Do you tattle on your co-workers when you find something missed? - page 2

by squatmunkie_RN

7,184 Visits | 43 Comments

I work in an environment where everyone smiles to your face while they are stabbing you in the back. With nurses who will lie and exaggerate the truth telling the NM on you in emails and phone calls, then smile and joke to your... Read More


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    Quote from eatmysoxRN
    The only time I tell my manager about missed things or incorrect things is when it is a pretty major issue. Example: a float nurse hung integrillin as a piggyback (no...)
    Looking at Mircromedex ...compatible in the same line as NS or D5NS with up to 60 mEq/L potassium chloride ...when using an IV infusion pump, administer eptifibatide undiluted directly from the 100 mL vial; the vial should be spiked, within the circle on the stopper top, with a vented infusion set.
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    Quote from eatmysoxRN
    The only time I tell my manager about missed things or incorrect things is when it is a pretty major issue. Example: a float nurse hung integrillin as a piggyback (no...) and then didn't unclamp it so 5 hours after she hung it when I came on duty I find a full bottle. That's a safety issue and that nurse needs more education then I could provide.

    The only other thing I email about is when a patient is very distressed over an experience and I cannot correct it. Letting management handle those problems seems most fitting. I'm glad I overall work in a facility that is less about punishment and gossiping and more about patient safety and facilitating learning.

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

    That is how I went about things. I only said something to management if it was crazy like hanging a drip as a piggy back or something that compromised patient safety.
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    Please excuse all my typos. Bottom line is if leadership does not or will not care, you could be stuck in a miserable environment for a long time. You might then be tempted to take on the old "If you can't beat them, join them" mentality. When that happens, these environments continue to flourish; b/c the negative cultural influences become pandemic.

    Sometimes for your own sanity and to make a point, you have to vote with your feet, so to speak. The problem in nursing is that people are hard-pressed not to do this; b/c they are thinking of their livelihood or career trajectory. And, to some degree, it's understandable.


    Problem is, it makes the problem worse for others and for the profession and for patients. I have read articles (can't access them now), where these kinds of toxic environments add to errors that negatively effect patient outcomes and progress.

    It's professional suicide on the whole to just say "Hooray for me and to hell with you." Yes, we all have to survive; but overall, at what cost?

    Of course, at this point in time, I feel a bit hypocritical, b/c I am back in school working to go into a whole different direction in health care. Part of it has to do with overall fit, and then another big piece of it has to do with the many toxic environments in nursing and nursing "leadership."

    Yes, toxic environments occur everywhere. But between the issue of fit and approach to treating patients, and the overall toxicity, the combination of these two things has pushed me over the edge. I would be miserable to stay in the field with the way it is generally run and the differences in how I think and function.

    But I can see people that love nursing (many aspects of it I have loved) just endure it b/c of income, or become part of the problem, or, eventually, they find a way to get out.

    All of this will eventually has/will have a tremendously negative impact on nursing now and in the years to come. You will have people in it that are toxic, who aren't necessarily as bright and dedicated, and/ot just tolerate it for a decent paycheck--along with an eventual shortage leading to not only a drop in quality and caliber of nurses, but also in quantity of nurses.

    Now, it's fine for some in a down market to say, "Hey, that will leave more room for me to get into the door." Just wait a second. When, however, you end up working like many of us nurses did in the 80's to early 2000's, short, and seeing patients suffer, and risking your license because of it, you will think differently about this when this comes back around again.

    No, the shortage may not be in all areas like it was. We shall see--b/c of the shift to out-patient services. But it will come again, and it's won't be something you will necessarily be excited about--even for many that just want a nursing job now. Again, those of us who worked short with very high acuity patients as well as very high numbers of patients, well, we knew exactly how burned out we became and how we feared for the loss of our licenses on a number of shifts. And I am speaking of seriously excellent nurses working under truly unsafe or ridiculously unsafe conditions.


