Being An Advocate

[tonicole]

I am a nurse who had a charge nurse bring my patient from a test without being monitored (as the policy states to monitor per unit requirement). I asked the charge nurse why they were not being monitored and the response was "it was only for a second". I did not fill out an incident report as required. So I asked my manager the following day about the incident which amounted to me turning him into the manager.

Is it nursing etiquette to never squeal on each other? Or did I do the right thing so it does not happen to another patient?

I understand the incident seems small. Any advice or criticism would be greatly appreciated.

[Sour Lemon]

I am a nurse who had a charge nurse bring my patient from a test without being monitored

(as the policy states to monitor per unit requirement). I asked the charge nurse why they were not being monitored and the response was "it was only for a second". I did not fill out

an incident report as required. So I asked my manager the following day about the incident which amounted to me turning him into the manager. Is it nursing etiquette to never squeal on each other? Or did I do the right thing so it does not happen to another patient?

I understand the incident seems small. Any advice or criticism would be greatly appreciated.

Choose your battles. Was the patient harmed? Is this really an issue that you need to write an incident report about and bring up to your manager? Maybe it is. Only you can decide. I assume the transporting nurse was responsible for the patient during transport. I think I would just be grateful for the help unless some giant piece of the puzzle is missing from your account.

[Double-Helix, BSN, RN]

The responses you get are going to be based on individual experience, history and the culture on your unit. My hospital, for example, encourages reporting all "near miss" safety events when someone could have been harmed but wasn't. Others subscribe to a more "no harm, no foul" mentality.

The fact is you tried discussing the potentially unsafe behavior with the charge nurse and when she didn't acknowledge your concerns, you reported a situation that you felt was unsafe. Whether everyone here agrees with you or not doesn't really matter.

[Crush]

You have to choose your battles. Go with your gut and whatever the situation was. Glad the patient is ok, that is the main thing.

[Double-Helix, BSN, RN]

Choose your battles.

You have to choose your battles.

This is not a battle. The OP simply reported a concern. It's the manager's responsibility to take it from here. Where's the fight?

[Sour Lemon]

This is not a battle. The OP simply reported a concern. It's the manager's responsibility to take it from here. Where's the fight?

The "battle" consists of trying to "make" others do as you think they should do. I encounter numerous imperfections and breaks in policy every day that I work. Some of them might be worth bringing up to a manager or writing an incident report about, but most are not. If I didn't "choose my battles", I'd have no time for anything except incident reports on some nights.

[psu_213, BSN, RN]

This is not a battle. The OP simply reported a concern. It's the manager's responsibility to take it from here. Where's the fight?

Oh, it's just a figure of speech....no real battle/fight. Obviously Sour Lemon and Crush know that there are no weapons being drawn.

To the OP, I'm not sure 'etiquette' is the right word. Consider it playing politics. It stinks, but politics play a huge role in who advances in nursing and who doesn't. If you are someone who is perceived as a nurse who will 'tattle' on another nurse for "little" things, you are going to lose political points with those you turn in and, sometimes, to whomever you are reporting it.

Without knowing more of the clinical situation, we can't really know how little or big this issue was. If you felt the situation was dangerous enough, sure, write up an incident report. If it's really not that dangerous of a situation, you might have been better off to let it go.

[JKL33]

Why didn't you fill out an incident report as required about the fact that the charge nurse who was helping you didn't have the patient on a monitor as required?

[Crush]

Without knowing more of the clinical situation, we can't really know how little or big this issue was. If you felt the situation was dangerous enough, sure, write up an incident report. If it's really not that dangerous of a situation, you might have been better off to let it go.

Politics do matter too. While we don't know the details of what kind of clinical situation it was it is hard to say for sure. You were there and you have to continue to work there. If this is an issue or was putting the patient at risk/jeopardy then fill out an incident report. If it was not a big deal and you and the charge nurse discussed it then depending on the situation, let it be this time but if it continues then it may bear reporting. Again, only the OP knows the clinical part to this and the culture of their unit. I am thinking, since you mentioned safety as a concern, then just an incident report would have been enough.

[FurBabyMom, MSN, RN]

I mean...I would probably have done the incident report, most likely as an anonymous report (our facility allows this). I think if you'd asked your manager for clarification about whether the policy had changed or if there were exceptions, and prefaced it as I've head "several different things"...that might have been different.

I try not to turn others in for things, especially if a patient wasn't harmed. Ultimately, there is a policy (or procedure or protocol) for most of what we do. The situation you describe references a charge nurse so you weren't responsible for their practice or behavior in any way if anything they were your immediate supervisor then. Your charge nurse has their own license and had something happened - it would have been on them for disregarding the policy/procedure/protocol.

I tend to over-report things. It's the culture of the team I work with. It's never been held punitively against me. Could it be? Certainly, I suppose if culture/management/administration saw things differently. Most of the events I report are things that have to be reported and/or benign in nature.

[slauren]

I don't understand the severity of your patient's condition/test that was going on but it seems like the charge nurse was trying to do you a favor cause he/she thought maybe you could use the help I'm assuming. If it was something minor with a completely stable patient, then I wouldn't expect the charge nurse or even other nurses to really help you with simple stuff like that anymore if you're going to tell on them (speaking honestly). But if it was something critical going on with the patient, then yes, the patient's should've been monitored. Like the other people commenting, pick your battles wisely.

[CBlover, BSN, RN]

The "battle" consists of trying to "make" others do as you think they should do. I encounter numerous imperfections and breaks in policy every day that I work. Some of them might be worth bringing up to a manager or writing an incident report about, but most are not. If I didn't "choose my battles", I'd have no time for anything except incident reports on some nights.

Couldn't be said any better.