Being "written up"

[Sassybottom]

I am a new nurse and this concept kind of worries me ...

What can you be written up for? What are the consequences? Who usually writes you up?

Thanks. I get knots in my stomach thinking about this.

[Princess Pam]

Hi Tweety, I guess hospitals are different. My facility takes medication errors very seriously, in fact so does the state board of nursing. All medication errors are reported via incident report and a counseling is given to the staff nurse in the form of a medication error. That counseling does go into the employees file. The state of Texas requires that if a nurse commits 5 medication errors in a years time, she should go before the peer review committee and that committee decides if she should be reported to the board.

Writing up and counseling are two different events. Our facility uses a form called "report of staff concern", staff use this form to write up any incident that warrants the manager getting involved. Yes it is true that the Manager, supervisor, or charge nurse can councel an employee for patient care related issues. In general, being written up is an infrequent occurance.

[CHATSDALE]

most of the places i worked writeups are not done on a lateral basis but anyone in a supervisory can do a write up

ie rn can write up a lpn or cna

lpn can write up cna

however if anyone sees something that is deemed harmful to a patient such as abuse, intoxication,etc then a cna can bring it to attention of that nurses superior but can not actually 'writeup' in fact is obligated to do so

a person can refuse to sign but it still goes in employment record you will always have a chance to write an addedum giving your side of the situation if you believe that the write up is in error

if you get a write-up or have to make an incident report consider it a learning experience and how you can improve yourself if you are in fact at fault

do not let the prospect of write ups to give you any stress, you will be fine

[NurseCard, ADN]

Ugh... I would like to think that there is a higher percentage of us who make mistakes from time to time and DO actually get written up at least once or twice. I've been written up since becoming a nurse. Twice actually. One of the writeups I had torn up and thrown away, because after careful consideration and coversation between various parties, it turned out that I had done nothing wrong. The other writeup I probably did deserve, although if the person who was charge nurse that night had been a bit more helpful and knowledgeable, I might not have been written up.

But... that's all in the past, at a different job. =) I've learned since then.

Where I work only the nurse managers and charge nurses are qualified to write people up. As a charge nurse I can usually counsel a person and get them to shape up before writing them up. I've recently given a verbal warning for insuborination to one of my problem tech's. Next time she will get written up.

Fortunately at my place of employment write ups are rare, as things can be nipped in the bud verbally before it gets to the point of being written up.

People often mistake "incident reports" as being "written up" and they are not the same thing. When you make a medication error this incident report is sent to risk management, pharmacy and your manager, but is not part of your personnel file in Human Resources. Of course as people say above you can be written up for making medication errors, usually this doesn't happen with an isolated inicdent, but repeated errors.

Nurses might be quick to write an incident report on a coworker about something and then go bragging "I wrote them up for........" which is all false bragging because they merely did an incident report and don't have the power to write anyone up.

Don't be scared because 99.999999999% of us go through our careers without being "written up".

Good luck to you.

[caroladybelle, BSN, RN]

I think you have to sign anything that goes into your file. l have a "coachable moment" in my file. I was talked to by the charge nurse and then I had to sign the paper. I didn't agree with the write up but I still had to sign.

No, barring someone grabbing you, holding you down and forcing your hand around the pen, you do not have to sign ANYTHING.

Management will give you some song and dance about it not being a admission and that you are merely signing to show that you "acknowledge" that this has been filed. But I have refused to sign a write up that I felt was completely inappropriate.

But by the same token, after said inappropriate write up, I no longer wanted to work for a facility that treated me that badly, and moved on of my own accord within a year.

If you are in a right-to-work state, it will make management look bad and you may find yourself taking the brunt of inappropriate anger.

[Zookeeper3]

When I was new and years later when I changed jobs, I asked the nurse I gave report to; "please tell me if I missed anything.. I'm new and want to know quickly if I'm forgetting something". When I wasn't due back the next shift I asked them to leave me notes in my mail box.

Several nurses said, "don't worry about it, we try to fix things when we find them" (meaning they just didn't write you up behind your back). But I responded... no really, if I don't know where I've goofed up, I can't fix it.

Now I have had to write myself up for some med boo boo's along the way, but generally people just mention to me if I've missed something. The longer you nurse, the more aware of details and chart checks you become. We all still can make a mistake.

oh, and BTW, no one can make you sign anything...they can write "refuses to sign". But I'd much rather write my rebuttal if I disagreed, even fighting the write up to the next level if it was wrong.