    Nurses need to take a stand about toxic environments-- by NOT being a part of them and NOT tolerating leadership that allow or encourages them. First because it affects you as a nurse and your profession; but also because you and your loved ones will be patients in the future! That's where you really see the tragedy--when it rubs up against you, your family member, or your colleagues. I remember colleagues, nurses and others that ended up at the mercy of unsafe/bad situations. You see unnecessary incompetence, unsafe conditions for any decent nurse, you name, and you don't forget it.
    Last edit by samadams8 on Feb 6, '13
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    that is how it is at my job. i used to never mention errors now i do, rarely. dont blame me that your incompetence is mentioned. but i am the type that will tell someone to their face and maybe never tell the manager. things like drs not notified of high temps, low bps etc, labs from hours ago not drawn. i dont care about things that will most likely not harm pt. i rarely go tell the manager cause i thought what is the point. nothing changes . but have come to realize that most other coworkers do tell and write emails on every little thing. i guess in an environment like that it might harm you to not do the same thing!
    WildflowerRN and squatmunkie_RN like this.
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    We don't "tattle" on my floor. If it's something minor we just fix it. It is something like a med error I will fill out an incident report. Where I work incident reports aren't used to punish anyone, they just track occurences.If a nurse makes an error and sometype of review or education is indicated they get it, quite often an issue is addressed by general education for the whole floor so no one is singled out.Having someone else write an incident report on you isn't viewed as an act of hostility, just something we required to do.I have also caught myself in an error and written one on myself.I have e-mailed a manager with concerns but this is handles confidentially and the other person never knows who spoke to the manager.
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    Quote from squatmunkie_RN
    I work in an environment where everyone smiles to your face while they are stabbing you in the back. With nurses who will lie and exaggerate the truth telling the NM on you in emails and phone calls, then smile and joke to your face. How can you work like this? When you're constantly looking over your shoulder worried about what mistake will go in your permanent file? If I find something wrong, something missed by the previous nurse I fix the problem and move on. (the shift is WAY too busy to stop and write emails on what the previous nurse missed by accident) But, now that writing emails and vindictiveness is what the NM wants from his staff, I guess I will give him that. I learned something last week. Trust NO. ONE. EVER. Please give me your thoughts!
    Oh the things I could say here! But to keep it short, the first and last time I reported to my manager because of the way I was treated as a float nurse within minutes of reporting to duty, I was made a DO NOT USE on that floor. After that, I only talk to my patients. I don't talk to anyone on the floor, in the hospital, in the city, or even in the county! I do my hours, pack my car, and drive my happy *** back to where I came from. When I see that I've gotten missed calls from the job, I just smile and think, yeah, you miss me, dontcha? Lol! So, no, I don't tell! (BUT!) If the patient complains to me about another nurse, I have o choice but to act on their complaints. So, I will ask the charge nurse if he/she could talk with the patient in room #--- when he/she gets a minute. Then the charge nurse can determine if the manager should be involved.
    Last edit by BSNINTHEWORKS on Feb 6, '13 : Reason: Phrase removal
    GrnTea, anotherone, and squatmunkie_RN like this.
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    Wait. I'm not for anyone "tattletaling" per say. I mean if it is truly a patient safety issue or something like that, well, you have to fill out incident reports and be as judicious and careful as possible. I am talking about standing up against unfairness and manipulative games and hypocrisy. My usual first approach if there is something in question is to go directly to the horse's mouth. I try to handle something in question the way I'd like it to be handled if it were me.

    But the toxic, backstabbing abuse, well, that gets really tricky in terms of how to deal with it. Like I said, if it is a strong enough level of toxicity, I will find another position. I may or may not write a letter to administration as to why. It depends. But I'm not hanging around though for a bunch of crap that no one really cares to clean up. When the toxic level gets high enough or serious mistakes really take hold, maybe then they will be smart enough to deal with it. In the meantime, I'm not wasting my life with it if I can help it. If something is rotten, it either has to moved, or you have to move. When they leave it there to rot and rise to toxic levels, well, I'm going to move away from it.
    anotherone likes this.
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    If you find an error that compromised patient safety, reporting it is not "tattle-taling", it is doing your job.

    I have found some pretty critical errors when working in the hospital. Filing an incident report led to an email being sent to the manager with the information. The one that immediately comes to mind: I was caring for a patient with rapidly progressing cancer who developed acute hyponatremia eventually discovered to be from Cerebral Salt Wasting. EVERYTHING we were doing with him was based on his sodium levels and he was ordered for q 6 hr Na+ levels. I drew his level as ordered and sent it to the lab. A colleague sent labs only a minute or so before me. Soon thereafter, labs were resulted for my patient and they listed an Na+ level of 137. His most recent level had been 131. It seemed like a big jump but the night before he had jumped from 123 to 129 over the course of a few hours. Not long after that, another set of labs came back that listed the Na+ level at 134. I called the lab to find out what happened and they stated "we have two samples for him." I insisted that that was impossible because I had drawn the labs and sent the sole sample down myself. Then they told me who'd signed the other one and what happened became clear... my colleague had mislabeled her patient's specimen with my patient's label. Despite receiving samples labeled for two patients in one bag, the lab ran the specimen from the other patient labeled with my patient's name and resulted the labs as if they were my patient's. Had we not caught this error, we may have mistakenly believed that my patient's sodium level was normal and that we had successfully treated him... if we had made any decisions based on this incorrect lab value, his sodium likely would have dropped again, perhaps critically so. This error had to be reported and it wasn't tattletaling. This situation should have never reached the point that it reached because it was the hospital's policy to cancel all lab orders if specimens were received for 2 patients in the same bag because they couldn't be sure if they were actually samples from 2 patients or if part of the sample was mislabeled, as was the case here.

    The point of reporting errors isn't to tattle on co-workers, it's to figure out what happened to prevent it from happening again.
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    I'm an open book. I blurt out every mistake I make for God & everyone to hear b/c I'm terribly neurotic. Your floor needs more people like me so there's no need to tattle.
    catlvr, Orange Tree, GrnTea, and 2 others like this.
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    We have an online reporting system in place at my facility that allows you to report incidents and is supposed to be "blame free". The types of things we report are usually med errors, falls, and the occasional incident with a physician. I agree with the poster that said the reporting systems are only as good as the leadership. I made a med error when I was a new grad and immediately filled out a report on myself..I figured it was better for me to "tell" on myself than for someone else to do it. I am now a charge nurse and I recently had nurse tell me that another nurse routinely made med errors and our nursing manager never made her fill out an incident report. If management isn't going to make you fill it out, what good is it?


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