Occurence reporting to punish other nurses

[sistrmoon]

Several of us have noticed a trend amongst the newer nurses to write PSNs on piddly things and even exclaim with glee to their coworkers that they're "writing a PSN on that!"

I'd like to say management takes a non punitive approach to PSNs and uses it strictly as quality improvement, but that's not the case. I once tried to write one anonymously(because I was tired of it being turned back on me when I wrote one) and they apparently questioned everyone until they figured out who wrote it and then called me at home to question me about it and basically said we weren't allowed to submit anonymously.

I'd like to say management sees what's going on and discourages it, but yeah no. I'm not talking about legitimate occurrences that need to be reported. I'm talking about a pimple on someone's backside reported as a pressure ulcer the previous nurse didn't document. And the like.

It's turning into a very uncomfortable vindictive feel where no one has anyone else's back. Anyone else have this going on?

[la_chica_suerte85, BSN, RN]

I wonder how normal it is for these nurses to have had previous work experience at anything. I'm only a student but I have worked since I was 16 and I know better than to go into a new environment without learning the culture and the way things are done and then acting like you know better than everyone else when "by the book" things aren't followed. It's quite an expedient way to make enemies and reduce the number of people you can call on when you really need help.

[KelRN215, BSN, RN]

I don't get this. Just put up new tubing. This is one of those instances where you should just take care of the situation and move on.

Except for the time it's not... like when you realize the tubing was originally used on your patient's roommate, who is HIV+. That happened at the hospital I used to work at. Now, I've never written an incident report for unlabeled IV tubing... I did throw away unlabeled tubing multiple times/shift every shift I worked, though.

My experience in the hospital was the exact opposite of yours. People were more apt to cover up things than to report them... and the manager inevitably found out about them and then got on you about why you didn't write an incident report. I can't think of any time when it was ever any of my colleagues' goal to "punish another nurse". If you catch a reportable error, there's inevitably someone who's going to think you're "writing them up" or "tattling". Sorry but if you have a patient with an active infection plus neutropenia and is ordered for IV antibiotics q 6hr and I come on at 7am and the patient last got a dose at 5pm yesterday and the next scheduled dose on the MAR is at 11pm, the patient has missed 2 doses of a critical med with the potential to miss 2 more if I don't catch it and that's reportable.

[RosesrReder, BSN, MSN, RN]

I don't know where you guys work but at my place, it takes an act of God and great lengthy troubles to submit an incident report. I don't bother unless they affect patient safety or are a huge near miss event. Our pharmacy is the biggest trouble at my place. Everything else gets fixed and a friendly reminder to the culprit in private or during report suffices most of the time.

Lord knows no one is perfect and petty cow waste is a waste of time.

[redhead_NURSE98!, ADN, BSN]

I don't get this. Just put up new tubing. This is one of those instances where you should just take care of the situation and move on.

I dunno, why should I be responsible for 30 minutes of changing tubing every time I work, including doing the detective work on "was it changed last night and just not labeled and/or documented? When was the last one scanned out of supplies?" I didn't work the floor that much, but every time I did work, I had at least two that were past due or not labeled. It gets tiring doing everyone else's work for them. (Wouldn't file an incident report though.)

[nynursey_]

I've only ever filled out a report concerning a medication documented as administered but seen spiked, primed, and hung (yet not attached to the patient) upon my arrival to the room. The antibiotic was off schedule completely and the patient subsequently missed a dose.

I think that was definitely reportable. The patient didn't get their required dose of antibiotic therapy and ​they were septic.

[sistrmoon, BSN, RN]

Except for the time it's not... like when you realize the tubing was originally used on your patient's roommate who is HIV+. That happened at the hospital I used to work at. Now, I've never written an incident report for unlabeled IV tubing... I did throw away unlabeled tubing multiple times/shift every shift I worked, though. My experience in the hospital was the exact opposite of yours. People were more apt to cover up things than to report them... and the manager inevitably found out about them and then got on you about why you didn't write an incident report. I can't think of any time when it was ever any of my colleagues' goal to "punish another nurse". If you catch a reportable error, there's inevitably someone who's going to think you're "writing them up" or "tattling". Sorry but if you have a patient with an active infection plus neutropenia and is ordered for IV antibiotics q 6hr and I come on at 7am and the patient last got a dose at 5pm yesterday and the next scheduled dose on the MAR is at 11pm, the patient has missed 2 doses of a critical med with the potential to miss 2 more if I don't catch it and that's reportable.[/quote']

Yep both those are incidents I would write reports on. My whole point is some people seem unable to make a judgment call on whether a report needs to be written or not.

Would you write an incident report if the off going nurse ahead of you dropped a pill and the new dose hadn't come from pharmacy yet? I'm talking about writing an incident report on the nurse for dropping the pill. That's the kind of frivolous reporting I'm talking about. Or reporting a zit as an undocumented pressure ulcer that was "missed by the previous nurse."

[sistrmoon, BSN, RN]

I dunno why should I be responsible for 30 minutes of changing tubing every time I work, including doing the detective work on "was it changed last night and just not labeled and/or documented? When was the last one scanned out of supplies?" I didn't work the floor that much, but every time I did work, I had at least two that were past due or not labeled. It gets tiring doing everyone else's work for them. (Wouldn't file an incident report though.)[/quote']

You have to scan your tubing?

Our intermittent sets have to be changed every 24 hours anyway. I usually do a quick check and then just put the next dose of antibiotics on new tubing if I need to. The biggest annoyance for me is when 24 hour chemo is running attached to fluids and the fluid tubing is overdue to be changed. The chemo and chemo tubing is changed every 24 hours so why wasn't the new fluid tubing put up when the chemo was changed? So then to change the fluid tubing you have to detach the chemo. Big pain in the ....

[sistrmoon, BSN, RN]

Also, just to clarify, this isn't me whining about other nurses "tattling" on me. I've only been tangentially involved in the examples I've given. Sometimes a nurse will proudly tell me about what they've written a report on and show me the "evidence." I'm concerned about the general working environment it's creating and have heard the same from other nurses. I'm not imagining it.

[cardiacfreak, ADN]

The only time I have reported IV tubing problem was when I received a patient from another floor who was receiving tube feedings and the bag and tubing hadn't been changed for 3 days. I usually don't sweat the small stuff because I have probably forgotten to change IV tubing or apply a tag to the tubing myself. I hate filing reports because at my facility it is a long computerized form, it's a real pain in the you-know-what. I pick my battles.