Saturday, December 26, 2009

Two incidents

The night was filled with anxious and jumpy residents, coming down from their highs of the Christmas holiday. One resident fell. She is probably not injured. I have not had a fall in a while. What exacerbated the night was that one of the aides either can't hear alarms or won't answer them- I'm not sure which one. Some residents ring their call bell when they want something; others just get up, setting off their bed alarms. The point of the bed alarm is to get to the resident before he/she falls. This particular aide, unfortunately, does not answer call bells or bed alarms. She falls asleep with them blaring in her ear, seemingly oblivious.
Another resident (also assigned to this aide) was trying to fall out of his bed early in the morning. His linens and diaper were wet. Another aide helped me get him cleaned up. A dressing was on his right elbow. The aides know that nurses are supposed to dress wounds, so only another nurse would have placed the dressing. The dressing was loose and there was slight bleeding. I cleansed the wound and redressed it. When the day shift arrived, Nurse Temperamental found him with a bleeding arm, stating that it was an undocumented wound. I told her that I found the wound at 5 a.m., but with a dressing that only a nurse would have done, so I did not suspect that whoever previously dressed the wound had failed to document it. I told her I would do the incident report as it did not happen on the day shift. She was annoyed, as usual, and stated that she already did it. I'll explain it by stating that I did not get to investigate the history of the wound before the day shift arrived and started the incident report; the resident was not in distress so I dressed the wound and continued on with my med pass. This is true- I was still busy passing meds until 8:00.
This sort of a thing happens all of the time. Other nurses discover an issue and treat it unofficially until some other nurse "discovers" it and is saddled with the incident report.

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