I was doing paper works today. I was swamped because I have to review all the three admissions that came yesterday. Aaah... I am so overwhelmed and could not think of what to do next. Albeit, I have to do it because per policy all charts must be completed within 48 hours. And I cannot be so relax because time is ticking. I have to make the PASRR, review the medications, check if all the assessments were done, progress notes in time, and care plans initiated. Whew.... what a job!
I still have to do all the clinical checks from the daily communications, lab reports, abnormal vital signs and weights, do the IDT, care planning, verifying the order completeness, do the UDA audits, and many more. I feel so scared just thinking of it everyday. But oh well, got to lessen the loads so that I can very efficient in beating the deadlines. Despite of this things to do daily I still have to check off all those required webinars and meetings in between. I just don't know how I juggled all those times. It was just fleeting and boom it's done. Hehehe....
Break time for me is non-existent and I just used it up to finish my routines. Sometimes I nobbled something just to feed my stomach and to get some energy and sugar. I bite some apple wedges, sometimes peel an orange and nibble some of the ears. That's how I spend my break, multi-tasking as the same time.
I was in a very deep focus of my work when one of my subordinate told me to check for a patient who fell in her room. When I went in I saw the old lady lying in prone position on her right side with her head turned to the left, I saw blood gushing from her mouth and my subordinate had put some gauze there to abate the bleeding. I assessed her and noted that she was very alert and oriented, asked her for any pain, and checked if there was severe injury. I ask the charge nurse to help me turn her slowly on her back then help her sit down and eventually put her on the wheelchair.
When we put her on the wheelchair I ask her if she has pain and she was pointing on her head that it really hurt. I told the charge nurse to give her pain pill and then continued to talk to her asking her what happened why she ended up on the floor. She said that she was getting out of her bed then all of sudden she fell and hit her head badly on the wall. I ask her if she used the call light but she did not remember. All she remember was she was getting up to go to the bathroom and then she fell.
Her upper lip was swollen and sustained a tear from the fall which was really bleeding profusely and could not stop. I asked the charge nurse if she is on any anticoagulant and he said yes. I ask her again if she has any pain aside from her head and she said none. Since she is on anticoagulant and the lip is profusely bleeding I decided to ask the supervisor to call 911 to transfer her to ER for further eval. I don't know if she has bleeding internally so I cannot take the shot of keeping her in the facility because of the impact of the trauma to her head.
Soon after 911 team came and I gave them report of what had happened, then they assessed the patient and prepped her for the emergency transfer. I told the supervisor to call the MD and responsible party and then I informed the CNE about what happened. Then I instructed all involved what happened and discussed to them what to do in their documentation. I also asked the supervisor to gather some statements of the witnesses and anybody who saw the unfortunate situation.
I was so devastated that happened. I was also contemplating if I have done something to prevent it, maybe it didn't happen. Blame and guilt succumbed to me. As a leader I should have warned my team to check on those patients who were high risk for falls. But wait a minute..... didn't I do that everyday during the morning huddle. Or was it just all my team members were just lazy and stubborn to check on their patients? And now that this happened, it all goes back to me because I neglected to always remind my staff members to be keen enough to those patients who were high risk for falls.
Then in the afternoon, when I was about to leave the hospital called that the patient was admitted in ICU because she sustained a subdural hematoma when they did the CT scan of the head. She will stay there for neurological monitoring until she is stable. Thank God she did not have a hemorrhage. Whew.... that was a close one. But still it is inevitable that the lawsuit will arise sometime. Things like this that happen is for sure a good criteria for suing. Hopefully, this patient would not.
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