[justme1972]

The internet is a HUGE thing. You would be shocked at how many people lose their jobs over this, and when I was working regular jobs, it seemed like every month someone was losing their job over e-mails, pulling up websites, chats, instant messaging, and of course, the infamous Media.

[CseMgr1, ASN, RN]

every place is different.

some will write you up at a seemingly benign incident, e.g., perceived insubordination.

some will write you up with more obvious infringements, e.g., stealing, being impaired.

and then there are places/units, that will ignore/cover up the most blatant of erros for some, while writing up others who are victims of their environment.

you need to read your p&p manual re: your facility's disciplinary policy.

anything that violates your bon's codes of professional misconduct and pt negligence/abandonment/abuse issues, are examples of what are truly notable.

do your job.

stay away from the trashy gossip.

meticulous documentation.

being a team player.

be receptive to constructive criticism and learn from it.

but don't ever be anyone's doormat.

value your role as a nurse, and love yourself as a person.

you'll do just fine.

best of everything.

leslie

Exactly!

[Tweety, BSN, RN]

Hi Tweety, I guess hospitals are different. My facility takes medication errors very seriously, in fact so does the state board of nursing. All medication errors are reported via incident report and a counseling is given to the staff nurse in the form of a medication error. That counseling does go into the employees file. The state of Texas requires that if a nurse commits 5 medication errors in a years time, she should go before the peer review committee and that committee decides if she should be reported to the board.

Writing up and counseling are two different events. Our facility uses a form called "report of staff concern", staff use this form to write up any incident that warrants the manager getting involved. Yes it is true that the Manager, supervisor, or charge nurse can councel an employee for patient care related issues. In general, being written up is an infrequent occurance.

I didn't mean to say that medication errors aren't taken seriously, they are. But they aren't routinely "written up" the same as a disciplinary write up. Medication error counseling is indeed and documented by the manager on the incident report. This does not go to HR the same as a disciplinary write up. It stays on the incident report in Risk Management.

My point is there is a distinct difference between a disciplinary write up that only a charge nurse and a manger does and an incident report.

As I said is one is med error prone, obviously disciplinary action needs to be taken and this person is given written warnings, reported to the BON, etc.

[Tweety, BSN, RN]

Ugh... I would like to think that there is a higher percentage of us who make mistakes from time to time and DO actually get written up at least once or twice.

You should not necessarily be written up for making mistakes. Mistakes happen. God knows I've made a few mistakes in my nursing life, medication and otherwise, and yes my med errors had incident reports written because of them.

Just because I have made a med error and have filled about an incdient report about it doesn't mean I have been "wrriten up". In the couple of med errors I've made I've filled out the incident reports myself because I'm the one that discovered them.

Personally as a charge nurse I've never written anyone up for an honest mistake. I've gone to the person and counseled them, they've seen the light and understood and life goes on without them making a mistake. Mistakes should be a learning experience. (Obviously I'm not talking about dangerous sentinal events.) I've also found my fair share of med errors that others have made and have done incident reports, again I go to the person and talk to them about it. This doesn't mean they are "written up" and disciplinary action taken.

[buildingmyfaith57]

im not r.n. or l.p.n was a c.n.a. but i feel you don't have to make a mistake to be written up or do you have to be fired. you could be minding your own business and still be written up or fired.

[oldiebutgoodie, RN]

also for making inappropriate comments. (I was written up for telling a doctor he could "kiss my ass.") :)

But I'll bet it was worth the write-up!

Oldiebutgoodie

[DEB52]

At our hospital there are different levels:

1) management note-which the manager or clinical team manager writes a note to remind herself/himself of an incident that was discussed with the employee. nothing is signed here.

2) verbal warning is the first step and informs the employee of what occured and what could happen if this occurs again. This is signed by the employee and the management person giving it.

3) written warning is the next step This is also signed by both.

4) DMD-Decision Making Day Last step before termination.This lets the employee know that she/he has had several warning about the issue and that if it occurs again then she/he will likely be terminated. This is also signed by both.

There are many reasons that this could occur. If your place of employment has an employee handbook, they should be listed there. Also laws on your states BON can also be listed if a violation has happened.