Incident Reports...aarrggghhh!!!

Nurses General Nursing

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I am so frustrated by some coworkers' attitudes about incident reports. Why can't they understand that I am NOT being "mean" and "writing people up"?

To me, it is writing up an incident or problem in hopes that it can be fixed and avoided in the future.

I don't "write everything up"---if someone missed giving a med, or timed something wrong on the MAR, or forgot to unclamp the IVPB tubing or change a dressing, I just fix it and go on.

But if it is the same person doing the same thing wrong, it needs to be addressed. If an IV is grossly infiltrated or has purulent drainage around the catheter, I will complete a report. Those can possibly cause harm, so I do it.

If a nurse physically signs an order off but then does not carry it out, it's "written up".

I don't just go around specifically looking for things or people to write up, but as charge nurse lots of stuff gets brought to my attention (by nurses who refuse to fill out the reports) or I catch stuff as I look over charts.

My boss is good in that she wants them filled out---for the same reasons. She also doesn't review them with the person in an accusing or punitive way.

I want to do a good job and make sure our patients are taken care of in a darn good way. But errors do happen and must be addressed.

If my coworkers could just keep remembering that we are not "writing each other up" and not "being mean" by filling out these incident reports.

Guess I'm just ranting...thanks for listening! :-)

So your manager wants reports completed for med errors made for the fourth/fifth/ninetieth time. But is there follow-up to fix the system problem that created the error, or discipline for lack of diligence, if such is the case?
You and 75% of Allnurse's members all ready know the answer to that question. Besides education (which the op has given), the primary answer to fixing the system's problem to preventing many errors is better staffing. And we all know how management reacts to that suggestion. All I can say is to keep doing your job bc you don't want to get written up by the manager for not completing incident reports. My approach would be to tell my subordinates that it is nothing personal but the manager wrote me up for not doing an incident report and that im not going to lose my Job over you all.
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It's been my experience that a visit and inservice from the risk manager is very useful to get everyone on the same page as to what variance reports (the proper term, since they document variance from usual or expected events) really mean, how they are compiled and used, and what the statistics are for comparable facilities. I"ll bet your RM would looove to come and share. Really.

Sure, they come and share. And management that wants to use IRs in a punitive way will CONTINUE to use them in a punitive way.

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Specializes in ICU/PACU.

Does management provide positive feedback to staff or do the nurses only hear about what they are doing wrong, is what I wonder.

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Does management provide positive feedback to staff or do the nurses only hear about what they are doing wrong, is what I wonder.
Often what we do is not noticed until we don't do it!
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I am so frustrated by some coworkers' attitudes about incident reports. Why can't they understand that I am NOT being "mean" and "writing people up"?

To me, it is writing up an incident or problem in hopes that it can be fixed and avoided in the future.

I don't "write everything up"---if someone missed giving a med, or timed something wrong on the MAR, or forgot to unclamp the IVPB tubing or change a dressing, I just fix it and go on.

But if it is the same person doing the same thing wrong, it needs to be addressed. If an IV is grossly infiltrated or has purulent drainage around the catheter, I will complete a report. Those can possibly cause harm, so I do it.

If a nurse physically signs an order off but then does not carry it out, it's "written up".

I don't just go around specifically looking for things or people to write up, but as charge nurse lots of stuff gets brought to my attention (by nurses who refuse to fill out the reports) or I catch stuff as I look over charts.

My boss is good in that she wants them filled out---for the same reasons. She also doesn't review them with the person in an accusing or punitive way.

I want to do a good job and make sure our patients are taken care of in a darn good way. But errors do happen and must be addressed.

If my coworkers could just keep remembering that we are not "writing each other up" and not "being mean" by filling out these incident reports.

Guess I'm just ranting...thanks for listening! :-)

Well, why don't you address it with your coworker before writing them up?

Yes, it is mean, and it will cause tension between you and your coworker, do you want to come to work knowing that some of your coworkers hate you because you wrote them up?

Instead of writing an incident report, why don't you speak with your charge nurse and hint at it.

people make mistakes, and if everyone wrote everyone up for everything they've done accidentally wrong, your charge nurse will have a pile of paper to read.

My manager told me this "a lot of people complain about the stupidest things that i have no time for" Managment hate complainers...

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Well, why don't you address it with your coworker before writing them up?

Yes, it is mean, and it will cause tension between you and your coworker, do you want to come to work knowing that some of your coworkers hate you because you wrote them up?

Instead of writing an incident report, why don't you speak with your charge nurse and hint at it.

people make mistakes, and if everyone wrote everyone up for everything they've done accidentally wrong, your charge nurse will have a pile of paper to read.

My manager told me this "a lot of people complain about the stupidest things that i have no time for" Managment hate complainers...

If you read the rest of my posts, I did say that I do address it first. It's not like I look for stuff to write up.

I am a charge nurse on my unit--most of the problems get brought to my attention. Other staff doesn't want to fill out incident reports so it falls on me.

I don't go to my boss and "complain". I am trying my best to do what she asks of me.

Thanks.

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Yes, I definitely mention incidents the first few times. Usually just to say "The Fole for Mr. Jones was ordered to be dc'd, but we got it" or "that Vanc order you signed off didn't get put on the MAR so we started it tonight". But after the fourth, fifth, ninetieth time, I guess it gets old. I really try to help the new nurses especially, whether a new grad or new to facility. Lots of those mistakes are due to not knowing.

I guess on average, I fill out 3 or 4 a month, unless we have a bad "fall spell".

I would love to be able to ignore the "error/incident" part, but usually feel I can't. Either the doctor brings it to my attention as charge, or it gets discovered during chart checks or audits. So then my boss wants to know why the report wasn't filled out. It's something she expects of us.

I know everybody makes mistakes. I absolutely loved "writing myself up" for errors. But, we gotta do what we gotta do.

But if you are finding a trend, then some suggestions for re-educating might be in order. Reports are reports are reports, until someone does something to help change things.

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Specializes in Infusion Nursing, Home Health Infusion.

Have you thought about approaching your manager with a list of the 4-5 top problems or issues that you see and an action plan for each problem? Yes, it is a lot of work but I have been very successful using this technique. The best ideas and solutions often come from the people in the trenches that see the problems day in and day out.

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Specializes in Med/surg, Quality & Risk.

I guess I am wondering how many times you have written people up. Have you spoken to the offenders? Is it the same person you are writing up?

I thought OP was clear about who and why she wrote people up. As charge I write more incident reports than average too, mostly at the request of my supervisor or a physician. Whenever that is the case I start the incident report with "this variance is being written at the request of Dr. Who." One thing I am tired of dealing with is IV tubing changes. I'm tired of playing IV Tubing Detective and wondering if this un-labeled tubing was changed last night and not labeled, brought up on admission and has never been changed, etc. Wastes my time and the hospital's money and I'm going to start writing them up, it's not like it will go against a particular nurse. Once when I went to look at the room charges on an unlabeled tubing, I discovered that this person hadn't been charged out new tubing since admission (9 days). The patient also stated no one had ever changed her tubing except for me. The best part was that she also had TPN running. Yum!

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Specializes in retired LTC.

To redheadNurse - you sound like my kind of nurse! I usually start out as the IV Princess; then I become the IV Police: the I become the IV Gestapo!!! Unlabelled IV tubings and PICC drsgs not chg'd per facilty P&P set me off on a warpath. Keep up the vigilance!

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