Unwitnessed/unknown patient fall; returned 18 hours after discharge


I currently work on a Neuro PCU. I had a patient, I.R. she was on my unit for some time. Came in with AMS ended up having a left lacunar infarct. All Neuro deficits resolved by day 2 of her admission. She is a pleasant woman in her 60s, currently fighting lung cancer.

I had been assigned to her previously during her stay and she had been working with PT who by her last few days deemed her safe to ambulate independently. I was assigned to her again on the day she was discharged. Her husband was at bedside during my initial explanation of her being discharged and that I should have paperwork ready to go in an hour or so. Her attending also was in route to see her prior to sending her off.

I was discussing prescriptions and her home care needs with the doctor at the nurses station, the patients husband had run some belongings down to the car, and a tech had just left the room after removing her IV.

After finishing my 5 minute conversation with her doctor I received a call to take report from another patient coming up from the ED. After finishing report, the attending had already seen her and I went in to discuss her discharge paperwork and ordered transport to take her downstairs in a wheelchair.

The next day, the same attending doctor comes up to me while I'm giving report to my charge nurse and says "guess who is sitting in the ED with c/o confusion/AMS?" well it was my patient from yesterday. The attending continues to tell me she apparently had a fall in the bathroom before discharge in which she states she landed on her bottom. I told him I was never informed of the patients fall and she was never in any distress or verbalized any unusual events to me during my discharge instructions to her.

The attending tells me he asked her why she didn't say anything about it. Her response "i told the nurse but I asked her not to tell you". I told him (being on a Neuro floor especially) if I had known about her fall I can assure you the patient would not have been discharged and you would have been informed right away. We take falls seriously on our unit and follow proper protocol with every witnessed and Unwitnessed fall report. Why would I risk my license over that? My charge nurse agreed with me.

Needless to say, I haven't heard anything from the hospital as ive been off for 2 days and typically any occurrence that is being looked into constitutes a call on your day off. I am just looking for advice as to what I need to do to potentially prepare myself if I'm approached. I've always filled out incident reports for situations that call for them. Does risk management typically favor the word of a patient over that of a nurse?

I definitely would not let a post stroke patient leave the hospital if she fell on her bottom or not and out of everything would not keep a fall to myself because the patient told me to!