Falls

Nurses General Nursing

Published

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?

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
On 4/15/2019 at 2:07 AM, Marija1 said:

I guess the issue at this facility is how the staff have been trained. None of the nurses have done a neuro when sending someone off to the hospital. Nobody has ever been disciplined for it until now. If we were never trained properly then how can we do everything right? What’s missing here is that management is not doing their job properly. We are only as good as our management. The other res was not sent out to the hospital due to her injuries being minor. There is only so much one nurse can do in this situation. I am actually confused as to what you aren’t understanding here? I get you are trying to help but you aren’t seeing the bigger picture here. If most of the nurses there don’t do this it speaks volumes to the training we received!

I'm sure the facility is subjected to audits and has to show that things are done a certain way. It's a bummer when protocols change and no additional training is provided, but you're not sounding very self-directed. When you make statements such as "We're only as good as our management" that sounds very passive and defeatist. Then you say "If most of the nurses here don't do this..." Perhaps they are trying to change the culture and believe your attitude is detrimental to the other staff.

You already mentioned taking frequent leaves of absence. That would certainly make you a less-than-valued employee in your employer's eyes. It does sound like they were just looking for a pretext to fire you. Unfortunately, you gave them one.

3 Votes

The frequent leaves of abscenses are necessary as I have anxiety and depression. No my attitude is just fine actually. No different than anyone else’s around there. Actually I am very self directed. You are being very judgmental. They recently changed their fire protocol and expected us to know it before it even existed. They don’t have monthly fire drills like they are suppose to. So yah I would say management is to blame. Have you met our management? They don’t even listen to the nurses when we all self direct including myself. Maybe come work there then you will know!

1 Votes
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
On 4/15/2019 at 4:07 AM, Marija1 said:

I guess the issue at this facility is how the staff have been trained. None of the nurses have done a neuro when sending someone off to the hospital. Nobody has ever been disciplined for it until now. If we were never trained properly then how can we do everything right? What’s missing here is that management is not doing their job properly. We are only as good as our management. The other res was not sent out to the hospital due to her injuries being minor. There is only so much one nurse can do in this situation. I am actually confused as to what you aren’t understanding here? I get you are trying to help but you aren’t seeing the bigger picture here. If most of the nurses there don’t do this it speaks volumes to the training we received!

What's missing here is that you are a nurse, and you think it is okay to use the excuse that the facility didn't train you to do a proper neuro assessment when a proper neuro assessment is taught in every nursing assessment 101 course. That is the main issue here.

8 Votes

Funny since I know an RN in the hospital that gets their patients up first and back into bed before they do the neuro assessment. The issue is not how the neuro assessment is done it’s about when. And funny why then has no nurse at the facility perform them when sending someone out to the hospital. Like I said before passing judgement make sure you have all the facts.

0 Votes
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
2 minutes ago, Marija1 said:

Funny since I know an RN in the hospital that gets their patients up first and back into bed before they do the neuro assessment. The issue is not how the neuro assessment is done it’s about when. And funny why then has no nurse at the facility perform them when sending someone out to the hospital. Like I said before passing judgement make sure you have all the facts.

You can go back and "dislike" my comment all you want because you are being sensitive, but that doesn't change the facts of this scenario. You need to take accountability for yourself and do not blame manamgement or your coworkers for everything.

As an educated professional, you know better than to use the excuse that "none of the other nurses do it" as your reasoning. A patient hit their head hard enought that it caused a laceration. The basic nursing skills you learned in school should tell you to do a quick neuro assessment at some point. The excuse that other nurses don't do it would never hold up in court.

Your patients deserve better and your hard-earned license deserve better.

6 Votes

Did you even read the scenario? Do you work at a retirement home? Do you know anything about employment law and harassment? Have you ever been a target? I suppose you make no errors and are the perfect nurse right? I am actually disgusted with your attitude thinking you are perfect?

0 Votes
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
3 minutes ago, Marija1 said:

Did you even read the scenario? Do you work at a retirement home? Do you know anything about employment law and harassment? Have you ever been a target? I suppose you make no errors and are the perfect nurse right? I am actually disgusted with your attitude thinking you are perfect?

I did read the scenario. I do not think I am perfect. I've made plenty of errors in my career. And I've taken accountability for them.

5 Votes

And if you were terminated for those errors you are gonna say “oh well”??

0 Votes
Specializes in Varied.

There seems to a multitude of systemic and individual problems at play here.

It is clear, that despite having a policy for 5 years, you failed to meet the expectations of the facility. For that reason alone, you can be found to be negligent and justifiably fired.

The remaining details are irrelevant, truly. If you performed your assessment per the policy, they would not have grounds to fire you. You should practice to the highest standard, not to the standard of those around you.

I would highly recommend that you reflect on your actions and how to enhance your ability to perform to the highest standard set forth by your board of nursing.

I do believe the systemic factors are plentiful, but you only have an impact on yourself and the actions you decide to perform. You should have followed protocol, to the best of your ability, regardless. I'm sorry to hear you were terminated, however, it does sound you are trying to ameliorate that.

7 Votes

To the best of my ability? I had two people on the floor at the same time. I had to assess two people at the same time. There was a crowd of people hovering. I had only a dietary aid to help with that. That was the best I could do in those circumstances. But you were not there so you have no clue.

0 Votes
Specializes in Varied.
5 minutes ago, Marija1 said:

To the best of my ability? I had two people on the floor at the same time. I had to assess two people at the same time. There was a crowd of people hovering. I had only a dietary aid to help with that. That was the best I could do in those circumstances. But you were not there so you have no clue.

Once you take responsibility for your mistakes, you will understand where we are coming from. Also, you do not know what I know or don't know. I'm fully aware of the poor-work conditions related to LTC facilities.

End of story: you failed to perform an assessment that is required by your facility. You are fortunate that they do not report you to the board of nursing, as it is negligent behavior.

"Negligence is defined as doing something or failing to do something that a prudent, careful, and reasonable nurse would do or not do in the same situation. It is the failure to meet accepted standards of nursing competence and nursing scope of practice."

You have heard, from several nurses, who would have performed the neuro assessment post-fall, therefore, you were negligent...

https://journals.lww.com/cns-journal/Citation/2017/07000/Negligence_and_the_Nurse__The_Value_of_the_Code_of.3.aspx

5 Votes

I did the best I could with the resources I had. So no I don’t think it is a reason to terminate. Especially if I was not treated fairly! So yes it does matter that all the other nurses are not up to standards as well. This is my lively hood we are talking about!

0 Votes
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