My patient fell, am I gonna get in trouble

  1. So I'm working at the LTC and I only had 2 days of training. And yesterday is my 1st day working as a CNA, on-call. I work from 3-11pm caring for 19 pts. I supposed to work morning-shift but yesterday it happened to be afternoon- shift, ratio is 1:19, 3 cna at each station. Morning shift ratio is 1:8, 5 cna at each station. Again yesterday is my 1st day working and and patient fell when she tried to get out of bed to get her slipper. I didnt even know this event happened til later the nurse informed me about it and said that the pt is ok, no injury. Then the nurse did the incident report about this fall and asked me to wrote down my name and signature. When my pt fell I was busy caring for my other pts. I felt so guilty when I heard that my pt fell even though the pt dont get hurt or anything. By the way this pt can do some walking w/ the assistance of the walker but she mainly sit in her w/c to get around.

    My question is, am I gonna get fire or in trouble about this? What happen to that incident report now, are they gonna send it to the state or the higher up to go against me? I'm so worry and upset all night about this thing, plz let me know am I gonna get in trouble about this...
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  2. 11 Comments

  3. by   cloudstrife1ph
    incident report is just part of a protocol. it is needed to have a written data on what happened and to inform it to the people involve to the patient's care for them to know what interventions to do to prevent it from repeating next time...

    you're not in trouble since the patient is still somewhat ambulatory and the pt. didn't ask for your assistance...
  4. by   tavia_yeung
    Thanks so much cloudstrife1ph for the reply. I feel so relieve now after reading your post. Thanks god that my pt is not getting hurt and also that I'm not gonna get in trouble b/c of this fell.
  5. by   tavia_yeung
    QUESTION:

    Let's say if my pt doesnt ask for my assistance and they get up and fall and get hurt badly so in this case am I responsible for this fall, am I get in trouble for this or not? In my original post my pt doesn't get hurt but what happen if next time the pt get hurt for not asking for my assistance. So this time am I still dont get in trouble, b/c the pt doesnt wanna ask for help.

    I'm wondering all about this b/c I had another pt that refuse to let me help them change brief, ect b/c I guess they're embarrassing and they think they can do by themselves. This pt can moving around w/ a walker but a little weak. This pt is the spouse of the pt that fell which I mentioned in my original post, they're roommate.
    Last edit by tavia_yeung on May 3, '10
  6. by   cloudstrife1ph
    Re: My patient fell, am I gonna get in trouble
    remember the patient rights. the patient have the right to refuse any treatment or assistance as long as his/her decision making isn't impaired.

    the patient refused any help and you should respect that. anything that happens to the patient for declining an offered assistance is already the patient's fault. you offered help to do something but the patient doesn't want you do to it, he/she is liable for themselves...

    what will save you in this situation is that that patient is ASSIGNED to you and you tried to do your job by offering help. just don't forget to inform your supervisor about the refusal asap to protect you if something bad happen about the patient's refusal...
  7. by   CoffeemateCNA
    You've gotten good advice so far.

    The only time I can think of that you would ever get in trouble for a fall is if you hadn't put the appropriate safety measures in place. For instance, call light within reach, siderails up (if applicable), fall mat at bedside, personal alarm turned on and in place, etc. You would have to do something pretty bad to get fired -- ie, if you were transferring a Hoyer lift by yourself and the person fell. The worst I have ever seen for a regular fall is a write-up (and this doesn't usually happen).

    Don't feel bad. We can't be everywhere at the same time. Falls happen (even though we don't want them to). The only way your management would be 100% successful at preventing ALL falls is to implement a 1:1 staffing ratio. I don't know about you, but I don't foresee that happening.

