can my supervisor write me up (i'm an rn) because a patient fell?

[calypso1]

let me explain the situation. it happened the other day i was busy in one room passing my meds (i was giving an insulin shot) when the alarm rang, i did my best to finish my care as fast as possible and then ran into the room.

my cna and i got the patient up and put her back to bed. 2 days ago while talking with my supervisor she said she will write me up because the patient fell; i explained to her that i was passing my meds and could not be at 2 places at the same time and that as soon as i was done with the insulin i went to the patient's room.

1) can she write me up because a patient fell while i was pasing my meds?

2) can i reply to her "warning, memo"?

3) how bad is a write up in an rn's file?

[king_of_the_hill_fan]

Well, did you complete an incident report? I've had 3 falls from the same patient - one a week - on my shift. No write ups, but my incident reports are scrutinized.

[Miller86]

Well why weren't you at two places at once? Being with another patient is not a valid answer.

I'm kidding. Your supervisor sounds completely unrealistic. Was this patient fall risk? Was it expected that someone be with them during their bathroom visits? If not then it's impossible to be expected to get everything done on a tight schedule and be with all the patients at the same time. It was an accident. So does she plan to write up someone for every time a patient falls?

Just explain to her what occurred and if she writes you up then she is absolutely absurd. I guess they can write you up for anything but just explain the situation and document everything nicely and cover yourself during incidents like that.

I'm sorry to hear this and I wish you best of luck.

Ps. my patients fall. I can't be in a million places at onces. I document everything, ensure they are assessed, doctor is aware and family is notified when needed.

[Davey Do]

calypso1:

Most of the time, Administrators have to note problems, hold someone (or something) responsible, and perform a corrective action. It's nothing personal. It's just the way it is.

Basically, (from a negative perspective) Administrators can do just about anything they want at any time. They won't suffer negative ramifications if their action is not inappropriate or if the process has a policy to back it up.

Of course you can reply to the written warning. I'd encourage you to do so. You may also request that a copy be placed in your file along with the warning memo.

The negative ramifications of being written up vary from absolutely no effect to being something that places a nail in your coffin. Chances are, with you, calypso1, it's merely a formality.

Respond to the written memo ASAP. Drop deadline: One week.

I wouldn't worry too much about it. The best to you.

Dave

[Orange Tree]

Wow. Your supervisor sounds like a freaking genius. She needs to assign a 1:1 if she expects someone to be available at the patient's side every minute of every hour. I would have no problem telling her that.

[stram87]

You are not responsible unless you did something that lead to the patient falling. For example if you used bed rails and didn't place them back in position. Other than that you are not responsible.

[ImThatGuy, BSN, RN]

You should be asking your personnel department.

[NurseCard, ADN]

If the patient was a known fall risk, and the ordered precautions weren't in place when the patient fell, then I guess it is reasonable that you might get in trouble for the incident.

Otherwise... sometimes patients fall; it usually isn't the nurse's fault. The incident has to be written up though, regardless of whether it is anyone's fault. Your supervisor, by writing you up, may just mean that she's making an incident report and putting your name on it, since you were the nurse caring for the patient. Maybe?

[DCtraumarn]

If your patient was a high fall risk you needed to ensure that it was documented and all the appropriate falls prevention/interventions were in place. As for side rails - it is two or three and not four. Four side rails are considered a restraint (in acute care) and can be used in certain situations but you must have an order and document. They are not used for falls prevention in acute care unless the patient is on a specilaity bed with particular mattresses. They can also be used for patients on seizure precautions - again with an order. If you transporting on a bed, then they need to be up x4 during transport.

So potentially if you did not maintain appropriate safety precautions....yes.

Do you use proactive hourly rounding in your facility?

[Mulan]

Yeah, she can write you up, and she is probably hearing about it from her superiors about all the falls on her floor, and maybe it is even impacting her financial compensation in a negative way.

It runs downhill.