When a patient falls, a CNA should assess for injuries and report the incident to the nurse

When a CNA witnesses a fall, the moment can feel heavy. Your first reaction sets the tone for safety, recovery, and the person’s trust in you. So, what should you do? In most settings, the right move is straightforward: assess the patient for injuries and report the incident to a nurse. It sounds simple, but there are important steps and reasons behind this approach. Let me walk you through them so you feel confident when the unexpected happens.

Why this order matters

If you rush to stand the person up or brush off the fall, you risk hiding injuries that aren’t obvious at first glance. Some problems aren’t visible right away—like fractures, concussions, or internal injuries. A quick, calm assessment helps you spot red flags before they become bigger problems. And letting a nurse take the lead on the next steps ensures the patient gets a formal evaluation, as well as proper documentation so everyone involved knows what happened and what to do next. In other words, you’re protecting the person’s safety and the care team’s ability to respond correctly.

What to do first, exactly

1. Stay calm and communicate

• Speak in a soothing, confident voice. Reassure the patient that you’re there to help.

• Check for responsiveness. If they’re awake, ask how they feel and where it hurts. If they’re not fully alert, use your best judgment about how to proceed and alert the nurse immediately.

2. Do not rush to stand them up

• A common instinct is to help someone back on their feet right away. That instinct can backfire. Moving a person who may have a hidden injury can worsen damage.

• Instead, pause and observe. If the patient needs to be moved for safety (for example, to clear a walkway or to reach a chair), wait for nursing staff guidance before any movement.

3. Assess for injuries and symptoms

• Look for obvious injuries: bruising, bleeding, deformities, or an inability to move a limb.

• Check for less obvious signs: dizziness, severe headache, confusion, neck or back pain, or loss of sensation.

• Note changes in skin color, temperature, or swelling. If you suspect a head, neck, or spine issue, treat the situation with extra caution and escalate immediately.

4. Keep the patient comfortable and safe

• If the patient is on the floor, help them to a comfortable position that doesn’t cause more pain. Do not try to straighten joints forcibly.

• If they’re in a chair or bed, keep them there unless you’re instructed otherwise by a nurse.

• Encourage them to stay still and avoid activities that could aggravate injuries.

5. Call for the nurse or supervisor

• This is your pivotal step. Notify the nurse in charge as soon as you’ve done the initial assessment.

• Provide a concise, factual report: approximate time of the fall, what you observed, the patient’s current condition, any injuries you noted, and any actions you’ve taken.

• If the facility uses an incident report or electronic health record prompt, document the event promptly and accurately. This isn’t about blame—it's about continuity of care and safety.

How to document and report like a pro

• Time matters. Record the exact time of the fall and when you alerted the nurse. If you saw or heard something that might have contributed to the fall (like a slippery floor or a wet rug), note it too.

• What you observed. Jot down the patient’s mood, level of consciousness, complaints of pain, and any changes in movement or sensation. Use neutral language and avoid speculation.

• Actions taken. Describe what you did to keep the patient safe, what you checked, and what you advised them to do or not do.

• Follow facility policy. Each place will have its own form for incident reporting and a set of steps to ensure patient safety going forward.

What not to do after a fall

• Don’t move the patient without guidance from a nurse, unless there’s an immediate hazard that requires action.

• Don’t ignore the incident or assume the patient is fine just because they say they feel okay. Pain and internal injuries may develop later.

• Don’t delay reporting to a nurse or supervisor. Timely notification is essential for proper assessment and treatment.

A quick checklist you can keep handy

• Check for responsiveness and airway/breathing.

• Look for visible injuries and any signs of pain or swelling.

• Keep the patient still and comfortable.

• Call the nurse or supervisor right away with a concise report.

• Document the incident and the patient’s status accurately.

• Monitor the patient for any changes and be ready to assist as directed.

What this looks like in Alabama care settings

Alabama’s health care environments—whether a hospital, a long-term care facility, or in-home care—put a premium on patient safety, clear communication, and thorough documentation. Falls are a common risk in many settings, especially for residents with limited mobility or cognitive challenges. The standard approach is universal: assess, report, and document. In practice, this means you’ll be part of a coordinated team effort where the nurse leads the medical evaluation, while you provide the initial assessment, comfort, and safety measures.

You’ll also see fall-prevention strategies woven into daily routines. Before a resident gets out of bed, you may see bed alarms, non-slip footwear, clutter-free pathways, and proper lighting. After a fall, you’ll likely be involved in a quick review of what happened and how to modify the environment to reduce future risks. This is where your eyes for safety and your quick, calm communication become valuable, not just to the patient in the moment, but to the broader care plan that follows.

A practical mindset for real-life care

Think of a fall as a prompt to practice mindfulness and teamwork. You’re not only guarding physical safety—you’re supporting emotional well-being too. A resident who’s just fallen might feel frightened, embarrassed, or unsettled. A few reassuring words, keeping them informed about what you’re doing next, and ensuring their comfort can ease anxiety in addition to addressing physical concerns.

If you ever worry about whether a fall was “serious enough” to report, remember this rule of thumb: when in doubt, notify the nurse. It’s better to err on the side of caution. You’ll be thanked for your vigilance, and the patient will benefit from a prompt, professional assessment.

A brief digression that still points back to safety

You know how a simple safety habit can prevent injuries? It’s the same idea here. Slipping hazards, uneven flooring, or equipment left in walkways—these little culprits add up. In Alabama care settings, as in many places, staff education emphasizes recognizing risk factors: poor lighting, clutter, wet floors, and insufficient assistive devices. By reporting a fall quickly and documenting it clearly, you close the loop on prevention and care. It’s a small action with a big impact on someone’s day, week, or even life.

A comforting, realistic takeaway

If you’re walking into a patient’s room and you see a fall has occurred, you’re not just a helper in the moment—you’re a crucial link in the chain of care. Your observational skills, your calm demeanor, and your commitment to following the proper channels make a real difference. The right sequence—assess, report to the nurse, document, and monitor—helps ensure prompt medical review, appropriate treatment, and a safer environment for everyone else who uses the space.

In closing

Falls happen, and that’s a fact of healthcare life. But the way you respond matters a lot. By focusing on a structured, safety-first approach, you protect the resident’s health and reinforce the trust that’s essential in caregiving. The key steps are simple:

• Assess for injuries and possible hidden problems.

• Report to the nurse promptly and clearly.

• Document accurately and follow up with careful observation.

• Keep the person safe, comfortable, and informed.

If you ever find yourself in a fall situation, remember: you’re not alone. The nurse and the broader team are there to guide the next steps, and your careful actions pave the way for the best possible outcome. That steady, patient-centered mindset—that’s what makes care real, practical, and deeply human. And in the end, that’s what truly matters to the people you’re helping.

If you’d like, I can tailor this toward a specific setting you’re working in—hospital, skilled-nursing facility, or home health—and add some local resources in Alabama that might be useful for daily practice.