When to call the Doctor regarding a fall?

[LStar]

Hello, I am a new RN with a bit of LPN experience. I had a quick question. I was working at a nursing home at the time as a LPN on second shift, when a patient was found on the floor. The patient was alert, no harm, vitals were stable and was able to get back up. After assessing the patient I charted and filled out a incident report. I was about to call the doctor and the RN said since the patient is not hurt it's okay to just fax the incident report to him. I was just wondering if I should have called the doctor still anyways even though there were no injuries or was it okay to fax the incident report without calling? Thank for any advice :)

[kathy313]

The LTC I worked at...we called the doc and the POA. If there wasn't an injury, we would call POA at a reasonable time (if the fall happened late on 2nd or during 3rd shift). Always the doc, regardless of the time.

I hated calling families late at night, didn't want to scare anyone!

[jessiern, BSN, RN]

I would always call the MD. Serious injuries may not be evident from a head to toe assessment, and patients may deny pain when it is present (had a little old lady with her head gapped open deny pain b/c she "is a silly old lady and doesn't want to be a bother" - also denied hitting her head during the fall). If the patient's health declines r/t the fall, and you did not notify the MD you orifice will be on the line.

[pennyaline]

Hello, I am a new RN with a bit of LPN experience. I had a quick question. I was working at a nursing home at the time as a LPN on second shift, when a patient was found on the floor. The patient was alert, no harm, vitals were stable and was able to get back up. After assessing the patient I charted and filled out a incident report. I was about to call the doctor and the RN said since the patient is not hurt it's okay to just fax the incident report to him. I was just wondering if I should have called the doctor still anyways even though there were no injuries or was it okay to fax the incident report without calling? Thank for any advice :)

Unless you have a facility policy that states telephone notification of the MD is not necessary for every fall and outlines specifically under what circumstances it is not necessary, call the MD as soon as possible after the incident. After hours and late night calls will go through an answering service and on-call doc anyway. Don't feel bad about calling them at weird hours, as this is all part of being a physician.

If the day comes that you didn't telephone a doc when you should have, don't rely on the doc to take your side. Word to the wise.

[Virgo_RN, BSN, RN]

We always call the MD for a fall, whether the patient was injured or not. The doc may want to do a workup to discover the cause of the fall, if it was not mechanical.

[SuesquatchRN, BSN, RN]

I thought I responded to this.

We call if we suspect an injury and/or want to send them out. LTC.

[NurseLoveJoy88, ASN, RN]

I usually fax the md for no visible injuries and notify poa.

[nyteshade, BSN]

I always call the MD and POA for fall. Who are you to say that no injury occured? Lawyers look for things like this, when a family member decides to sue a year later, because a new finding "could have been related" to that unreported fall. Always remember that, especially in the LTC setting...

[SuesquatchRN, BSN, RN]

I always call the MD and POA for fall. Who are you to say that no injury occured? Lawyers look for things like this, when a family member decides to sue a year later, because a new finding "could have been related" to that unreported fall. Always remember that, especially in the LTC setting...

Huh?

I have LOLs who roll OOB every night almost. They are care-planned not to be injured WHEN to roll OOB from the low bed to the mats.

I am expected to assess. You have pain, you're going. You have a hematoma, you're going. You bounce when you land and laugh and you check out okay, you're staying.

[txspadequeenRN, BSN, RN]

although i agree the doctor needs to be notified...if you work in ltc then you know that a doctor or np does not normally come out and see each resident that falls so yes it is up to the nurse to determine if injury has occurred...if we did not determine that we would have to send out each resident that fell. this is the reason for good assessment skills then follow up several days following the fall.

i always call the md and poa for fall. who are you to say that no injury occured? lawyers look for things like this, when a family member decides to sue a year later, because a new finding "could have been related" to that unreported fall. always remember that, especially in the ltc setting...

[imaRN08]

in the LTC facility i worked at, it was policy if the res was not injured and was stable, then the MD could be notified by fax, but it had to be within 24hrs. POA's we notified at a reasonable time. if they were injured (minor like skin tears etc), we had to call Dr's office, or the triage nurse at the office and leave a msg and could notify fam at reasonable time. if the pt required tx like stitches, poss fx, etc we would have to notify triage or office immediately and POA immediately. always make sure to check your policy though. if you are still unsure, ask your DON

[RoxyDi]

Risk managers will tell you to follow your company policy, always. Injury or no, follow your policy. Notifying the MD of a fall is simply updating him/her of the patient's status. Medications may need to be adjusted or other orders changed even without injury. Use good judgment and never make decisions based upon fear of bothering the doc.