Can I get in trouble because one of my residents fell?

[BigPat]

I've been an STNA in the State of Ohio for almost 5 years. I like to think I'm a good aide, but my coworkers (and residents) sometimes don't make me feel this way. I work 3rd shift. I worked Sunday night, nothing unusual happened that I was aware of, I gave report, clocked out, and went home. I came into work last night, and was told that first shift had found one of my residents on the floor yesterday morning right after shift change. This resident claimed that she had been on the floor for over an hour. I KNOW I checked on her no more than a half hour before my shift was over, and she was in bed sleeping. I expressed to the 3rd shift nurse that was working with me last night that I felt bad because that had happened, presumably on my watch. I have never, ever in the six years I've been in this field, left work with a resident in less than optimal conditions. The third shift nurse calmed me down a bit, but then first shift showed up. I went to every residents room with them. Verified that everybody was in bed, asleep, and dry. Apparently they don't want to take my word for it anymore. The nurse made me feel like I was about 3 inches tall. I seriously cried on the way home from work. I feel horrible to think that a resident may have fallen on my shift Monday morning and I didn't know about it.This resident was not a known fall risk. I'm just so beside myself. I don't work again until Thursday night. (If they don't fire me, that is). I'm the type of person that hates the waiting game when it comes to this. Do you think I am going to be written up/ fired/ executed by firing squad for this?I've never been disciplined by this company in the past 18 months that I've worked there.

[morte, LPN, LVN]

I would want to know EXACTLY when the patient was found on the floor. "right after shift change", is open to much interpretation.

[LCinTraining]

I agree. I would ask to read the incident report.

[BostonFNP, APRN]

In the end, the nurse is responsible.

[Nurse_B]

This is why you should always do walking rounds during report.

[funtimes]

I doubt you would get in serious trouble if the person wasnt a known fall risk and so you didnt forget a bed alarm they were supposed to have on. The patient said they were on the floor an hour, but that doesnt mean they were. Could have been 10 minutes. As someone else said I would check exactly when they were found, as there is a tendency for CNAs to blame everything on the previous shift.

[fastwalkslowtalk]

I would be more concerned as to why the resident fell in the first place. As for responsibility, as long as you did your bedroom checks per your facilities policy and and made sure the resident was safe and secure on your rounds then it's not your fault that she fell - especially if this resident was not a known fall risk which would require more frequent room checks. Failing to report and document the fall (charting, writing an incident report, etc) would put you are risk for disciplinary action. Typically rounds are done once every two hours with call lights answered as needed. Unless there was a specific reason or concern to go back to that particular residents room I can not see how the nurse could find fault with you. With residents who are fall risks, checks could be as frequent as every 15 minutes to an half an hour. Tab alarms and "bed bugs" should also be used with other precautions such as a floor mat on the side of the bed to cushion and absorb any impact for patients who are severely at risk for falls. Just make sure that your residents have the call light within reach and follow you policies regarding room checks and walking rounds.

[nguyency77, CNA]

I would like to share a story about resident falls with all of you lovely CNAs, in the hope that you don't make this mistake.

At my facility, our dietary department has a tendency to be lazy. They do not help pass trays, consistently give residents food that they can't have/don't like, and stand around blasting the hip-hop radio station and talking about hot female coworkers instead of doing what they're supposed to be doing.

To fix this problem, our ever-so-brilliant-administrator said that the kitchen staff now had help the CNAs move residents out of the dining room and into their rooms. One of my CNA coworkers thought, Oh great! I'm just going to stay in the nursing station and text, since dietary is helping put people back in their rooms.

Guess what happened? The dietary staff was not trained to transfer people, and rightly so. They're supposed to be in the kitchen, and not transferring people in the first place. One of the kitchen aides put a man into his bed. This gentleman had those wedge-shaped bumpers that were supposed to be secured to the bed as a safety precaution. The aide put the guy on top of the bumpers without securing them, promptly left, and the man fell. Thus, the CNA who was responsible for him got in major trouble because she was not doing what she was supposed to be doing.