    Make sure you read any paperwork that you sign. Incident reports are always done. At my facility, the nurse even has the CNA write a short narrative describing what happened or what you saw. Incident reports are just used to cover the facility's behind and to help find measures that can be put in place to help prevent such falls in the future.
  8. by   tavia_yeung
    Thank you very much cloudstrife1ph and coffeemateCNA for the great advices.
    Quote from cloudstrife1ph
    just don't forget to inform your supervisor about the refusal asap to protect you if something bad happen about the patient's refusal...

    Thank you for reminding me about this b/c I forgot to inform the higher-up or nurse about the pt refusal, but next time I would remember to do so to protect myself from getting blame on for the fall.

    Quote from CoffeemateCNA
    Make sure you read any paperwork that you sign.
    Thank you for reminding me about this b/c when the nurse gave it to me I just signed it and forgot to read it before sign any paper.
    Last edit by tavia_yeung on May 3, '10
  9. by   Heinz beans
    You should not get blamed for a fall. Incident reports are used for risk management and not to blame people. It allows the facility to improve the quality of care and prevent this in future. This could have happened to this lady anywhere at any time -don't blame yourself.
  10. by   rosey2007cna
    I would also recommend that you document the refusal in the CNA chart book as well. Make sure that you put the day and time that it happened.
  11. by   tavia_yeung
    Thank you Heinz beans & rosey2007cna for the replies as well.
  12. by   CalledtoCare
    Document, document, document! Just make sure and write on the incident report (if your Nurse has not already) what safety measures were in place at the time of the fall (ex. if the call light was with in reach, bed was in req. position, rails in position per care plan, ect...). This keeps you out of trouble and your facility. Which, if your facility isn't getting in trouble -that cuts your chances of getting in trouble by a lot!

    Basically the patients/residents have the right to fall. The only sure way of making sure a resident doesn't get up and get hurt is to restrain them, and we all know restraints should be used as only a last, last, LAST choice to maintain resident safety (and of course have to be ordered by a doc). You just do everything in your power to make a fall less likely.

    You will be fine, it sounds like you care and are concearned for their safety. Just do the best you can and know that accidents happen. These are people we are caring for with their own minds. We cant control everything they do, even if it is for their own good.
  13. by   Menders Heart
    So I'm sitting here watching Trustpoint Hospital in Murfreesboro TN go through some excellent chang not all that Glitters Is Gold here. It's being taken over by a Acadia. That's the golden side. It's going to be an awesome place when it's done

    Today I feel sorry for poor nurse who's got excellent rating reviews except for the last 3 weeks. This particular nurse has had three jumpers. People who get out of bed and fall. The first one managed to use a phone cord to undo the restraining tent. The second one had an NG tube and managed to walk across the room when the nurse went to escort them back they jerked away from her and fell to the floor. The third one was one that was not to have the alarm turned off but she managed to talk the CNA and the turning it off. The patient immediately left the bed and fell to the floor period even though the CNA had the patient explain to the nurse and own up to the patient asking to have it turned off and the CNA admitting to it the CNA was not reprimanded or given a day off now the nurse is on administrative leave facing termination period She is a newer nurse that I believe has been here approximately a year This nurse is held responsible for all three occurrences and is facing termination today. So Acadia is using this hospital as to be quote their Flagship Hospital unquote.
    So all-in-all to make this Hospital look gold you're going about it the wrong way and not handling things correctly this nurse is an excellent nurse who still need some more grooming but they're throwing her to the wolves and kicking her out the door only to start over and repeat the cycle again. It's true I'm feeling some animosity towards the hospital and their policies over proper training of a Night Nurse to Acadia yes it's more about the share holders paper to compete with Saint Thomas Hospital across the road. Yes it's true the pay here and the differentials for night and weekend are excellent in contrast to the other hospitals around. But if you're willing to take higher pay here, you may be at greater risk to jeopardize your accreditation and your license so take a lesser paying job with more training . I wish this nurse good luck and prayers are with her and her family. The Nurses Union is about to come full play in Tennessee , but not soon enough. Fire at will as abused here in Tennessee all too often.
    Last edit by Menders Heart on Mar 7

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