Incident which aresident with dementia had been complaining of pain

Incident which aresident with dementia had been complaining of pain Essay Assignment Paper

Discussion – Week 3
While working in the long term care unit, there was an incident in which a resident with dementia had been complaining of pain and had become less ambulatory. In a review of the medication administration record, the resident was receiving more pain medication than before. As a nurse manager, the staff was asked questions about the ambulation change, and no reasons for the change were documented. A couple of weeks later, there was a call-out on the 11-7 shift I had to cover as the charge nurse. When speaking with the unit secretary familiar with the resident, we began discussing the decreased mobility and pain concerns. During this conversation, the unit secretary told me,” you did not know?” and I replied, “know what?” A couple of weeks ago, the unit secretary replied that the resident was trying to stand from a sitting position and fell backward. Didn’t the nurse tell you? My response was,” I did not receive any incident report from a witnessed fall.”

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At this time, I began to review documentation from the date the resident fell. There were no neurological checks, no vital signs taken, and no mention of any falls in the documentation that a fall occurred. From here, I was responsible for filling out an incident report, notified the physician, family member, and administration. The physician was made aware of the X-ray recommendation, with findings, noted a lumbar fracture. This finding was reported to the Department of Health as it is a reportable incident. My initial thoughts were, I cannot believe the nurse would not share this information. The nurse working on duty the day of the incident was placed on administrative leave for three days while the case was being investigated. After interviewing multiple staff on all three shifts, the activities director, the maintenance staff, and the Certified nursing assistants, the investigation’s conclusion led to the termination of the Licensed Practical Nurse. As a nursing obligation, I was responsible for reporting neglect/abuse to the local Ombudsmen, Adult Protective Services, and the Department of Health Professionals. This was an unfortunate situation that affected this patient’s overall health, in which he later was admitted to hospice and expired.

The first challenge in this situation is that the patient had dementia and could not verbally express what had happened. Another challenge was that the unit secretary assumed management was aware of the fall. Strategies included interviewing the staff who provided care to the resident and interviewing those who may have had some interaction with the resident during the past couple of weeks. A second strategy, when the patient initially was given pain medications, an X-ray should have been obtained after a few days of given pain medications.

All employees were required to complete an abuse inservice on the initial hire and yearly. After this incident, we hired a consultant to come into the facility to review abuse training, which was mandatory for all licensed staff members.” Since the knowledge influences awareness of abuse, expertise, and preparedness of caregivers, the care team, and nurses as the first line of treatment is responsible for identifying and reporting mistreatments and supporting vulnerable populations such as the elderly (Saghafi, et al., 2019, para, 7).”

Abuse is something not to take lightly and is a reportable offense in which you can lose your nursing license. I had two takeaways from this situation. The first is being more intuned to the care given to dementia residents. Secondly, some nurses will surprisingly make a poor unethical decision, affecting others’ health outcomes.

Incident which aresident with dementia had been complaining of pain Essay Assignment Paper

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