OMG! Unreported Patient Fall

Published

Specializes in Pediatrics.

I am currently working a home health case through an agency in addition to my per diem Medicaid cases. I just got a voicemail on my cell phone from the the full time night nurse (I cover her days off) telling me to please call her back about something urgent. A few minutes later my agency called and left a message for me to call them. They called all my phones and from three different numbers including one blocked :uhoh21:. Of course my heart is beating because I don't know what is going on and I am panicking going over last night in my mind...did I sign for the meds?

Did I fill out the BM book? etc, etc. OMG, what did I do or forget to do?

Then the day nurse called. I am OK with her and answer. The client has been taken to the hospital with some internal injuries from school; she had tarry stools and some other problems. Did I notice anything last night because I didn't chart any abnormalities... I tell her no. Last night she slept through and this morning she roused easily for AM care, meds, and breakfast without a problem. Mom said to leave her in bed and she would transfer her to the w/c later since the day nurse wasn't due until 8 and I left at 7. When I left everything was fine.

Well, day nurse tells me that the night nurse told her that when turning the client she fell out of the bed Saturday night.

This is a 250 pound teenager with legs stuck apart in contractures, legs forming a right angle at the knees bilaterally. You have to push her completely over on her side to change her and clean/dress her but it does pose a small problem with her balance. I can see how it can happen.

The problem is THIS. The night nurse did not document the fall and doesn't want to tell the agency what happened. Day nurse says it was on purpose because the client was being uncooperative. I don't know if Day Nurse just threw that in for drama or what.

Theoretically it can fall on ME. This nurse is known to lie. OMG, I'm freaking out. Then again, I don't know for sure that the DAY nurse isn't the culprit.

I call back the night nurse but no answer. I call the agency and tell them what I know: Everything was fine on my shift. The supe says "OK, I'll be in touch," and hangs up.

There is no day nurse on the weekends (just a night nurse) and mom said that Sunday the client slept most of the day because she hadn't slept the night before. She didn't notice anything out of the ordinary either.

One of us is going to take the fall for this, I already know it, but it honestly WASN'T me. OMG! I am really freaking out. This is not good.

*I am looking at my copy of the report and it is thorough with the survey questions and the narrative but she didn't have anything significant to chart. There weren't any visible ecchymotic areas, areas of tenderness, or manifestions of pain.*

OMG~I hate that I don't know who to believe. This is a problem in this industry.

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i would think there would be an investigation...

and the pt or parent would be able to identify who was involved.

dang.

i can't even begin to believe it was done purposely.

leslie

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Specializes in Pediatrics.

dang.

i can't even begin to believe it was done purposely.

leslie

Pt. is nonverbal unfortunately. I don't know that it was done on purpose. I don't even know who did it OR if that's what really happened. What I do know is that there are only three of us on the case and I was the last one to see her before day nurse. I will NOT be the patsy for anyone though. I will take a polygraph if I have to. I work with less than honest nurses, both of them, but I find day nurse to be more true than full time night nurse. Just from other dealings with both of them separate from the case. I am nervous though. I don't care that there will be an investigation I just don't want to be included. I had nothing to do with anything, accident or otherwise. My heart is beating so hard right now.

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Specializes in all things maternity.

With a 250 lb pt, wouldn't the perpetrator have to have had help getting her back into bed? So there is probably a witness out there someone and witnesses talk! Its just a waiting game.

Vickie

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Specializes in Pediatrics.

Unless she just used the Hoyer...

I am calling mom tonight. I don't know what I am going to say. Maybe I'll go up to the hospital if the client is admitted. I don't know why I am so nervous. I guess it's all the horror stories I've heard over the years...guilty until proven innocent sort of thing... :(

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Just keave it alone and let the agency investigate!

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Specializes in Med-Surg, ED.

