Incident reports at our facility sound very similar to the incident reports described by RNmb. While they can be used against you if a pattern of unsafe behavior is established, for us, they are used to help understand why something happened. They address communication, system or technical errors, education/training deficits, and other issues that need to be addressed. It's a means to track problems, look at issues from all areas, and learn how to avoid such issues in the future.
I've had several incident reports written about me. Every time we have a fall, and incident report is written. Once I miss programmed a PCA pump and delivered 10x the amount of drug to a pt. I caught it at the follow up check; but initially neither I nor the second, verifying RN discovered it. I was one of several nurses who had this issue, and our tech and risk management departments decided it was a programming flaw within the pumps, and recommended we replace them with another design. It led to the purchase of brand new pumps from another company.
Another example: after several incident reports regarding new nurses not following protocols, our floor decided to do an ongoing education with the new nurses, for their first year of employment. Once a month they attend a 4 hour class that reviews what do to in certain situations (chest pain, code blue, hypoglycemia, etc). It is to supplement and reinforce their orientation, and to improve their practice. While they all hate coming to a class, they all also report that it does help them, and incident reports have dropped. It's helped so much that we *all* might have to start attending some sort of on-going orientation on protocols!
I have never felt in fear of my job following an incident report. I have never had one waved in front of my face in a threatening manner. I *have* had our director/assistant director give me the print out and ask me to tell them what happened, why I think it happened, and how I would recommend avoiding the incident in the future. In our hospital, on our floor, it is a genuine process, with the intent to discover problems and improve practice.