Just when I thought I was getting the hang of things.

[twokidsmom,rn]

It will be a year come this July since starting in HH. Have been doing good the past few months. Still getting calls on fixing oasis here and there but getting better. Planning on sitting down with one of our Oasis checkers to see if she can give me more in sight on how to fill them out. Which is good, I can use some help.

TOday walked into a patients apartment. She lives in an independent section of a ALF. She had a total knee done over a month ago, came home last week from a rehab center.

Today she was laying on the floor, stated she was sitting on her sofa and slipped off the edge onto her knees. Was unable to get up so she laid down and waited until someone came. She said it was about 15min.

I took all vitals they were fine, neuro check was neg. Housekeeper and I got her to the sofa. CHecked her from head to toe, no open areas, no brusing. Knee was red but not open, stated she did not have any pain. Pulse ox 96%, BS 134. I called PCP gave all the vitals and described the fall. Called her daughter/POA, told her that she is not safe to be alone. Fixed her lunch, made her bed because she was incont. during the night.

Issue is: rec'd a call from my clinical manager asking me about the fall. SHe rec'd a call from the ALF asking if I had seen her fall. And why did I not tell them.

I was going to but since she is independent I thought the nurses would say she is independent and they do not monitor them. SO I did not say anything. Patient ended up calling ALF nurse during the afternoon since she had developed some drainage. But when I left her there was no openings at all. Not sure if she had fallen again or if the knee opened up later in the day. I should have called the ortho MD but since it was just red and no pain I did not. I just called the PCP to report the fall.

[caliotter3]

I can sort of see why they would be miffed that you did not make them aware of what happened. Just remember in the future, to always report anything that is out of the ordinary to the honchos at any facility where you visit a patient. If you had informed them, they probably would have checked on her and maybe could have prevented something else from happening later.

[Kyasi]

I agree w/Caliotter3. Cover all your bases and let everyone involved w/her care know. If in doubt, call your Supervisor first and ask who you should notify. In this case, probably the Ortho doctor should have been notified. Since she landed on her knees, he may have chosen to examine her or to do an xray to see if there was any damage to the joint that you couldn't see. This way you have covered your tail in case you missed something on your assessment or if further complications occur after you leave.

Kyasi