Who writes incident reports, you or the doc

[niteshiftnurse]

After having a terrible nite, I have come to realize that I'm sick of doctors that are rude. I had an admission last nite from the ER, which the pt was seen by the ER doc at 5pm. He arrived on my floor at 11pm. Shortly after his arrival, I had a discharge, transfer to ICU and an admission. There was an order for a consult to be called "today". The ER secretary didn't call the consult because it wasn't STAT. Chart checks on the floor were not done till 3am (that would be the next day) I had to call the doc at 6am because of no order for tylenol for a temp. He asked me if the consulting doc had seen the pt and I said no and explained to him (very nicely) that I didn't get the patient till almost 11pm. He said that the blame should go on the ER for not calling in the consult. About 5 minutes later he called back and wanted me to write an incident report about why the consult wasn't called. At that point I was at the boiling point (obviously he didn't make any points with the nurse in the ER, so TAG.........I was it). I told him if he wanted the incident report made, he should make it himself and turn it in as it was the ER's place to call. Needless to say, I got a visit from the head honcho from the ER and she informed me that it was the DOCTORS place to write the incident report. I already had it done so I gave it to her. Just wondering if anyone else has had this happen to them. While I still had my feathers ruffled, I asked her why a doctor would order a diet for the patient, po meds and accu checks when the patient was NON_RESPONSIVE. I really don't think he even saw the patient. She said that was a good point.

[canoehead, BSN, RN]

If the doc wants an incident report filed and you don't agree that there was an incident then it is his right to write one out himself. If he orders you to write one I see no need to follow his order-just tell him he can do it himself. Of course, if there was an incident and you agree there was it is good form to write one in the name of protecting future patients.

The offending doc in this scenario sounds like a turd, but you gotta separate that from whether the patient suffered because the consult wasn't called. At our hospital if a doc wants a consult called immediately they generally make the call themselves and give a report to the other doc as a courtesy. Perhaps that would have been appropriate in this case since he wanted it done ASAP.

[gwenith, BSN, RN]

Ditto the above

[SmilingBluEyes]

No one TELLS me to write incident reports. I do them when I am involved, and know the writing of such a report is necessary to cover the situation and my behind. If a person feels it is needed, let HER or HIM write it up. NO CAN FORCE you to write an incident report.

[MandyInMS]

Guess in that situation first I'd call my nursing supervisor and inform her of the situation..even though I KNOW what she'd say...make out the report stating it was under the instruction of Dr.Turd...and have her co-sign it with me...blah @ incident reports...nobody likes those darn things :/

[yannadey, LPN]

I 2nd what SmilingBluEyes said.

[niteshiftnurse]

Thanks for the advise. It will be interesting to see if anything comes of it. You guys are great

[nimbex, RN]

ok. have to fess up, when a doc says "write up a report", I always have, never occured to me to say no. AND, I'm a fairly outspoken person.

So thanks to you all, my new answer is..."do it yourself if you feel the need".

[P_RN, ADN, RN]

He who finds writes. NEVER include incident report filed in your notes.

KISS...keep it simple......"patient received on unit at 2300. Consult called to Dr T....:) at 0600.

Sometimes I'd put a sticky on for the NM with names etc but usually an incident report is a Heads Up for management so they're not caught off guard when questioned. NEVER assign blame.

[redshiloh]

Those orders written for a nonresponsive patient need to be written up...I believe that would be medical malpractice.

[mattsmom81]

We have 'complain forms' that we utilize when docs or family members are unhappy. This eliminates every piddly complaint going to management in the form of incident reports.

If the doc INSISTS on the incident report, I do it, making it clear I am writing it at HIS request. Also been known to paper clip the unit's side of things (outside the facts) so that gets looked at too.

I had a peeved pulm doc the other night with similar scenario...ER doc intubated and called PCP...PCP gave phone order to ER staff at about 8 pm -pulm consult for vent mgmt...pt got to me at 1130 pm and of course ER hadn't called pulm. So I get to call the very

unhappy doc after midnite.

Now I don't know why it's so hard for our ER staff to at least CALL the consults at a reasonable hour...but it is. Seems like a passive aggressive thing to me....or turf issue.

We nurses just do the best we can with all these egos.

[Agnus]

If incident reports are utilized as they were designed to be they are for tracking errors and finding and eliminating the cause.

THEY ARE NOT SUPPOSED to be for disaplining someone.

He who finds an error writes the report. If some one (such as a Doc) asks me to write one. I write only what I know to be factual. If all that I know is that the Doc asked me to write it and if I have no first hand knowledge of a situation I say that the Doc aske me to write it and I have no first hand knowledge.

I have never had a problem doing this but then again my facility does not use these punitively.