occurrence report=doctor hates me

Nurses General Nursing

Published

Well,

This has been bugging me. I wrote an occurrence report for a rapid response and then patient died within a short time frame after a procedure. My manager told me that I was in the wrong for writing it and that MD doesn't want me to take care of his patients and also somehow another surgeon chimed in about "my conduct" during this review! Its a long story, but is that a JUST culture? Feels like retaliation to me for something our unit and MD could learn from? Does it make them look bad at higher up? A policy was changed to make me look bad too. I am trying to see if union can help me but doesn't look promising. PS our "manager" never been in this position before so she is trying to "make peace" for "my error" of reporting.UGH!

Had an "out of left field" catastrophic "occurrence" once. Huge potential for a brain dead or all dead patient, neither of which happened. Walked out of the hospital 2 days later despite over 30 minutes of CPR. Total flail, expertly handled.

Occurrence report for "too many people and too disorganized" written by people that were completely non contributory to the success. I wondered what they were doing there myself. Ended up with meetings by amateurs lecturing experts on how to more expertly do their jobs.

I doubt it was this one "occurrence report" that had the negative effect that it did. If there is a culture of "gotcha" in order to empower and validate groups that crave influence, it doesn't take much to provoke someone just doing their job.

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Specializes in Emergency, Telemetry, Transplant.

Was this device used on the floor in the postoperatively? Is the issue that you and other members of the staff were not trained in this device? (This is starting to feel like 20 questions.) If so, that raises bigger issues about the hospital not properly training nurses in a device that is being used in the facility. Did this contribute to the pt's sepsis?

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So, surgeons are not "doctors" any more? Another thing to remember

:roflmao::roflmao::roflmao:

I meant to put internal medicine doctor. Sorry!!

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I get from this is that a patient came out of surgery with a device with which you weren't familiar, or a device being used in a way with which you weren't familiar, and so this caused you to question whether it had been used properly and suspect that it was not proper use of the device. And you had a feeling that something wasn't right. Then you told your manager something was amiss and there were two other people who agreed that something could be amiss.

What was done about this in real time? Did you report to the physician that something seemed amiss? Find out why the device was being used in this manner?

Out of curiosity, how would you feel if you knew the patient had the procedure d/t being unwell - or the case wasn't as simple as you might have thought, and it turned out that temporizing measures had to be taken and that's why the device was used/used in that particular way?

Are you of the impression that medical/surgical care isn't reviewed unless a nurse fills out an incident report?

No one can say whether it was right or wrong for you to file the incident report, but you appear to be assuming at least a couple of things and/or looking at this from a very limited vantage point.

Regardless, this isn't about you. If you believe a patient was harmed d/t incompetence and now a cover-up has taken place, you'll have to decide what to do about it to protect future patients. If you don't have those concerns, then I would drop it - yesterday.

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"Occurence report for RR" can be, for example, about making several calls to covering provider in escalating clinical situation which were either not answered, or response was clearly outside of "common practice" (like not ordering "septic set" for patient with crushing BP, fever and tachycardia/tachypnea, ignoring deteriorating viral signs, not ordering ICU transfer when it was clearly indicated, etc).

I do not understand the second part. Things, including drugs, devices, monitors and everything else, are used "off label" all the time simply because it is not possible to push every single thing through the multiple steps of EBM. If one "never saw using this thing like that" in X+1 years, it doesn't mean doing so is unsafe or illegal. Policies also cannot encompass everything, and they are changed all the time. Unless you are a specialist, making conclusions of some devise being used in a certain way may easily cross scope of practice line.

And, yeah, hospitals are not required to "report complications". With "compliance line" or without it.

I understand that you probably were just thinking along the line of "iamjustdoingmyjob, iamjustsoooomuchconcernedaboutsafety", but at least with the second part you hit where it hurts most. This "guardian angel" nursing behavior is what irritates physicians beyond means because it affects their function, their decision making and their sense of power. They are picked on by insurance companies, sales, contracts, etc., etc., WAY beyond normal human tolerance level, and "report" of some bedside RN voicing her "concerns" just because she never saw something done can be that last straw.

If I were you, I would run out of there ASAP unless you agree to become a walking target. It may not be "just" but it is what it is. Physicians, and especially surgeons, bring $$$$$ in hospital, nurses bring little to nothing. Fact of life, love it or hate it.

Doctors are picked on? Please don't try to get folks to feel sorry for them any more than we feel sorry for insurance companies or for turncoat supervisors and writers of policy like OP's.

OP, I think the advice to get out is probably pretty good. I don't know. I guess you could try to talk to the doctors to see if there is any forgiveness. Apologize 7 ways from Sundown if you want to keep the job. If not, well, best wishes on finding a new one. I'm sorry all of this has happened. Learn the lesson about ratting out doctors.

And while nurses don't bring in patients (money), we contribute a great deal to their care and health.

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So, surgeons are not "doctors" any more? Another thing to remember

:roflmao::roflmao::roflmao:

Of course surgeons are doctors. However, they focus on cut and run. I have seen very few surgeons that could also manage their patient medically.

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Well,

This has been bugging me. I wrote an occurrence report for a rapid response and then patient died within a short time frame after a procedure. My manager told me that I was in the wrong for writing it and that MD doesn't want me to take care of his patients and also somehow another surgeon chimed in about "my conduct" during this review! Its a long story, but is that a JUST culture? Feels like retaliation to me for something our unit and MD could learn from? Does it make them look bad at higher up? A policy was changed to make me look bad too. I am trying to see if union can help me but doesn't look promising. PS our "manager" never been in this position before so she is trying to "make peace" for "my error" of reporting.UGH!

You did the right thing. Administration and the almighty surgeons are trying to SHUT YOU UP. Please continue to fight for your patient.

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yes and no its something that could be used but in reality the patient died and my occurrence report was simple but the message to the manager to look into it went too far.

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Specializes in Critical Care; Cardiac; Professional Development.

If you weren't even there for the RR, I really don't think your filing this report was appropriate. It would be appropriate for an inservice perhaps or grand rounds case study if learning was the goal. But triggering a full on investigation when you weren't even present is definitely going to ruffle feathers. I would move on as soon as possible.

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