Nurse might not report incident

Salisburysteak, BSN, RN · Jul 18, 2012

Sure and so can that nurse for not doing an incident report. What if that resident had broken a bone ao or hit there head.

If this resident is having altered mental status, the resident should be checked on more often and possibly obtain a UA c C & S. If this resident has a bed alarm and it was not turned on and family decided to report this to the state....bad things can happen for the facility, nurse, and CNA giving care.

I wrote a CNA up for not telling me one of her residents had fallen. The only way I found out was she told me 2 hours after it happened. Her attitude "he always falls" And proceeded to tear up the write up in front of me and the supervisor. She thught I was being a mean nurse for writing her up.

All falls need to be reported and documented.

My :twocents:

orthonurse55 · Jul 18, 2012

I think you could get written up, but not for failing to write an incident report. When a resident/patient falls. it is up to the CNA to call the nurse BEFORE you help the resident up. The nurse is the one who should determine whether or not the patient is allowed to get up or if they should be sent to the hospital for possible injuries. From what I have read, aside from that, you did everything you could do and the nurse failed to write an incident report, which is her job.

I would go further with this, before it backfires in my face. I teach CNA classes and I will tell you what I tell all of my students - that nurse will NOT be your friend if you end up in a courtroom! Cover your own A** because if push comes to shove, she may say you never told her.

Columnist · Jul 19, 2012

Moved to Nursing Issues On Patient Safety for more discussion.

LovelyOverload · Jul 19, 2012

I think you could get written up, but not for failing to write an incident report. When a resident/patient falls. it is up to the CNA to call the nurse BEFORE you help the resident up. The nurse is the one who should determine whether or not the patient is allowed to get up or if they should be sent to the hospital for possible injuries. From what I have read, aside from that, you did everything you could do and the nurse failed to write an incident report, which is her job.
I would go further with this, before it backfires in my face. I teach CNA classes and I will tell you what I tell all of my students - that nurse will NOT be your friend if you end up in a courtroom! Cover your own A** because if push comes to shove, she may say you never told her.

I told her in front of another nurse. I have a witness. I also sent a email to my self stating what happened. I'll see if they did a incident report. If not then I well tell the manager.

LovelyOverload · Jul 19, 2012

Sure and so can that nurse for not doing an incident report. What if that resident had broken a bone ao or hit there head.
If this resident is having altered mental status, the resident should be checked on more often and possibly obtain a UA c C & S. If this resident has a bed alarm and it was not turned on and family decided to report this to the state....bad things can happen for the facility, nurse, and CNA giving care.
I wrote a CNA up for not telling me one of her residents had fallen. The only way I found out was she told me 2 hours after it happened. Her attitude "he always falls" And proceeded to tear up the write up in front of me and the supervisor. She thught I was being a mean nurse for writing her up.
All falls need to be reported and documented.
My

Patients have fell before and the aide didn't get written up; however, the nurse always reported it.

amygarside · Jul 19, 2012

incidents like that need to be reported, for your sake and the patient's. i agree with what

orthonurse55 said.

sauconyrunner · Jul 19, 2012

Where I work, EVERYONE is responsible for filling out incident reports. Not just nurses. So I am not exactly sure why anyone is waiting for a nurse to report an incident that the aide witnessed. Incident reports are supposed to be non punitive, and to help people figure out where in our process we need improvement. But I know in reality that is not always the case...

psu_213, BSN, RN · Jul 19, 2012

From my time as an aide....

1. Whomever 'found' the patient on the floor filled out the incident report. I the CNA discovered the pt on the floor, they would will out it the report (if I was filling out the report I would do so with the help of the nurse so that I used the correct wording....i.e. "pt observed on floor" rather than "pt fell"). This did not constitute guilt on the aides part.

2. As an aide, we had to initial a 'treatment book' on each resident on each shift. For example, things on the list would be "honey thick liquids," "gripper socks in bed," "bed alarm AATs when in bed." In other words, we were initialing that we did each of these things. If they were ordered a bed alarm and the bed alarm was not it, it 'fell back' on the aide who put them in bed. The nurse may have to share some responsibility, but the aide would be the first one looked at in that situation. Do you have something like that in your facility? How do the aides chart on what they did for residents?

Salisburysteak, BSN, RN · Jul 19, 2012

Patients have fell before and the aide didn't get written up; however, the nurse always reported it.

This CNA did not tell me until 2 hours after it happened! I did not get a chance to properly assess the resident, and this CNA got the resident off the floor and put this resident in the WC like nothing happened. Had this CNA notified me pronto this CNA would NOT have gotten written up.

What others have stated, you can write up incident reports. Incident reports are used as a QA measure for facilities to improve quality of care and what can a facility do better. i e moving resident closer to the nurses station or moving the bed around so it easier for the resident to get the BR if needed. If you knew the nurses did not do a report, use your own initiative and write one yourself and tell the DON! CYA!

dudette10, MSN, RN · Jul 19, 2012

I told her in front of another nurse. I have a witness. I also sent a email to my self stating what happened. I'll see if they did a incident report. If not then I well tell the manager.

Good idea. There are still two questions posed to you in this thread that you have not yet responded to.

If I were you, this is how I would reflect on the incident and what my next actions would be.

1) It is usually procedure to report to the nurse that a patient fell BEFORE assisting the patient, so that the nurse can assess the situation. In what order did events happen? If you assisted the patient back to bed, then informed the nurse, in my opinion, that's the only thing you could have done differently.

2) Does your facility allow CNAs to do incident reports? If so, did you know that you could do an incident report at the time of the event? If CNAs are allowed, and you did not know you could do one at the time of the incident, you can write the incident report ASAP. If questioned about the time lag between the incident and the report, be honest. Let them know what happened the night in question, that you were not aware that you were allowed to do incident reports, you checked policy, and as soon as you knew you could do the report, you did it.

Refrain from he said/she said in the incident report. Focus on what happened with the patient and simply state that you reported the incident to the nurse. You don't need to include what the nurse said about not reporting the incident. The time lag between the incident and your reporting of it will be enough for a smart NM/DON to figure out that the nurse didn't do her job.

You sound like a very conscientious aide. Good job!

As an aside, the nurse scares me. If she feels that the patient "won't remember" due to altered mental status, I wonder what else she is doing or not doing to patients with the same cognitive deficits.