Nurses rat on nurses - page 7
I have noticed a disturbing trend amoung nurses. I am new to nursing so maybe I am wrong. Nurses seem not to have any loyality to each other. I have seen many nurses sell out, tell on, rat out, or... Read More
Mar 30, '03One thing I would like to point out. An incident report should not be deemed punative. It is a report of an unplanned, or unexpected event. As one who used to review these reports, I looked for trends.
Did one nurse make the same or similar mistakes several times? If so, I would talk with that nurse, and often some remedial work or suggestions would solve the problem.
Was there a systems problem? In one circumstance, we changed the way abx were delivered to the units. It solved the problem almost entirely.
I also noted the "frivolous" reports, and discussed them with the unit manager and risk manager and treated them with all the respect they deserved and filed them accordingly.
Although I cannot speak for all hospitals, I know that in many, there would be a similar system in place.
Mar 30, '03Oh! That it shoould ONLY be a case of "Protecting the Patient". I recently worked in a large ICU which had a habit of employing mostly new grads and had a culture of "By the numbers nursing" Patients had second hourly eye care given whether or not they required it but because it was "What should be done!" Any nurse not following this regime was suspect and gossiped about. As a consequence few staff who had experience elsewhere stayed there and they certainly would not be given any opportunities for advancement. In this way it became self rewarding. Even the nasty attitude toward agency staff became rewarding as more "double shifts" were available at mass overtime for staff. Strangely this wasn't entirely conscious but an adaptation to the prevailing culture of eat or be eaten. Various strategies were used including unrealistic expectations - one nurse was "told off" for not checking the safety equipment within 30 minutes of the staert of her shift and her defence that the patient was very unstable and required emergency interventions were dismissed as her not trying hard enough. Interventions which were quite reasonable were questioned on whim with the "goalposts" continually being moved i.e. One day you would be in trouble for ceasing oxygen on a young patient with So2 of 97% on room air the next day you would be in trouble for not ceasing oxygen therapy on a patient who only had an SAO2 of 94 % on 4 lpm! Could go on but this is real and has NOTHING to do with protecting patients!Last edit by gwenith on Mar 30, '03
Mar 30, '03Question: What would you do in this situation?
I came on shift and was reviewing am vitals. Mrs. A had b/p of 178/106. Went to assess her, no other acute signs, no HA, visual disturbance, etc. HR, RR normal, no pain or any other distress... Reviewed her meds...still searching for a reason...just about to call the Doc when something tells me to check out the Clonidine patch to her chest. I peeled of the white "covering" to the patch and what do you know, there is no Clonidine patch! The nurse who applied the patch 3 days earlier clearly did not realize that the white "cover" is not the medicine (despite the fact that it is clearly written on the label). I immediately applied the dosage, rechecked the b/p 1 hour later with a result of 140/88. What would you have done regarding the nurse who made the mistake?
Mar 30, '03I would have written an incident report describing the above, and given a copy to the nurse manager (or however you handle incident reports in your facility).
Mar 30, '03I would also have spoken to the nurse responsible for the error, to help her learn from her mistake.
Mar 31, '03At my last regular job (prior to traveling). The director was very biased. Some nurses were terrible and the UD blew it off. Others could have walked on water and still been written up for not attending enough staff meetings.
One of the Golden girls - made over 8 errors with narcotics - in 1 week (wrong drug given) - staff was held over at shift change for bad narc counts. She gave the wrong ABX three times - these incidents repeated themselves many times over several monthes - med error forms written repeated - the staff that complained, were told that they were being judgemental - nothing was done to the nurse.
It finally came down on her when she ran in a continuous day bag dose of chemo in 6 hours, at the detriment of the pt.
Yet, others get called on the carpet, for a pt being woken up for vitals "too many times" and the pt complains.
It is not ratting on anyone if the events being reported endanger the patient. And if someone is making a lot of "little" mistakes ...frequently that is leading up to a really big one on the horizon.
Mar 31, '03I think is all comes down to what we all learned in school....using your best judgement. Period!