do other careers get "write-ups" as much as nurses?

blondy2061h, MSN, RN · Mar 13, 2010

Write ups were never meant to be punitive. It's not a person being written up- it's an error. And while one final person may have made the error, it's usually a system failure at a variety of steps that resulted in it. The purpose of write ups is to prevent errors that can harm patients, not to punish people.

I haven't experienced people being written up for trivial things like you describe at my facility.

cardiacmadeline, RN · Mar 13, 2010

This is my opinion on "write ups". Some hospitals and nurses use them as "punishment" for staff members. This is not what they should be viewed as. I will write an occurence report if I see the wrong antibiotic hung on a patient or if I find a medication programmed wrong, etc. I don't write an occurence report on someone for taking a pager home by accident, that's silly. Also when I write an occurence report, I (and my facility) don't view it as a "write up" on my coworker. Sometimes I don't even know who made the mistake, and honestly I don't care. That is something my manager looks into after reading the report. Facilities and nurses should be viewing occurence reports as something to learn from and using them to fix recurrent mistakes, not to pick on their coworkers for petty and ridiculous things. Yes, nurses may write more occurence reports, but there should be. We are dealing with life and death everyday, mistakes should be brought to someone's attention to help prevent future mistakes, not to "punish" people and they certainly should not be used to promote negativity in the workplace.

NurseGloria · Mar 13, 2010

Employers create paper trails in order to pull them out when they need to reduce the payroll by removing employees from the workplace. If the employer can make a case that a nurse was terminated for cause, the nurse does not get unemployment insurance. That means that the employer's unemployment insurance experience rating will not increase.

If the employer lays a nurse off and admits it was to reduce payroll, she will collect unemployment and the employer's unemployment insurance expense will increase. If the employer can intimidate a nurse into quitting by threatening termination or turning her into the BON, she will probably not get unemployment insurance. The employer's unemployment insurance expense will not increase.

Older nurses will be targeted for layoff because the older the age of the group, the higher medical and worker's compensation rates for employers. Nurses should be very careful about writing each other up, especially for a single, non life threatening error.

With time pressure and the number of tasks to completed in a fixed time frame, errors are inevitable. Most nurses feel horrible about making errors and really try hard not to.

Don't help management fool an unemployment hearing officer into denying a nurse her unemployment by helping management to create a long "nit picking" list. I'm not saying to ignore serious errors and not try to understand why it happened and how to prevent it in the future. I'm guessing that most of the time it will be an understaffing or inexperience situation.

Mr. Evans · Mar 13, 2010

YES! Esp. Time Warner Cable, that why I'm in such a rush to finish school! We're always getting written up for sales....I mean I don't know how many of you have TWC for anything? But I know you are paying an arm and leg for it, and then you have people that are still without jobs and they expect us to sale these people new service....and pay for it how???? GESH!

DoGoodThenGo · Mar 13, 2010

No, nurses being "written up" is not new, you are just hearing more about it as the Internet has allowed a central source for venting.

For much of history, wherever there has been numbers of females in an area or such, a hierarchical system for governing them was put place, with various rules and regulations imposed to among other things keep order. After all women/girls weren't supposed to think for themselves, and therefore someone in higher authority had to map things out for them.

Convents, boarding schools, domestic service (in large households or commercial establishments), the military, secretarial pools, and so forth all for the most part followed models where rules governed most if not all aspects of one's work. Failure to follow said rules, even when they were petty and or contrary left one exposed to being "written up", or as it was called then having a "notation made upon one's record".

Nursing, with it's roots in both military and religious life, and by virtue it attracted large numbers (ok, mainly) women, has for much of it's history been practiced under rules that governed not only patient care, but the nurse and her behaviour as well. An ideal nurse was closely matched in her traits as the ideal wife; that is she was supposed to be docile, subservient, easily trained and followed orders without question.

In religious orders and the military there is, or was a great emphasis on breaking down self will, and forming a person that will go with the flow so to speak. One of the best ways of doing this is to have rules and consequences for breaking them.

A quick glance through any hospital's manual of nursing practice from say the 1900's to 1970's or even today would turn up a vast array of rules we today would regard as totally silly. However a nurse whom violated any of those said rules, stupid or not, risked being written up, and or told off.