If I were you I would just not do anything. You know you are innocent but if you start getting all nervous and asking lots of questions etc...they will start looking at you funny. Just let it lie and understand the truth will win out. Don't call mom, don't go to the hospital, don't do any of that. Just let it happen and be ready to call your in case they try to put this on you.

Good luck.

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Specializes in LTC, Home Health.

I would just sit back and let them do their investigation. I hate to say it but with as nervous as you are you can seem very suspicious to people. Relax. At one time or another a lot of nurses have dealt with situations like this.

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Specializes in Pediatrics.

I know I can look suspicious. I am nervous simply because I am the last one on the case and I am the fill-in. I don't trust the nurses and I don't want them to gang up on me or try to use me to gang up on one another. This is one of the reasons I left one of my other cases a year or so ago. Two nurses turned on a third nurse and the whole thing was so nasty and bitter and I didn't feel safe in that environment. I hated having the nurses come and talk about each other behind each other's backs and I didn't like the whole atmosphere. I've prayed about it, talked to my mom and she said I was overreacting. If everything was fine when I left the client in the care of the mom and the client didn't start showing symptoms until this afternoon then it will likely fall in the day nurse's lap. The more I think about it, it makes sense to me too. I'm not going to worry about it.

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At least, you'll TRY not to worry about it. ;)

Seriously, just keep your mouth shut and your head down and let the chips fall where they may.

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Specializes in Infection Preventionist/ Occ Health.

If it makes you feel better you could contact a lawyer with experience in these sorts of matters. He or she would likely give you the best advice as to how to proceed in this case.

Good luck and I hope that it turns out okay.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Looking at the story:

Monday dayshift nurse calls you to inquire about care you gave pt Sunday night as change of condition while at school: pt taken to hospital as tarry stools, internal injuries suspected. You confirm documentation that no change noted.

Day shift nurse called other nurses reporting change of condition/hospitalization and asking if any issues noted...

You report

Then the day nurse called. I am OK with her and answer. The client has been taken to the hospital with some internal injuries from school; she had tarry stools and some other problems. Did I notice anything last night because I didn't chart any abnormalities... I tell her no. Last night she slept through and this morning she roused easily for AM care, meds, and breakfast without a problem. Mom said to leave her in bed and she would transfer her to the w/c later since the day nurse wasn't due until 8 and I left at 7. When I left everything was fine.

Well, day nurse tells me that the night nurse told her that when turning the client she fell out of the bed Saturday night.

This is a 250 pound teenager with legs stuck apart in contractures, legs forming a right angle at the knees bilaterally. You have to push her completely over on her side to change her and clean/dress her but it does pose a small problem with her balance. I can see how it can happen.

The problem is THIS. The night nurse did not document the fall and doesn't want to tell the agency what happened. Day nurse says it was on purpose because the client was being uncooperative. I don't know if Day Nurse just threw that in for drama or what.

This is called HEARSAY..... reporting anothers conversation. Your a allowing it to color YOUR perception of events/staff. Day shift nurse ethically obligated to report conversation between herself and other nurse to agency. You should not comment on a second hand conversation as not present when occurred; nor should you make any comments to this nurse regarding other night nurse activities ----only person you should speak to is agency supervisor that you report to and only then relay info other nurses have passed onto you in report. Any concerns parent expresses to you regarding other nurses unless directly relieving them and finding problems also should tell family to notify agency---don't let them pit one person against the other.

You are off duty. Allow agency to do it's job along with hospital performing tests etc. Do not contact pts family nor visit patient in the hospital. I would not even write further on the bb as no one knows who's reading public info. Keep personal comments to yourself. If futher investigation being made, that is time to notify your insurance carrier of situation.

Staying calm and keeping a cool head will show that you have nothing to hide.

Wishing healing for the patient.

PS I've changed title of thread, as you have no proof anyone was pushed. I can easily see if siderail not up on bed during care activities, that this type pt can accidentally fall out of bed...almost happened to me once with immobile overweight contractured pt while remaking occupied bed --luckily half rail up and able to prevent fall.

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