The continuing saga...I went to the UM this morning

  1. Asked if I could speak to her in her office because I had something I had to get off my mind. Told her the whole story and she says, "Yes I know,------- told me yesterday afternoon at 3:30 when she came in. She came in the door and then came right to me." (She was the nurse who called the doc, but failed to tell him the part about finding the resident on the floor and falsified the nurses note and the 24 hour report note) I'm thinking the other nurse whom I questioned about why she didn't make out an incident report and why no one told the doc he was found on the floor next to his bed, probably called----- at home and told her I was questioning her. I had the incident report all made out, but didn't give it to her since ------ told her about it already. The UM said, "The doctor is aware of the alleged fall and examined him and found no injuries. It's too late to make out a report because it has to be done within 48 hours of the incident." (I don't understand the reasoning behind that. Anything to do with injuries that may occur within that time frame?) She also said, "Thank God he didn't sustain any injuries, but I'm going to have to talk to these two about documentation whenever an incident occurs." I said, "Don't forget to tell them about 'telling the truth' in their documentation also and that falsifying reports could cause them to lose their license." And she said,"Oh don't worry, I will! And had he sustained any injuries from this alleged fall, they'd certainly be praying hard today because I would have presented this to the Board of Nursing!" I asked, "why do we attract these people?" She said I wish I knew so that we could fix it!" I said, "well don't worry, I'm sure we're not the only place that has them."
    So there you have it. The charge nurse fessed up, but I didn't know it and went to the UM anyway. When I went in to work last night, I expected to see ------ to ask her about this whole thing, but guess what? She left early...naturally...I am relieved that she told the UM herself, because I really didn't want to be placed in the middle of it all. But I think the outcome should have been handled alittle more severely. I don't know, maybe it was and she just didn't tell me. I wonder though. Had I not questioned the nurse that found him and asked her why she didn't initiate an incident report and why the doc wasn't informed that he was found on the floor, I just wonder if the truth would have been revealed by -------. Maybe my questioning was all I really had to do to get ------ motivated to speak up. I don't know. But you better believe that the next time I witness something like this, I will initiate my own incident report and state the facts as I saw them.
    Thank you so much for all your feedback everyone. You don't know how much I appreciated it and how much encouragement you gave me to go to my UM even though I really didn't have to in the end. You guys and gals are the greatest! This is why I can't stay away from here even if I tried to. Hugs to you all....and may God bless...
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    About night owl

    Joined: Mar '01; Posts: 3,254; Likes: 53


  3. by   P_RN
    Not fill out a report after 48 hours? That's idiotic. It may not be timely but it is valuable information for the risk manager and may just avoid a lawsuit. Will the NM follow through? Our NM's very sly about SAYING stuff like that but then just adding to the gossip mill. Don't let this turn around and bite you on the butt.
  4. by   geekgolightly
    I'm proud of you and hope to be like you when I become a nurse.
  5. by   mattsmom81
    Facilities can be very sly in dodging their risks. Tough situation you found yourself in...glad you came through intact.
  6. by   gwenith
    Don't throw away that incident report. Take it home with you and if you already have discarded it write up your account now. This is about protecting your own backside. Of course you could always e-mail this thread to yourself. It should stand up in court as it has a time and date showing that you posted soon after th e incident.

    Remember a record of what happened does not have to be a "legal document" on special paper nor does it have to be unemotional or written in the third person. It has to be your words written as soon as possible after the incident.
  7. by   night owl
    Thanks for the tip Gwenith. I've already struck it in my folder marked "For future reference hopefully not." One never knows....
  8. by   atownsendrn
    Proud of you night owl. Hope you never find yourself in that position again!!
  9. by   kids
    I missed your original post but am gathering that a patient had a fall and not one but 2 co-workers lied/concealed/omitted the fact it had happened. From your UM's response all I can say is WOW...I know why your facility attracts these kind of people...because this kind of thing is tolerated. I have never worked anywhere that if that situation happened that the person/people would have still had jobs AND the BON would have been notified.
  10. by   krispynurse
    Way to go Night Owl....and keeping the incident report is a very good idea. Remember always CYA cause noone else is.
  11. by   Huq
    All such good advice.