Does it matter in terms of direct patient care if the pillow slips on a bed just made by a nurse faces away from the door? Well if that is the way the hospital wanted it done, you did it that way. Should your head nurse or worse, DON spy a newly but incorrectly made bed, you could be sent back to do it again. What is that? You "won't", well now you have exposed yourself to charges of insubordination and perhaps truculence.

Similarly, if the rules state a nurse "shall for no reason remove any hospital property from the premises without prior permission......", and one takes home a pager, scissors, gauze, scrubs, etc even by mistake, one can be written up.

There are still quite a few DONs, supervisors and head nurses whom feel "human error" is no excuse for breaking rules, and must be dealt with promptly and perhaps harshly. After all failure to do so could represent a threat to their authority and subsequent orderly running of the hospital, and then where would it all end?

Actually being written up is only part of the bag of tricks, and could be considered being treated lightly. Back in the day the range of options for dealing with any sort of infraction, however minor left the nurse exposed to being floated, sent on vacation (paid or unpaid), suspended, and or transferred.

flashpoint · Mar 13, 2010

Where I work, "write-ups" are primarily used as part of a learning process...they may lead to discipline, but not usually. When someone gets "written-up," the DON and the administrator get together with that person to figure out why whatever happened happened and what can be done to prevent that in the future. So...if you make a med error, they try to figure out if the order wasn't clear or if it was late from pharmacy or whatever.

I have worked places that write people up for everything...and it is a disciplinary process. I once was written up for not giving a girl enough stickers after she was seen in the ER. I was also written up for buttering toast wrong (I didn't get the butter and jelly all the way to the crust). I was written up for refusing to do an EKG on a patient when I was in the ER with the ambulance service and was very obviously off the clock. And, I was written up for refusing to help a patient in the ER when I was a patient in the ER.

If write-ups are handled in the right way, they can be a good thing...if not, they are a joke or degrading or a path to vengeance.

scoochy · Mar 13, 2010

I agree that "write ups" can bring about a solution to a problem; however, the write up often times just goes into an individual's personnel file, with no corrective plan of action taken. The "write up" now becomes potential "fuel for the fire," if you catch my drift.

Gone are the days of acknowledgement of work well done. You're lucky if you get it once/year in a performance appraisal. I am now trying to make more of an effort to say "thank you" to CNAs more frequently, as well as "give back" to nurses who have helped me through a tough evening. Sometimes I get so caught up in my own responsibilities that I forget my co-workers who are "in the trenches" with me!

**RosesrReder, BSN, MSN, RN** · Mar 14, 2010

For those of use saying that at your workplace "write-ups" are not used for any punitive purposes and merely as a learning experience to correct what might have cause it...........take of the rose colored glasses.

Trust me, management will make a paper trail to use when/if needed. Those 'non-punitive' write-ups or variance reports as my facility calls them, are more than what they sell them out to be.

I have seen a couple of nurses so far that those came back to bite them in the rear (despite the mistakes were usually understaffing issues), when it came for them to leave the company.

ItsTheDude · Mar 14, 2010

people get written up and fired all the time from all types of other jobs, but few other jobs have the potential for injury and death to customers that errors in health care have.

**RosesrReder, BSN, MSN, RN** · Mar 14, 2010

people get written up and fired all the time from all types of other jobs, but few other jobs have the potential for injury and death to customers that errors in health care have.

That is right. Wouldn't you think that management would properly staff at the very least for those reasons? At the end, the individual nurse pays the consequences. Then management replaces them quite easily.

GadgetRN71, ASN, RN · Mar 14, 2010

Yes, you'll find in this profession that nurses are looked at as children and are disciplined as such..it's so stupid. :rolleyes:

Kim, HHRN · Mar 14, 2010

I wish there was some type of reform on education in the workplace. I am a fairly new graduate and what I have experienced so far in terms of training in the health field workplace is something to be desired. This is unfortunate. It seems employers in the health field are "reactive" (after the fact) instead of "proactive" (educating on errors that could occur and educating the workers to previous mistakes that have been made).

For instance, there was a med error that was made by 4 nurses on 4 different occasions on my unit because the pyxis was loaded incorrectly. Instead of taking a chance on errors, why not offer a class on different errors that could possibly be made? Or errors that have been made by others in the past, to use as an example (the people who commited the errors omitted, of course).

This is so sad because comparing to my other past work experience in customer service, we were prepared and equipped for the things that "could happen". I just thought that the health care industry would operate the same way. Boy, was I naive.........

Maybe I still am, thinking we could have more reform to make errors less common....just my two cents.