policy regarding patient fall and transfer to the hospital?

[Ms.RN]

what is your facility's policy regarding transferring patient to the hospital after patient falls and there is a possible fracture?

yesterday my patient fell and complained of pain of left hip. so i called the doctor and he wanted a stat x-ray done. because my shift was over before i can get the result, i gave report to the next shift nurse to call x-ray company and get the result and call the doctor and family. for some reason this nurse couldnt get the result because a person working in x-ray company is not answering the phone. so the morning shfit nurse finally got the result and sent her to the hospital for a fracture.

next day i came to work, morning nurse gave me a report that don was ****** off for not sending patient to the hospital. then don called me during my shift and told me that i should've sent her to the hospital because her treatment was delayed and if family decided to sue the company we are in big trouble. she also said, if i called her she could've told me to do this and that and sent her to the hospital. i'm like okay just ignore the doctor. so do you think her treatment was delayed even though we are waiting for the x-ray result? do you send patient right away to the hospital if there is a possiblity of fracture? do you think family can sue me?

[CoffeeRTC, BSN, RN]

Why didn't the next nurse call the doctor back and tell him/her that there will be a delay in the xray results? Did that nurse document what was happening? What was the status of the pt during this time? If it happened at change of shift, both nurses should be involved in this...you start the incident report etc, next nurse finishes it.

Anymore, I try to CYA and will kinda ask for a trasport to the ER for an Xray. Our turnaround time with the xrays varies, so just to be on the safe side, if a fracture is suspected...I'm a shipping them out.

We don't have a policy per se....just nursing judgement and doc orders and good, good documentation. Any type of incident with injury...the DON gets a call at home.

[CapeCodMermaid, RN]

If I suspect a fracture, I skip the portable xray part and send the patient straight to the ER. I worked at one place where a patient had fallen at 3am and they didn't send him out because the doc said it was the middle of the night and the ER might get mad. I got there at 7 am and saw the man was in agony. I called 911 and then told the doc I was sending him out. They got a tag on state survey that year for delay of treatment. YOU are the one there to assess the resident. I never wait for an order if I think the person has to go out. One of the regs states if the MD does not call back or is unavailable, a person with sufficient knowledge to determine the event is an emergency may send the patient out...you bet I have 'sufficient knowledge"