I was working in a long-term care facility. We had a patient who fell while under the care of the other nurse working with me. I was the one who responded to the call button and found the resident sitting on the floor. I called the other nurse to inform her that the resident fell. I was terminated because I was not able to assess the resident for range of motion. The grounds for termination were neglect, but the resident had no injury. Do you think this is fair?
Nancy Brent replies:
It would be difficult to determine what is fair based on the information you presented in your question. So, only a few general comments can be made.
It would seem that any time a resident falls, whomever discovers the fall would be required to assess the resident for his or her overall well-being, including range of motion. It is assumed this is the policy in your long-term care facility. You did not mention why you were not able to do so.
It is also assumed that policy requires a nursing note about the fall be placed in the resident’s chart, along with an assessment of his or her condition, any notifications that were done (e.g., DON, family, physician) and any treatment or medications given to the patient. It is also assumed an incident report would be required and directed to the DON or other specified person in the facility.
You did not mention if the resident’s nurse had any discipline imposed due to her actions in this situation. A major concern here is why and how the resident fell.
Regardless of whether or not there was an injury (it is not clear how this was determined from the information in your question), patient care policies, particularly those regarding patient injuries, need to be followed. If you think you have been unfairly treated, you can grieve your termination through the employer’s discipline and grievance policy. To help you with this process, you can consult with a nurse attorney or attorney in your state who works in employment law with employees so you have some guidance through the process.