No 1:1 sitter for fall risk patient

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What do you guys do if there is a MD 1:1 ordered for a confused, high fall risk patient but due to inadequate staffing, you were unable to get that 1:1. How would you document that? Do you mention "no staff available for 1:1" in your notes (I'm guessing not) I've run into this problem numerous times

If there was a clear doctor's order for a 1:1 for one of my patients, and I am told by staffing that there's no one available I would call the doctor on call and tell him as much. If I am not given the resources to carry out a doctor's order, well, I figure I better call that doctor for clarification and guidance. If pharmacy doesn't send me an ordered medication or it's equivalent, aren't I required to notify the physician that I can't carry out the order he ordered me to do? Same thing.

I would never chart "1:1unavailable" in the medical record. But I would make sure to fill out whatever incident reports or risk-management reports the facility has. I would make darn sure that there was a paper trail showing that I raised my concerns to nursing management and to the ordering physician.

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