Last night an hour before shift change, my baby came back from surgery and was on a vent. Vent keep on beeping off, CXR was done, NNP looked at X-ray, X-ray showed that the ETT was in to far, so it needed to be pulled back just a bit, so our RTs in NICU pulled back just a bit and vent continue to go off. RTs examine vent and tubing and decided that the baby needed a 3.0 instead of a 2.5...so they notify NNP, but NNP was nowhere to be found, page NNP...RTs decide that it would be in the baby's best interest to go ahead to change the ETT..myself and another RN was at bedside. Anyway, ETT change, baby was fine, no harm to baby whatso ever...NNP came back when RTs were securing the new ETT, look at ETT and agree that it was the baby's best interest to change the tubing and everything went smoothly from there. 15 minute before shift change, one of the RTs comes up to me and stated that an incident report needed to be filled out because it was an "unplanned extubation"...so I did that...then went back to my charting and charted what happen. At the I wrote, "...incident reported filled" in the nurse's note. My question is, was I wrong to put "incident report filled" on the note???
the simple proof that such a previous ir exists, particularly multiples of such regarding same, would not allow a hcf to deny any such knowledge of whatever the issue at hand is and therefore proceed as if this ‘whatever’ had only occurred as the failure of one individual or a team or whoever at hand.
so in other words, if you were brought in to testify about an incident, you’d bring evidence from a previous incident into court.
three words: class action suit.
copping a condescending attitude isn’t a defense or a way to justify your point.
all you have provided to support your position are your opinions and hypothetical situations. i’ve cited two sources upon which i base my statements and could easily conduct a literature search to find others.
i really don’t care what you do; i just hope you realize your behavior may put not only yourself, but also your colleagues at risk.
Miss Mab: If there is concern that IR's are disappearing, why would one continue to work at that facility?
Our nursing license is with the state, not the hospital where we work. If things are that dangerous and sneaky, then the facility should be reported to the appropriate outside agency, or one should seek employment at a more reputable facility.
Scared that you'll get called out by a lawyer for having no proof that you reported an incident? How about charting "Charge Nurse notified", rather than "IR filed"?
Incident Reports/Statement of Events are internal documents only. If you write in the patients chart that an incident report or SOE has been filled out then a lawyer can ask to see it. If nothing is mentioned about a report a lawyer cannot ask for it. It is a way for the hospital to keep track of incidents and to discuss new procedures/policies to help avoid it from happening again. If a patient falls, chart only the exact facts as you know them. That's all. Nothing more, Nothing less.
I think perhaps some of you aren't really clear about what an incident report really is. I will admit that the whole process doesn't always work the way it's intended but,..it really is designed to help fix internal flaws in the way the hospital carries out it's day to day dealings with pts/dr/vendors/visitors etc. It isn't a way to get someone in trouble, it isn't a "write up" it is a tool to help catch flaws and figure out a better/safer way to do things.
For instance we switched to a new computerized MAR and the pharmacy supplied us with prepackaged meds for each pt. We had a small "laser gun" we used to scan the pt name band, then the bar code on the med. When we did this a screen would pop up stating it was ok to proceed with administering the med. The computer kept track of the time and if the med was outside our 2hr window for administration, the RN would have to "explain" why the med was not given at the right time. Well this was all well and good,..except that if the pt was to recieve 2 tabs of a particular med or only 1/2 a tab,.the computer wouldn't catch that,.we'd scan the med and it would tell us to administer the med. Now this was often caught by the nurse but frequently it wasn't. So we all filled out incident reports. Not that day shift didn't give the right meds or RN-Caridac made a med error,.but that med errors were happening and part of the problem was a computer software issue. The software was fixed and now we are warned that the pts dose is 1/2 of what is provided by pharmacy etc. This was nothing that anyone outside of the hospital needed to be aware of,..and was a way of making pharmacy aware of a problem that needed to be fixed.
I can assure you that if the problem had continued and god forbid someone was hurt by this,.charting incident report filed in the chart for the last 50 times this happened would not have helped anyone. If pt Jones is injured,.the attorneys aren't going to be allowed to review the medical charts of thousands of other pts to prove I'd been c/o this problem for months.
Also,.recently in the bimonthly news letter from the MO Board of Nursing I read of a nurse who had her lisc suspened for taking home notes about her pts. Evidently someone saw her notes,.told someone else blah blah blah and reported her. So be careful with those.
Just one other note before I shut up,.....notes about my pt are the last thing I want durring a deposition!! Attorneys are nasty, sneaky and will find fault in the best of charting,....as far as I'm concerned the least I remember the better. "I don't recall sir,.I don't recall"! You should read some depositions some time,...mine was 12hrs long and we never even went to court!! Horrible,.horrible!
aeauooo
482 Posts
so in other words, if you were brought in to testify about an incident, you’d bring evidence from a previous incident into court.
three words: class action suit.
copping a condescending attitude isn’t a defense or a way to justify your point.
all you have provided to support your position are your opinions and hypothetical situations. i’ve cited two sources upon which i base my statements and could easily conduct a literature search to find others.
i really don’t care what you do; i just hope you realize your behavior may put not only yourself, but also your colleagues at risk.