Nurses writing up nurses?

getoverit, BSN, RN, EMT-P · Jan 24, 2008

sorry that happened to you. you shouldn't feel incompetent at all. Have you thought about speaking with the night nurse and asking her why she did it? I think writing each other up is a last resort, when everything else has failed. and if your boss said not to worry about it, then I'd leave it at that. I don't think anything should go in your personnel file unless it originated from the manager.

putmetosleep · Jan 24, 2008

Don't beat yourself up so much! Mistakes do happen--if your nurse manager said not to worry about it, then trust her and just try not to think about it anymore! Nurses do write other nurses up all the time--you'll come to learn which nurses you work with are quick to do so. Just take this experience as a learning opportunity; it will probably keep you from making the same mistake twice! At least there was no harm done to the patient. Maybe you should ask your manager if you can wait a little longer to have students with you--not that you're not capable, but the first year of nursing really needs to be a time when you're learning your way around and focusing on your practice--in my opinion, someone with only 8 months experience is still learning herself, and doesn't need the extra stress of mentoring students. Good luck and don't worry!

steelcityrn, RN · Jan 24, 2008

I do not feel that nurse should have written you up for something without giving you a chance to explain. Then, if deserved, your nurse mng should do the writing.

RN1989 · Jan 24, 2008

Technically she did the correct thing.

If Phenergan was ordered and you did not give it, then you went against the doctor's order. This is not within your scope of practice. If you did not give the Phenergan because of too much sedation, then you should have told the doctor the situation and allowed him to decide whether or not you should give it. If you did not give it because you forgot, you should have notified the doctor that you forgot to give the med but that the patient was very comfy with the Dilaudid. You could then have documented that the Phenergan was not given, doctor notified, no further orders.

Everyone makes mistakes and it is horrible when the mistake is yours. But it is a mistake and any risk manager and attorney will tell you that any and all mistakes should be documented per hospital policy. This covers everyone. You need to separate yourself from feeling that you were picked on. You do seem to have had a lot of things going on but this does not mean that you did not make a mistake and should not be reported. In a good system, incident reports are used to fix system errors, not punish the person who committed the error unless it was an ongoing problem or horribly negligent. From what you describe, you had way too many patients and too many students for a newbie to be working trying to deal with all at once. The students should have had patients that were cared for by experienced nurses so that you only had to deal with the patients in your care - not babysit students too. This is a system error that needs to be corrected.

If you are conscientious in your duties, this isn't going to harm you. Take it as a learning experience. You need to know what your limitations are and work to prevent something similar from occurring again. I know that it is hard not to wonder if they are out to get you. So many nurses use incident reports to be vindictive that it can make you paranoid. Don't let it. Learn from it and go on. And when the shoe is on the other foot, you will know that it is your duty to report errors when you find them, even when it isn't the popular thing to do.

If more people wrote up incident reports on ALL of the errors and problems that occurred every day in every hospital - we might actually be able to show the public the purposely understaffing and under-training causes errors and deaths - not the actual persons involved. Few errors are the result of one person, they are a result of a terrible healthcare system.

ASSEDO · Jan 24, 2008

I hate nurses that write up other nurses. It's so second grade.

lindarn · Jan 24, 2008

I am a new RN, and I have been working on a med-surg floor for 8 months now, and up until this point things have been going well. Yesterday we had students on our floor, and I love having a student because I was one just a short time ago, but I had 4 nursing students on my cart, plus 7 patients to take care of, as well as a doctor coming in to do a bone marrow biopsy on one of my patients that I had to assist with, plus a new admission! Needless to say, I worked my tail off all day without even breaking for breakfast or lunch. Things were hectic but everything was given and done on time. Well, I came in this morning to find out that the night nurse who had my patients wrote me up because I forgot to give the ordered Phenergan to the patient before the biopsy. I did give the dilaudid which sedated the patient more than enough and she slept through the whole procedure. I spoke with my manager and she said that she saw how hectic it was for me, and not to worry about it, but I am shocked that this nurse who wasn't even there took it upon herself to write me up, and now this goes on my record. I love my patients, and it eats me up inside when I forget something, I admit my mistake, but should one nurse be allowed to write up another one without consulting the boss first? I've been crying all afternoon about this, and feel like I need to quit, the incompetence that I feel is immeasurable.:urgycld:

This is what is known as, "horizontal violence" that is directed at you by a co-worker. This practice is driving nurses away from the bedside in droves. There was no reason for the night nurse to write you up for that infraction.

