Falls

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I worked at a retirement home for 18 years. I was since terminated. One of the reasons is that I had two falls happen at the same time and apparently didn’t handle it up to standards. I quickly assessed one woman and moved her and got her up. I then brought her to her room for further assessment by which I saw a cut on her head. I then sent her out to the hospital. I didn’t get a chance to take her BP or do a neuro assessment. I moved her and got her up without doing them first. Would you say that was negligent? I sent her to the hospital where they could do all the tests?

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What did you assess then? Did the EMT take vital signs upon arrival to take her to the hospital? Maybe you did more of an assessment than you thought but didn’t chart it? Falls have very specific protocols. You need to make sure you follow them.

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I was told I didn’t check pupil size etc, didn’t offer pain meds etc, I assessed her ROM and looked for any external rotation of leg etc, didn’t see the head injury till she was under better lighting, the paramedics do the BP etc

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Why didn’t you check pupil size? What was your facility’s protocol with falls? Why did you not chart the BO the paramedic took? It was a blood pressure.

You had a few minutes before EMS arrived. What did you do? Neuro assessment should have been one of the priorities once you assessed airway, breathing, circulation, vitals.

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I’m not trying to bash you or anything, just trying to get you to see what the priorities should be when the elderly fall. I work in a Neuro icu and falls can have very bad outcomes.

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Specializes in SICU, trauma, neuro.

The big issue I see is lack of neuro assessment. I know it’s tough when two residents fall, but a neuro check takes less than a minute to do, and is really important. Especially since EMS and hospital staff don’t know her baseline — so they don’t know if signs they see are concerning or not. Obviously if it’s bad enough to have fixed pupils it’s concerning.... but what about confusion? Is she usually sharp as a tack and now a&ox2? Or does she never know where she is?

Since she has a lac on her head it’s safe to say she hit her head.

What about the second resident?

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My facility didn’t have a neuro protol until 2014, the nurses that have been there for a long time have never done one when sending someone to the hospital. My sister that is a RN doesn’t do one till the patient is up and back into bed. So in reality this has not been the protocol so I did things as we have done for years.

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I did a visual assessment and when she was up walking I assessed her ability to weight bare etc. Then continued an assessment of ROM and pain once she was up and in her room. I applied a dressing to her head, prepared a transfer sheet. Stayed with her till paramedics arrived to make sure she didn’t pass out. Many things were done before paramedics arrived. I also checked on the other res who got herself up. Did a quick assessment of her as well. There is only one registered staff on and no psw. I only had a dietary aid there to help.

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I’m going to take a wild guess here and say that the fall was an “easy” way to get rid of you. Why they wanted you out I have no idea, but that’s what it sounds like to me.

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Finally someone who gets it lol! Yes they have been picking on me for a long time. They never had a supervisor for quite some time since the last one left and suddenly making new protocols for us to follow after years of doing things differently. The woman was perfectly fine so why the need to fire me? Why not just say please do this and that next time! We have had a few supervisors come and go and they expect us to keep track of all the changes each one made! I guess my question should have been why termination why not just a warning?

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I have anxiety and depression and took stress leave more than once with the constant torment they inflicted on me! Guess they didn’t want to keep paying for my leaves so made this excuse!

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6 hours ago, Marija1 said:

Finally someone who gets it lol! Yes they have been picking on me for a long time. They never had a supervisor for quite some time since the last one left and suddenly making new protocols for us to follow after years of doing things differently. The woman was perfectly fine so why the need to fire me? Why not just say please do this and that next time! We have had a few supervisors come and go and they expect us to keep track of all the changes each one made! I guess my question should have been why termination why not just a warning?

I’m not understanding this. Your post asked a specific question regarding you being fired for falls. You admitted no Neuro or vital sign assessment was done. Your facility has a protocol in place and you did not follow it. It’s been in place for 5 years.

Falls are a big deal in the elderly. That’s why there are protocols in place. It’s not to make more work for you.

Now, if there is more information going on in the background regarding your job, I wouldn’t know as you never mentioned it. You trickle it in later.

I was simply trying to get you to see how to prioritize in this instance. 2 falls are difficult to manage. An assessment does not take a lot of time. Was the other pt not sent out to the hospital?

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