were in play at time of the incident when the child you look after was injured. The changing table was too small, there was no side safety rail, no safety straps and there was supposed to be two members of staff with the child at the time.

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tennis1618 t1_j94az6k wrote

Please don’t beat yourself up about it too much. Obviously it’s understandable you feel bad about what happened but it was a genuine accident and the kid is fine so that’s all that matters at the end of the day. You can’t control how the parents feel so I wouldn’t obsess over what they’re thinking because that will drive you nuts.

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suprdafastboii775 t1_j9416mx wrote

it's not your fault.

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edit: it's very very long

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edit again: took me like ten minutes to read it

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