Patient Assisted to Floor During Ambulation: Aides Not Negligent, Court Rules
Legal Eagle Eye Newsletter for the Nursing Profession
Quick Summary: The aide followed standard procedure by leaning the patient against her chest and allowing him to slide down her leg in a gentle manner to the floor, when the patient said he felt faint.
The physician’s orders to ambulate the patient were appropriately carried out by two aides, as it was Sunday and no physical therapists were on duty. The two aides had twenty-six years experience between them.
The patient was walked down to the nurses’ station and back up the hall, with one aide holding him on each side.
Back in the room he was told to hold on to the wall, while one aide still held him and the other made his bed.
The nurse was summoned immediately. She found the patient on the floor with the aide cradling his head.
The nurse took his vital signs, asked him if he was all right and assessed him for external signs of injury before the three of them put him in bed.
The nurse immediately summoned the physician, who ordered x-rays. There was no indication the position of the bone graft had slipped.
COURT OF APPEAL OF LOUISIANA, 1998.
The Court of Appeal of Louisiana recently upheld a jury’s finding that two hospital aides followed the applicable legal standard of care and were not negligent in how they dealt with a patient who became light-headed during ambulation.
Before the incident in question the patient was admitted to the hospital for a lower-back diskectomy and spinal fusion. The procedure had to be repeated fifteen hours later because the physicians detected slippage of the bone graft material used in the surgery causing nerve impingement.
Two days after the second procedure the orthopedist ordered ambulation, which was done twice the same day by two physical therapists without incident. The next day two aides ambulated the patient. Before getting him back in bed he became light-headed and had to be assisted to the floor.
Two days later he was discharged from the hospital. Eight days after discharge he came back to the emergency room with extreme back pain, but x-rays were negative for slippage of the bone graft. He continued to complain of back pain but no further surgeries were done.
The court ruled this same technique of assisting a patient to the floor during ambulation is what is widely taught to licensed and non-licensed nursing personnel and is a proper method for safely handling a patient who is about to fall. The court noted it was fully documented in the nurse’s charting that this method had been used, apparently successfully in avoiding injury to the patient.
The court accepted the testimony of the nurse on duty as a witness on the facts of the incident and as an expert witness on nursing standards. Her testimony was buttressed by the testimony of an orthopedist who had sat on the medical review panel, that the standard of care for nursing care of post-surgical orthopedic patients had not been breached. Hunter v. Medical Center, 718 So. 2d 636 (La. App., 1998).