This is so prevalent in nursing. It is a way to have some modicum of control over your peers, since nurses have so little control over anything else. It is a common practice in individuals who have little control and alot of responsibility, as nurses most often do. As I said, the practice is driving nurses away from the bedside big time. That doesn't excuse it at all.

Lindarn, RN, BSN, CCRN

Spokane, Washingnton

CaliNicuRN · Jan 24, 2008

To be the devil's advocate here...... I wouldn't look at it so much as the night nurse writing up the day nurse. I would view it as policy and procedure. A med was missed. If the noc nurse noticed it and didn't document it somehow she was negligent in her own right. I don't feel it is so much about LOOK AT YOU, you made a mistake, but instead I see it as a mistake was made and it needed to be documented. Yes, the noc nurse could have called the doc and notified him/her of the missed med without making a write up. The nurse could have come directly to the poster and talked about it, and indeed she should have. I just don't think that negates the fact that something was in fact missed.

Yes, I have been written up for mistakes. Some of them I think should have been just corrected and the nurse should have told me. I was new and learning. But a missed med is a missed med.

To the original poster... We've all had days like yours. You did a great job with a grueling patient load and students to boot. The mistake was minimal, your manager said not to worry and above all NO harm was done.

Keep up your good work.

ICRN2008, BSN, RN · Jan 24, 2008

Everyone makes mistakes. The first time I made a mistake (I was working in the lab at the time and incorrectly entered a lab result into the computer), I felt sick for 2 days. I can assure you that it will happen to you again, but it is essential to learn to be objective about these things.

Yes, nurses can and should write up other nurses. The references to "second grade" and horizantal violence are absurd. You had an order and you did not carry it out. The next nurse came on and saw that there was a med on the MAR that was not given. She was obligated to address this in some way.

Remember, we are there for the benefit of the patients and we all make mistakes. Until we stop ignoring errors for fear of making our colleagues upset, we will never achieve a safe health care culture in this country. There should be a non-punitive system in place in your hospital (and every hospital) where mistakes are recognized and addressed through examining the environment, systems and other factors that led to these mistakes.

Filling out an incident report is not the same thing as initiating disciplinary action. Only a supervisor can do this. I urge everyone to remember this when they become upset at a coworker for bringing an error to the attention of the patient safety committee.

pagandeva2000, LPN · Jan 24, 2008

What I am wondering is if this nurse was not a supervisor, then, how does what she writes count on your record? If she wrote it to cover herself, then, understandable...but, I have only known that a supervisor can write you up where it can be a permanent part of your personnel folder. If your manager is understanding, then, I would not worry about it. But, I would never, even as a seasoned nurse take on more than one student. This is what they have clinical instructors for.

Anyway, do not beat yourself up. Even under the BEST of circumstances, things happen. Take this as a learning experience not to take on more than you can handle, and again, if the manager is not jumping down your throat, then, move on. I would take time out to speak to the manager again, tell her that this is really bothering you because you do, in fact, care about your patients, your job and your license.

suanna · Jan 24, 2008

I've posted this before and will probably post it again. If I make a mistake I expect to be written up. I'm not talking about being 2 hrs late giving a daily multivitamin but an error that could had or did effect the care of a patient. It is up to the nurse manager to decide if the error warrents further action. This is the only way to fairly gauge the effectiveness of a unit and it's staff. The conclusion that could be drawn from your "write-up" could be that proceedures like marrow biopsy take up too much of the floor nurses time and need to be done only in a special proceedures area. I can't tell you how many times nurses have covered for years for peers that were not only inept but dangerous but no one wants to "snitch". As a result staff that shouldn't be working in the area they are make the job more difficult for all the rest of the team. I'M NOT SAYING THIS IS THE CASE WITH YOU! From my point of view your omission was of no significant importance for the patient but phenergan isn't a sedative (at least that isn't what it's ordered for). If your patient had narcotic induced nausia/vomiting while under sedation they were at risk for aspiration pneumonia or worse. The best you can do is acknowledge the error, be more cautious in the future and recognize you are a good nurse who does a good job in caring for your patients. There has only been one perfect person that I have heard of and even He got nailed for other peoples mistakes. Don't be discouraged by an error now and then. If you have a reasonable nurse manager a write up is nothing but so much paperwork- except for the staff with real issues that need to be addressed.

Nursenan0 · Jan 24, 2008

Even as a supervisor I dont write the nurses up for a single med error. I do fill out an incident report if someone else hasnt. Mistakes happen. The write up comes when I keep getting incidents from the same nurse over and over. I have had nurses write an incident on themselves for a med error. Its a mistake, learn from it, and go on.