How does write ups work in the hospital?

classicdame, MSN, EdD · Nov 8, 2011

depends on facility policy (which every nurse should read!). Our hospital has a point system for infraction "acuity". Once the nurse reaches certain point level they are terminated. Some incidences achieve point level with ONE infraction, like stealing, harming patient, etc. In my state these records are essential for peer review, which is part of the NPA. Also, quality, risk mgmt and education use the topics (without names) to determine if processes or systems need to be amended. But basically, if the nurse is written up frequently, it is the NURSE hurting their career, not the policy.

TheCommuter, BSN, RN · Nov 8, 2011

Many hospitals use a method of disciplinary action commonly known as progressive discipline. This type of discipline often protects your workplace from litigation and having to pay out unemployment insurance benefits due to the amount of written documentation involved.

First infraction: verbal written warning or coaching (not the same as write-up; this simply documents that they have verbally warned you)
Second infraction: written warning (also known as a write-up)
Third infraction: final written warning (usually witnessed by two supervisory employees)
Fourth infraction: suspension
Fifth infraction: termination of employment

However, some violations are considered serious enough to warrant immediate termination, even if the employee has a clean personnel file and has never been warned or written up before. Sleeping on the job, abandonment, physical altercations, theft, substantiated patient abuse, and other misadventures can get a worker terminated on the spot without having to resort to progressive discipline.

Ms.RN · Nov 8, 2011

If two write ups are completely different, one for calling in to work and another write up is related to work performance, does it mean the second write up is gong to be a final written warning?

CrunchRN, ADN, RN · Nov 8, 2011

It depends on each employers policies....

caroladybelle, BSN, RN · Nov 8, 2011

This information depends on your particular institute, as each employer has different rules regarding disciplinary action.

This is why you need to review the employment and disciplinary policy of YOUR specific employer, as that is what counts. Anything we tell you will have very little bearing, as YOUR employer is going by the policies unique to it's institution.

chashmonit · Jan 13, 2012

is this new for your facility? our facility just adopted a point system, which they claim is the industry standard. many of us object strenuously (and for the most part, we are very conscientious, patient oriented staff) because of the increase in punitive rather than problem solving responses. we objected to being penalized with points for calling out sick because people will come to work sick rather than be penalized, putting patients and coworkers at risk. the response from administration was that they knew we had too much integrity to come to work sick. so if someone has an active mrsa infection and works in the operating room during a total joint replacement...

we also asked if there was a reverse point system, in which points were removed or credited to us when we weren't relieved on time or forced to stay late because of staffing shortages, and they essentially laughed at us. our department, even our whole hospital, is furious over these changes, myself included.

if this is new to your facility, what has been the general response of your staff?

Cna21 · Dec 8, 2021

I was fired for not reporting a o2 being low but wasn't even spoke to about it. Maybe they read my hand writing wrong it can be a lil messy sometimes but didn't get any warning. Or write up was my 1st mistake if it was a mistake. When another employee who happens to be my mom. didn't report a low blood sugar and got a write up and a warning. Was told she would be fired if it happened again shouldn't I have got a write up as well before being fired? I've been thinking about reaching out to corporate. But didn't want them to give bad reviews if someone calls frm another hospital for a job for me.

amoLucia · Dec 8, 2021

Cna21 - Any chance they could have mistaken the 2 of you? Or maybe Mom's personnel record was somehow in your file?

Both clinical conditions could be serious, esp if signs & symptoms are unreported and/or missed. Were the pts' clinically stable, or did yours have a really bad outcome?

Also, might you be probationary? Or NOT union? Then there's that old reliable of your state being able to terminate without reason.

Start asking your HR dept. Corporate freq will defer to its local facility first.

Good luck.

Cna21 · Dec 8, 2021

No they didn't mistake us. My pts o2 was up and down none stop but he was OK after I had. I only had him that one day he did pass week later. But had nothing to do with me he was already doing bad. Hr was there when they fired me so she won't be any help. I just don't think it was right my 1st mistake if it was even a mistake and im fired. My mom has a mistake and gets a write up and I've seen plenty of others get write ups.

dream'n, BSN, RN · Dec 8, 2021

1 minute ago, Cna21 said:

No they didn't mistake us. My pts o2 was up and down none stop but he was OK after I had. I only had him that one day he did pass week later. But had nothing to do with me he was already doing bad. Hr was there when they fired me so she won't be any help. I just don't think it was right my 1st mistake if it was even a mistake and im fired. My mom has a mistake and gets a write up and I've seen plenty of others get write ups.

How low was the O2 and how low was the blood sugar?

Cna21 · Dec 8, 2021

My pts o2 they said was in the 70s but it could have been a 9 my writing is bad some times my moms pts sugar was like in the 30 I believe he was real pale his nurse had went in there and saw he was pale and took the sugar her self and saw it was low