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?

On 4/14/2019 at 7:57 PM, Marija1 said:

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

I don't think pain meds are indicated when a patient has a possible head injury. OK, pupil check would have been ok, but it seems kind of strange that they would fire you over this instead of educating you. Did you get a new DON? Maybe they are cleaning house?

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Specializes in SICU, trauma, neuro.
10 minutes ago, Forest2 said:

I don't think pain meds are indicated when a patient has a possible head injury. OK, pupil check would have been ok, but it seems kind of strange that they would fire you over this instead of educating you. Did you get a new DON? Maybe they are cleaning house?

That’s assuming we’re talking about *sedating* pain meds... but I’m not sure that was the reason for not giving them, if a neuro assessment wasn’t a priority either

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17 hours ago, JadedCPN said:

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.

I hope that most of us will understand that some nurses graduated from nursing school decades ago and that some work environments are not up to standard. In those situations where there is a combination of both stuff happens. Places where management doesn't care or listen, places where there is unsafe staffing and places where nurses are not as knowledgeable, skilled in critical thinking or as assertive in their self-learning as others. I for one, want to encourage my fellow nurses to learn about how to handle the situations they are most likely to encounter on their jobs and to do a lot of self study to keep fresh. This is important because we carry such great responsibilities.

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11 hours ago, Marija1 said:

I didn’t see this message till now. It definitely covers all that I am feeling. All the nurses there are struggling from not having enough staff to help. So basically it’s stressful for us all. It doesn’t help that I have anxiety on top of that. I just think it’s a poorly run place and you are right it could be a blessing in disguise. Think it’s turning into an assisted living home without the assistance required. We are only one person. I am also starting to think that it’s somehow different in the States than our system here. But you definitely hit it on the nail here! Finally an answer that makes sense to me! Thank you!

It can be difficult to hear negative criticism. I have seen the acuity of retirement centers, assisted living, rehab and others increase as hospitals are no longer able to keep patients as long as they had in the past( that is only one cause). In AL we now have LTC patients and the retirement centers have the AL, the clientele changes but the names don't. The major incentive of health care is money based. Not what many of us like to hear but that is the way of things. A lot is expected of nurses and these expectations are very very difficult to meet and I believe are becoming more difficult.. Sometimes we just can't do it. If you are at that point then it is OK to try something different. No one should make you feel bad because of that. Good luck and I hope you find employment that brings you joy and satisfaction.

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12 hours ago, Marija1 said:

I also don’t agree that it’s “poor nursing skills”, it’s a lack of management support! We have had nurses speak to res families about applying to long term care and they are getting into trouble for that. There are res that need more care and the DRC stops it because they don’t want the res to qualify for long term care. It’s all about the $$

As far as the proper level of care and where patients should be I have fought that battle myself. The goal is to keep the census up because it makes business sense. The other side of that is that the level of safety and the needs of the client are not achieved. I hear ya.

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21 minutes ago, Here.I.Stand said:

That’s assuming we’re talking about *sedating* pain meds... but I’m not sure that was the reason for not giving them, if a neuro assessment wasn’t a priority either

I'm not sure. I'll be the first to say, I don't know the answer. I think she said they told her she failed because she should have offered pain medications. I am paraphrasing here.

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I do think they might be “cleaning up house” as it def looks like I became a target and they were looking for ways to get me out. They even blamed me for laundry not getting done at night and gave me a discipline letter for that! Yes we do laundry at night! Yes we got a new DRC. That was like the 5th one as they came and went for the last 5 years or so. Why? Likely because of management. They do only seem to care about the bottom line. There were minor issues before this incident so the falls were the final straw. But no re education before firing me took place at all. They said I didn’t give pain meds, start a TAR etc. In this facility we have never done all those things before sending them out to the hospital. I don’t know but something just ain’t right around there!

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18 years and they let you go just like that? It's not like you did nothing. Did you get the MD's permission to send the person out? When I worked in a LTC facility we had to let the MD know that the fall occurred, provide vitals, and then send the patient out if we were given authority. If the MD couldn't reached, then management was always available to take calls. Someone would give authority for the patient to be sent out or else it didn't happen. I must say, you deserve an award for staying at that place for 18 years. It is a shame things ended the way they did. Was your license affected?

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It was a Retirement home so diff than long term care. There was no on call physician, we had to decide on our own to transfer or not. Yes after 18 years this is the treatment I get!

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Thank you so kindly! Yes I stayed for 18 long years and would have stayed even longer but nope no choice. Working on reinstatement. I have a union and they told union that they did not report me to the CNO which is the board here. I am thinking if I did something so horribly wrong then why didn’t they report me?! That remains a mystery. So no my license is fine but kinda hard to get another job if you were terminated!

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They also condoned this omission of neuro vitals in the past by myself and others. They never investigated to see if others were doing this as well. They never sat down with me to ask what exactly happened or why I didn’t do certain things etc etc. I went on stress leave for their treatment of me. Then the night I came back they were waiting with a letter for me. So I was fit to come back but they fired me instead.

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11 minutes ago, Marija1 said:

They also condoned this omission of neuro vitals in the past by myself and others. They never investigated to see if others were doing this as well. They never sat down with me to ask what exactly happened or why I didn’t do certain things etc etc. I went on stress leave for their treatment of me. Then the night I came back they were waiting with a letter for me. So I was fit to come back but they fired me instead.

I feel like you were set up to fail. A person doesn't just work at a place for 18 years doing their regular stuff and now all of a sudden, the way you have provided patient care is a problem. If what you were doing was so wrong, management should have had that discussion with you 17 years ago. I do know that management changes but the point is, if you were a bad nurse, you would not have lasted this long. The point of reprimanding someone is so that they will stop what they are doing wrong, and also so they can be supported in doing things right. Usually staff is paired with someone who knows how to do things properly or to their liking, and they get retrained. Was there ongoing training?

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