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Am i potentially liable for this incident?

Nurses   (1,771 Views 14 Comments)
by NooNieNursie NooNieNursie (Member)

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Been there,done that has 33 years experience as a ASN, RN.

6,203 Posts; 68,900 Profile Views

If you had sent the patient to the ER, the ER physician would have ordered the head CT. The patient had a hematoma already. I don't know why you are relying on the Neuro assessment so much. A lot of times, those changes are late changes, meaning the damage is done. And to be perfectly honest, I don't expects you guys in LTC to be Neuro experts and pick up subtle changes.

My last terminal wean was a guy who fell, hit his head, thought he was fine. Took a nap, friends found him covered in vomit hours later. He was done at that point. The bleed was too massive.

Neuro is tricky and unpredictable. Take it from me. You are worrying too much about liability instead of the fact this pt should have been sent your the ER.

Like I said before, call your malpractice carrier.

a guy who fell, hit his head, thought he was fine. Took a nap, friends found him covered in vomit hours later. He was done at that point. The bleed was too massive.

Neuro is tricky and unpredictable.

Exactly. There is NO TIME to wait. We have been taught that a patient with a suspected concussion needs immediate studies. OP did not follow prudent nursing action.

Screw protocol.

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91 Posts; 1,945 Profile Views

If you had sent the patient to the ER, the ER physician would have ordered the head CT. The patient had a hematoma already. I don't know why you are relying on the Neuro assessment so much. A lot of times, those changes are late changes, meaning the damage is done. And to be perfectly honest, I don't expects you guys in LTC to be Neuro experts and pick up subtle changes.

My last terminal wean was a guy who fell, hit his head, thought he was fine. Took a nap, friends found him covered in vomit hours later. He was done at that point. The bleed was too massive.

Neuro is tricky and unpredictable. Take it from me. You are worrying too much about liability instead of the fact this pt should have been sent your the ER.

Like I said before, call your malpractice carrier.

Not to be argumentative but you're describing a non medical scenario.

The sleepiness of the gentleman is an early sign of brain injury. His friends did not know this. If they did they would have called 911 rather than let him take a nap and become a vegetable.

In our setting we knew to keep the pt awake all night to monitor him. At no point did he become sleepy, remained freely communicative and baseline.

Per my director our policy is to do neurochecks and report to the MD.

In hindsight i could have called 911 ems, and i think in the future i will take that action simply because this puts unwarranted risk on me as the second layer RN.

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