Pt 'fall', unit changing, other staff, ect

[hollyberry678]

Hi, needed opinions on this situation:

A patient on the night shift asked for her commode to be close to the bed, "incase I need it quickly, I know the call lights arent always answered fast". Pt had been given a supp. during the evening shift. Pt up to commode x2 already during night, with loose BM x1.

Went on 10 min break at 0530. Handed my pager to another rn. Came back, and Rn in pt's room, went in room, and rn said pt had called, and when she went in room, pt on floor by bed. PT denied falling, said she had 'lowered herself to floor". Pt stated she was okay. She stated she put call light on earlier, no one came, a 'male' answered. Floor had urine on it, rn had cleaned it up.

Being new, asked rn what I should do. She said nothing if pt didnt fall, to chart on it, I did.

Evening RN next day said pt claiming she fell. Evening rn upset at changes to unit, and thinks that call lights arent being answered and thus the unit is getting risky for pts. She cites this as an example.

She said she emailed the nurse mgr about this. She also said she was in talking to pts family about this, and also the fact that there are dust bunnies on the ceiling when the pt is on neutropenic precautions, ect

When I went into pts room that night to take vs, i asked her how her day was, "well it was good except the morning-- I FELL!! (big smile). I turned on light, and she saw it was me from night before...I said did you fall? Oh,I dont know..

Now tonight. After thinking about it, I was a little upset the RN who emailed the mgr jumped on the bandwagon that she 'fell', totally then against what I wrote in my note...I asked her about it, and she said nurse mgr would 'investigate'. Also I guess this particular nurse has been talking and talking about this...I told her that I didn't feel supported as what I wrote was somehow not accurate, ect, and she responded she is a pt advocate, and I was too sensitive..I hate when people tell me I am too sensitve

I had been sitting within earshot of call-light prior to going on my 10 min break, and didnt hear the light go off.

Anyway, thought/opinions on this? Thanks...

[EmmaG, RN]

In facilities where I've worked, if a patient ends up on the floor it is considered a fall and an incident report is filed. All you can do is document what the patient said happened, as it was unwitnessed.

[Kymmi]

I honestly do not understand what the question is or what you need a opinion on.

[CoffeeRTC, BSN, RN]

We call it a "found on floor" and would do an incident report for a unwitnessed fall. I would do an incident report for this. You can always be safe than sorry for things like this. The first time you don't do one....things like this happen. Patients will and have changed their story or they embelish it for the family and the next thing you know she fell out of bed becuse the call bell was going on for over one half hr and no one came and I had to pee......

[shellsgogreen]

i would have documented the fall, and incident report. in the comments on the report, i would put that patient denies fall, but was found on the floor. it's important to cover yourself on these things, but also here, you mention that the patient later claims she did indeed fall. she may have been confused, or blacked out at the moment it happened.

[hollyberry678]

I ended up being upset at the next evening's RN, who emailed the mgr, ect without talking to me first about it, so that maybe I could have followed up on it...And she was in the patient's room with patient and family apparently talking about how this unit is changing and cal lights arent being answered and its so dirty- dustbunnies, ect, (the unit is currently being remodeled so it will be brand new soon). and a little upset that I didnt know the procedure, I only charted on it as the long time RN advised me to.

Anyway, I told the evening RN that I was upset that she didn't believe my note, apparently, and that it didn't feel suppportive as a staff member...It all seems so negative, and I wasn't even there!!

[Ahhphoey]

I would have written an incident report on this only because I've had a problem with this in the past. I had a post op patient who had a cysto under spinal anesthesia and wanted to get OOB to the commode chair. Well, I tested the sensation and strength in her legs before helping her to first sit at the side of the bed. I helped her to stand, but realized that she wasn't as strong as I originally thought, so attempted to sit her back on the bed. She thought she could make it to the chair and grabbed at the chair while I was trying to get her back to the bed. In the end, I assisted her to the floor and got help to get her back into the bed. She profusely apologized and said it was her fault for trying to do more than she could. I chose not to write an incident report because she did not fall, but I did document everything. There were no obvious injury and she did fine through the night and was discharged as planned the following day. Several weeks later she came back to the hosptial demanding xrays and to be seen for free in the ER because she claimed she injured herself when she fell in her room after the nurse (me) left her alone to get OOB to the commode by herself. She claimed she was alone when she fell and I told her it was okay to get up by herself. Luckily, I the CNA I had gotten to help me get her off the floor had been nearby and knew I was in the room when everything happened. I had to go through an entire investigation into the incident and I did have to fill out an incident report later on, but fortunately I had documented so well, that the incident report was no problem. I did not get into any trouble as it was found that this patient had some previous "issues" and I had a witness that I was present during the assist to the floor. I did get talked to about filing incident reports though.

[mianders, RN]

I think the RN that is talking to families about the problems the unit is having is setting herself and the hospital up for all kinds of problems. Always fill out an incedent report when anything out of the ordinary happens to a patient. CYA!!