ALWAYS walk with your relief while you're giving report. If an issue comes up while you're doing your report, help the other aide fix it. If you did everything you were supposed to do, you can't get into trouble. Sometimes, residents will simply get up no matter how many alarms we put on them. It's not possible to watch 30 people at once, and things happen.

[Ntheboat2]

The nurse probably made you feel 3 inches tall because the nurse probably got in trouble for it. That is not acceptable for her to put the load on you. It's just the easy out for her. Unfortunately, aides get the blame for a lot of things. I actually overheard a nurse tell a patient one time that I didn't tell her that the patient needed her. That was a flat out lie as I insisted to her twice that it was urgent. It was just easier for her to blame her neglect on "the aide" than to take responsibility for making him wait 30 minutes. It happens a lot and it needs to stop.

A lot of people hate giving bedside report, but I love it for this reason. You give report right by the patient's door (if it's not appropriate to go in the room) and once you've given report, both you and the person you're reporting to have seen the patient's condition (asleep, bed alarm ON,brief clean and dry, bed rails as they should be, water pitcher filled, etc) then you have passed on the responsibility and there's no question about what was or was not done.

I wouldn't be offended that they "don't want to take your word for it" by having you do bedside reporting. It should be a good thing for you because now you will know that the next shift can see you did your job and nobody can blame you for things left undone. By the way, the nurse is ultimately responsible for his/her patients so if the nurse wasn't disciplined then you shouldn't be either.

[nguyency77, CNA]

A lot of people hate giving bedside report, but I love it for this reason. You give report right by the patient's door (if it's not appropriate to go in the room) and once you've given report, both you and the person you're reporting to have seen the patient's condition (asleep, bed alarm ON,brief clean and dry, bed rails as they should be, water pitcher filled, etc) then you have passed on the responsibility and there's no question about what was or was not done.

You are definitely right. If you do bedside reports, you can't be blamed.

At my facility we did this for safety reasons. We check each incontinent resident at shift change to make sure they aren't soiled in order to prevent skin breakdown and discomfort for the resident. This is also to verify that side rails are up and alarms are on.

I heard a case of an aide (not sure where it was) who left a resident on the bedpan. They did not do bedside reporting, and that aide told their relief that the resident was fine and asleep. He was NOT fine and asleep- he developed decubitus ulcers from the bedpan being left on him for hours. The ulcers got infected and I believe the resident died.

[big bear]

I am a new CNA and have been working in one of the best nursing homes in that area for almost 2 months. I already have 2 residents fall on my shift and that's because they went to the bathroom by themselves without asking for help. As some of you may already know, nursing homes are usually short staffed. I work the day shift and when it is less than 35 residents, the supervisor cancels 1 Cna so instead of 5 there will only be 4. The area that was assigned to me was a difficult one because 4 of my patients need 2 people Assist and in the morning I had to get 4 residents up for breakfast. As I was getting up the last resident, one of the resident finished eating breakfast and decided to go back to his room and go to the bathroom by himself. He had a stroke and so when he tried to stand up on his own, he slid down butt first on the floor and he started crying for help. When I got to his room, he was already on the floor. So I called the nurse and another aid to help him get up because he was big. The nurse suddenly asked me where his tab alarm was and I was surprised he had a tab alarm because it was my 2nd time on that assignment. The first time I had that assignment, one of the CNAs was kind enough to help me with him so in truth, this was the first time I am actually handling this patient myself.

It is so frustrating to have a resident fall on your shift but sometimes, there is nothing we can do becaus ethe residents themselves dont listen to us. We tell them not to stand up on their own and to call for help but because help arrives late, they just ignore advices and go to the bathroom by themselves. You also dont expect other CNAs to help you with your assignment even if they know that your assignment is the hardest because they think that it is not their assignment ao why should they bother..they dont really care and some of them can be very rude when you try to ask them for help. It is really hard and instead of looking forward to going to work, I am stressed with thinking what assignement I will have for the next day and it is not healthy for me to be this way. It is just so sad. How about you guys? Have you had similar experiences?

[SeattleJess]

This is why you should always do walking rounds during report.

That's a good idea but I have never even heard of walking rounds before, let alone seen it done!