    I cannot agree more that keeping a record is essential today in our profession

    I keep a folder and document anything that is out of the norm. Hopefully I will never need it, but one never knows.
  12. by   night owl
    You're not going to believe this. Last evening the same resident dove for the floor not once, but TWICE! Incident reports made out, doc notified and examined him. No injuries. Unbelievable. Well now they have wrist restraints on him. Won't put him in a low bed due to the fact that when he was in psych, he was a chronic "floor diver." If he was walking by you, he'd dive on the floor in front of you so that you'd trip over him, AND he would dive OOB at least once a night. Placed him in an enclosed bed and he tore the netting and dove through the hole! He'd probably spend his life on the floor once he's in a low bed. He's assaultive and will kick and punch you in a second especially when you're doing his care. Now he has a trach and a GT. The mitts he wears are to prevent him from pulling out his trach tube and GT... he did it twice one night for me. He's such a bad boy that I swear he's possessed and actually needs an exorcism! He's a real problem child to say the least. Maybe mitts and an enclosed bed would work for him now. I don't know, but we sure have our hands full with him.
  13. by   Nurse Ratched
    My goodness, nightowl - sounds like a repeat trip to the psych ward is the cure for him - we didn't fix him the first time!

    If he's going to dive for the floor anyway, doesn't mgt want him to have a low bed so he doesn't hurt himself?

    BTW - good work on bringing the situation to light. You can never go wrong when your first motivation is advocating for the patient .
  14. by   Pete495
    Unlike others, I?m going to be the devils advocate in this one. I understand the falsifying of documentation, and omission of information to the docs. That is just plain wrong. But to me, it sounds as if this patient has been doing this consistently. The fact that no incident report was filed did not bother me as much as mis-documenting the incident. Sounds as if this patient jumps out of bed a lot. So are you going to write an incident report every time a patient jumps out of bed or screams because he spilled his milk? If you have time to do that, then I want your job. I agree that nursing documentation should be complete and concise, but I have had many instances where situations have been kept cooler because I handled it in a discrete manner. I'm not saying I've never filed an incident report. I have in fact filed one, but only on my own patient where I was well aware of the entire situation. I'd much rather handle the situation with doc involvement, and document in my nursing notes.

    Basically, I'm just saying you should consider why things were omitted. Maybe they just thought it wasn't that big of a deal, and if it happens a lot with this particular patient, simple documentation on nurses notes might be sufficient. Even though the documentation was totally wrong, you could have simply made suggestions for the nurses involved to correct it. I'm not so sure I would have gone to the nursing manager over this. For one thing, it wasn't your patient. Second, it was 3 days later, and you decide to go back and check up on other nurses documentation? Also, why couldn?t you simply ask them to correct their documentation, and file an incident report?

    I don?t know how that sounds to you, but I probably wouldn?t be happy if some nurse came in 3 days later, looked through my documentation, and made accusations when she hadn?t even cared for the patient.

    After simply mentioning to the nurses that their documentation was incomplete, tell them to adjust it and consider filling out an incident report w/ the UM if they haven?t already done so. I think after this I would conclude my Business in the matter. I?m not sure I understand why it was necessary for you to get involved any more than that, esp. 3 days later. It?s not your patient, the patient was looked in upon, and it?s not even your ass on the line. I would just be careful in the future, or you will find yourself in hairy situations where you aren?t totally informed about what is going on. From your second post, it?s obvious you didn?t know that the nurse caring for the patient followed up with the indident. Maybe there is more to this than meets the eye is all I?m saying. And you wanted to report them to the Board of Nursing? That?s just wrong too if you don?t mind me saying.

    I?ve found many nurses put their heads where they don?t belong, and sometimes people get hurt, even patients in some instances. I don?t feel it?s right for someone else to make a patient assessment without knowing history or very little about the patient. People criticize and jump to conclusions because they aren?t totally informed. The bottom line was the patient was ok. The doc checked in. Nurses checked in. If there would be a lawsuit, it wouldn?t be your ass on the line.

    Please Don?t Hate me for being Different.