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Old 07-09-2010, 01:31 PM
Niff Niff is offline
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Default Patient Fall and Nursing Notes

We have a new RN, fresh out of school. She got her license last year and we are her first major case.

Mackenzie rarely gets on the furniture. We've always gotten down to her level because I've figured it's safer that way. Of course there are occassions when we let her climb or sit with us, but overall she's not interested. The nurse has a thing for sitting Mac on the couch. She's left her unattended that way once and I happened to be home and noticed, so I got her off the couch. Well today the nurse wasn't paying attention to Mackenzie (the nurse had turned the suction machine off and must have "forgotten" Mac was with her?). Mackenzie fell off the couch and bumped her head.

The nurse scooped her up, and of course I took her from the nurse and soothed her. It wasn't anything horribly bad, but it is the first time Mackenzie's ever fallen of the future and I wasn't very happy about it. The nurse immediately says "Do you think she's tired? Should I put her back in her crib?" I was a bit annoyed at this and couldn't understand her reasoning behind thinking Mac was tired at all. (Still having debates about why she would want to put Mac in her crib so quickly... but anywho...)

So the nurse apologized and I didn't say anything. I mean really, wth do you say to that? I couldn't say anything so I bet my tongue. The nurse eventually leaves and I go check the nursing notes. No where does it say that Mackenzie fell.

This makes me incredibly weary. Surely they're supposed to document that sort of thing? Had I not been home, would she have told me? I'm really not thinking that she would have.

Needless to say I'm fuming mad right now and not sure if I need to just calm down and let it pass... or just take it as the first warning sign to boot the wench out the door.

ETA: I just got off the phone with our nursing supervisor and she said the nurse DID go to the office afterward and they're filling out an accident report. She's going to talk to the nurse and figure out why she didn't chart it and call me back.

Last edited by Niff; 07-09-2010 at 01:36 PM.
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Old 07-09-2010, 01:41 PM
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sawyersmama sawyersmama is offline
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Oh poor Mac!
Sawyer fell off the couch once and I cried for like 4 hours haha
I would like to think that she just didn't know any better being a newbie, by the fact she didn't put it in the charts, but reported it to the office.
I would settle it with the supervisor, and the nurse, and keep it in mind as a warning sign, but I don't think it is.
I hope she works out! I am rooting for her haha
Kayla ~ Single mom to Sawyer (born May 12/09) diagnosed DiGeorge Syndrome - seizure disorder, developmental delays, right vocal cord paralysis, tracheal malacia, congenital heart defects (interrupted aortic arch type C variation, VSD, PFO, PDA closure, Bicuspid aortic valve), hypoparathyroidism, hypocalcemia, GERD, chronic lung disease, absent thymus, immune disorder.

* Love & Laughter for every Child *

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Old 07-09-2010, 01:52 PM
MomofTwoBoys MomofTwoBoys is offline
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I hope Mac is ok!
Hunter has fallen off the couch twice (once yesterday) now that he can climb up onto it, always scares him more than hurts him.

I tend to agree with Kayla, she, being a new nurse, probably wasn't as well aware of protocol as she should have been. I would make sure to address it with her yourself, and tell her that you want ANYTHING out of the ordinary documented inhouse.

As for putting her in the crib, it sounds like she was flustered and reacted with the first thought in her mind (obviously a completely strange, off-base, one but still, probably the first thing she thought was that Mac was too tired to sit on the couch by herself???? She must not have kids to know that thats a no no)....
Melissa, mom of two great boys... Christian 8 yrs old and Hunter 2 yrs old... former 24 weeker(born at 15.3 oz, 11 inches); bpd, pulmonary hypertension(resolved), nissen/g-tube, off of o2 12/17/10, off the vent 6/30/10... DECANNULATED 12/17/10!!!
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Old 07-09-2010, 02:07 PM
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destinyandmiracles destinyandmiracles is offline
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Well I am glad to hear that she reported it to the office. And maybe with being so new she forgot to put it in the charting???

I say give her another chance and maybe just let her know about how you feel about what happened??
Mommy to Ashton. Former 24 weeker, now 5 years old! Ashton has severe cerebral palsy, severe reflux, g tube fed, legally blind, cochlear implant for hearing, undiagnosed cyanotic episodes and tracheostomy which was done in Dec 2009. The love of my life! Also mommy to an angel, Hunter who came way too soon on March 28th 2009 at 18weeks and 4 days.
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Old 07-09-2010, 02:18 PM
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JWorthington JWorthington is offline
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I agree with what everyone else has said and also I would let her know that you don't put Mackenzie on the couch and you'd prefer that she didn't do it. hope she works out

Sam Feb 11 2003 Opitz G/BBB syndrome, mickey, nissen, autistic,supraventricular tachycardia, bronchiolitis obliterans. decanned May 30 2009. 2 brothers Jonathan (23) James (14).
I am first and foremost a child
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Old 07-09-2010, 04:52 PM
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kadiera kadiera is offline
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It's always a bit of a shock when that sort of thing happens, but kids are usually ok. My husband has been the result of more falls from the couch than I care to count.

Our nurses are required by the agency to document anything like that to protect them from abuse allegations. Most of the time, if it's more than just a little bump (like, oh, the day Alexander sat up in bed and missed the edge while the nurse was standing right there and the thud woke us from a sound sleep), they are supposed to call the agency to make an incident report.

The crib thing sounds odd. Maybe she expects Mac to sit on furniture safely, and was thinking at least she can't fall out of the crib? It's probably worth a discussion about what you expect.

That being said....toddlers fall. It's part of the process of learning to not fall. It's usually more scary than anything, and leaves occasional bruises.

Our solution has been that we've instructed PT and OT that they *must* teach Alexander a safe way on and off of the furniture - it's drastically reduced the number of frightening moments and bumps and bruises. He has a stepstool in the livingroom to get on the couch. He also has one in his room to get on his bed, but since it's a shorter-than-average bed, he's actually tall enough now to do without it.
Janet, crunchy pagan automotive engineer mom to Alexander, born at 27 weeks, 1 lb 7 oz | vent/trach/gtube @ 5 months for BPD | g-tube free 7/11, trach free 8/11. Also mom to Bethany born @ 28 weeks, 2 lbs | gtube @ 5 months | trach/vent @ 6 months for BPD, bronchomalacia, trach free July 2014!
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Old 07-09-2010, 06:22 PM
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mamaluvschocolate mamaluvschocolate is offline
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Any of us who have kiddos know the risks involved in putting a toddler on furniture unattended. I wonder if she has a lot of experience with children. I really hope it works out. At least she will probably be more careful next time
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Old 07-09-2010, 08:12 PM
Alex's mom Alex's mom is offline
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There was a time in my early 20's (single and childless ) when I cared for my first baby niece.

She almost fell off the couch one day- I caught her just before she hit the floor. I think I was shaking for the rest of the day.

I considered myself a responsible person, I was just clueless about some things. I learned. My stomach still drops when I think about it and my niece is 7 now.

I hope you and Mac weren't scared too badly. I bet you the nurse won't have to be told not to put her on the couch again.
Has a daughter who is vent dependent.
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