Hi guys. I'm a new nurse, been working for about 6 months, off orientation in September. I just had my first shift of the New Year... and with it came my first fall (probably the hospital's first fall of the new year, wow don't i feel special x_o) . And the kicker is that the patient had someone at the bedside watching her!! Apparently the person watching her fell asleep and woke up after hearing a noise... pt was on the floor. When I found her she was just sitting there. After getting the patient back into bed (with no help from this "companion," diaper and floor were soaked btw), after taking the vitals and checking for injuries (none, thank god) calling the manager and the nurse practitioner... we find out the "companion" (let's call her "susan") is not actually a private duty aide but an unlicensed person that was hired by the patient's home health aide (call her "Judy") to watch the patient over night!!! Now that I think about it... something was off to me about Susan, and now that i think about it Judy was actually a really good aide the night before (changing diapers regularly, good repore with patient who had dementia btw), and Susan was just... sitting there. A few other little things I had noticed were off, but I just chalked it off to hey, maybe the girls' new or something. Of course the real answer was Susan was NOT A HOME HEALTH AIDE at all. :uhoh21:Anyway the incident report is signed, i wrote a more descriptive note about the situation, I spoke with the covering manager and the nurse supervisor and so far they were very understanding, apparently the hospital does have a policy that aides that come in from the outside have to sign in and get guest badges, but they understood I was new and didn't know this. I did admit the patient the night before, so I did document the agency Judy came from. Some of the other nurses I talked to told me they never think to actually check whether a home health aide has a badge, they're usually just glad to have someone by the bedside. But still.... now I know to be extra careful with outside aides, especially if my patient is a fall risk!::sigh:: Not to mention we re short because we had to have an RN watch the monitors from 11PM to 7 (I work medicine/tele) so everyone took 1-2 extra patients, ancillary staff is short, patient with Alzheimer's keep taking of his monitor and finding new ways mess with his IV, one pt had a control freak for a husband, one pt has unresolved b/l LE pain, another s/p abd sx has an NGT tube, cardizem drip, and orders for Lopressor IVP at 6am, and the paperwork just kept piling up!! I didn't leave for an hour after my shift was over.The only good thing that came from last night was that my boyfriend stopped by at 1am with flowers to say happy new year. Coworkers were impressed :) Luckily it was quiet at that time and I got to take twenty minutes to have lunch with him... Anyway.... Happy New Year to you all.