The continuing saga...I went to the UM this morning

[night owl]

Asked if I could speak to her in her office because I had something I had to get off my mind. Told her the whole story and she says, "Yes I know,------- told me yesterday afternoon at 3:30 when she came in. She came in the door and then came right to me." (She was the nurse who called the doc, but failed to tell him the part about finding the resident on the floor and falsified the nurses note and the 24 hour report note) I'm thinking the other nurse whom I questioned about why she didn't make out an incident report and why no one told the doc he was found on the floor next to his bed, probably called----- at home and told her I was questioning her. I had the incident report all made out, but didn't give it to her since ------ told her about it already. The UM said, "The doctor is aware of the alleged fall and examined him and found no injuries. It's too late to make out a report because it has to be done within 48 hours of the incident." (I don't understand the reasoning behind that. Anything to do with injuries that may occur within that time frame?) She also said, "Thank God he didn't sustain any injuries, but I'm going to have to talk to these two about documentation whenever an incident occurs." I said, "Don't forget to tell them about 'telling the truth' in their documentation also and that falsifying reports could cause them to lose their license." And she said,"Oh don't worry, I will! And had he sustained any injuries from this alleged fall, they'd certainly be praying hard today because I would have presented this to the Board of Nursing!" I asked, "why do we attract these people?" She said I wish I knew so that we could fix it!" I said, "well don't worry, I'm sure we're not the only place that has them."

So there you have it. The charge nurse fessed up, but I didn't know it and went to the UM anyway. When I went in to work last night, I expected to see ------ to ask her about this whole thing, but guess what? She left early...naturally...I am relieved that she told the UM herself, because I really didn't want to be placed in the middle of it all. But I think the outcome should have been handled alittle more severely. I don't know, maybe it was and she just didn't tell me. I wonder though. Had I not questioned the nurse that found him and asked her why she didn't initiate an incident report and why the doc wasn't informed that he was found on the floor, I just wonder if the truth would have been revealed by -------. Maybe my questioning was all I really had to do to get ------ motivated to speak up. I don't know. But you better believe that the next time I witness something like this, I will initiate my own incident report and state the facts as I saw them.

Thank you so much for all your feedback everyone. You don't know how much I appreciated it and how much encouragement you gave me to go to my UM even though I really didn't have to in the end. You guys and gals are the greatest! This is why I can't stay away from here even if I tried to. Hugs to you all....and may God bless...

[P_RN, ADN, RN]

Not fill out a report after 48 hours? That's idiotic. It may not be timely but it is valuable information for the risk manager and may just avoid a lawsuit. Will the NM follow through? Our NM's very sly about SAYING stuff like that but then just adding to the gossip mill. Don't let this turn around and bite you on the butt.

[geekgolightly, BSN, RN]

I'm proud of you and hope to be like you when I become a nurse.

[mattsmom81]

Facilities can be very sly in dodging their risks. Tough situation you found yourself in...glad you came through intact. :)

[gwenith, BSN, RN]

Don't throw away that incident report. Take it home with you and if you already have discarded it write up your account now. This is about protecting your own backside. Of course you could always e-mail this thread to yourself. It should stand up in court as it has a time and date showing that you posted soon after th e incident.

Remember a record of what happened does not have to be a "legal document" on special paper nor does it have to be unemotional or written in the third person. It has to be your words written as soon as possible after the incident.

[night owl]

Thanks for the tip Gwenith. I've already struck it in my folder marked "For future reference hopefully not." One never knows....

[atownsendrn]

Proud of you night owl. Hope you never find yourself in that position again!!

[kids]

I missed your original post but am gathering that a patient had a fall and not one but 2 co-workers lied/concealed/omitted the fact it had happened. From your UM's response all I can say is WOW...I know why your facility attracts these kind of people...because this kind of thing is tolerated. I have never worked anywhere that if that situation happened that the person/people would have still had jobs AND the BON would have been notified.

[krispynurse]

Way to go Night Owl....and keeping the incident report is a very good idea. Remember always CYA cause noone else is.

[Huq]

All such good advice.

I cannot agree more that keeping a record is essential today in our profession

I keep a folder and document anything that is out of the norm. Hopefully I will never need it, but one never knows.

[night owl]

You're not going to believe this. Last evening the same resident dove for the floor not once, but TWICE! Incident reports made out, doc notified and examined him. No injuries. Unbelievable. Well now they have wrist restraints on him. Won't put him in a low bed due to the fact that when he was in psych, he was a chronic "floor diver." If he was walking by you, he'd dive on the floor in front of you so that you'd trip over him, AND he would dive OOB at least once a night. Placed him in an enclosed bed and he tore the netting and dove through the hole! He'd probably spend his life on the floor once he's in a low bed. He's assaultive and will kick and punch you in a second especially when you're doing his care. Now he has a trach and a GT. The mitts he wears are to prevent him from pulling out his trach tube and GT... he did it twice one night for me. He's such a bad boy that I swear he's possessed and actually needs an exorcism! He's a real problem child to say the least. Maybe mitts and an enclosed bed would work for him now. I don't know, but we sure have our hands full with him.

[Nurse Ratched, RN]

My goodness, nightowl - sounds like a repeat trip to the psych ward is the cure for him - we didn't fix him the first time! :)

If he's going to dive for the floor anyway, doesn't mgt want him to have a low bed so he doesn't hurt himself?

BTW - good work on bringing the situation to light. You can never go wrong when your first motivation is advocating for the patient :).