I got written up and it's bringing me down

[porterwoman]

I got written up by a surgeon for contacting the primary medical practice instead of the surgical practice. The pt is okay, no bad outcome. I talked to my charge nurse and another more senior nurse who takes charge several nights a week to get their input on which to call; both suggested I call the primary.

I'm new, only licensed 6 mos. This is my first time getting written up, and I'm dwelling on it heavily. I even had a dream in which the surgeon asked me, "Why did you call Dr. X instead of me??" I need to let this go!

This happens, right? We pick ourselves up and learn from it and go on, right?

I'd like someone to tell me that getting written up is just part of the job and that I shouldn't let it eat at me.

tx, porterwoman

[chadash]

I can undestand the surgeon pulling you aside and requesting that you call him first in a similar situation.

If he had a cow, well, that's his cow to tend to. You don't have to feed, water, or milk it.

If you used your proper chain, your manager should back you.

~faith,

Timothy.

This is utterly bovine! and also a golden opportunity to share my favorite cow joke:

Q: What do you call a cow who just recently had its baby?

A: Decalfinated

Hope that lifts your moood

[TheCommuter, BSN, RN]

I am another person who takes it very personally after I have been written up. I get a feeling of overwhelming doom and sorrow.

[porterwoman]

Uncontrolled n/v with bowel surgery.... I am very surprised the charge nurse told you to call the primary. However when I worked on the floors I worked on surgical floors and we always called the surgeons never saw the primary. However you did ask, you are a new grad. the charge nurse should have known. Also the primary should have turfed this to the surgeon so he would not be liable for any complications due to the surgery.

Yes, true, and the pt was admitted by the surgeon, so that's probably where I went wrong. However, that surgeon was not on call that night, nor was the pt's primary. I had the choice of talking to two different doctors who had not seen the pt as far as I could tell from progress notes and from orders. Plus, the primary practice had been writing orders/notes on the pt, as the surgeon had. Anyway, probably best to call the surgeon. Anyway. Live and learn. Thank goodness the pt is okay, and I did call someone. So it goes.

[group_theory]

I am a little disturbed at some of the responses in this thread.

Nurses are professionals and as such, shouldn't use games as "paybacks". Whether the surgeon was correct or not in writing up an incident report, there should never be any repercussion for filing such report - otherwise, future incidents might not get reported for fear of any potential retaliation (and the problems will persist). Docs should never retaliate if a nurse writes an incident report, and nurses should do the same.

It is quite childish to "call the doc for every single thing - that'll teach him/her". What happens if after the 10th page, the patient's condition takes a nose dive and you need to contact the doc. Do you think the doc will respond as quickly? Can you seriously look yourself in the mirror and say that you were not at fault because "that doc didn't respond to the page when the patient started to go downhill". Yes, retaliating by repeatedly paging will make you feel better - but at what cost? Your professional dignity? Your patient's health?

What should you do?

Talk to your hospital's management. Tell them you want a chance to submit your side of the story. Talk to the nurses on the floor whom you consulted. See if they're willing to submit their point of view on what happened. That way, all points of view will be represented in this "incident" and will on file.

And continue on with your life. Show this surgeon that you are a professional. Show this surgeon that you are an excellent nurse, one that is reliable and knows the patient and knows when to call the surgeon and when not to call the surgeon. That will you earn you more respect "as a nurse" than if you constantly call the surgeon for every non-issues.

[Zee_RN, BSN, RN]

Please don't dwell on this. This sounds like the surgeon's problem, not yours. You'll acquire a better sense of whom to call when as you gain experience. In many cases, you are right to call the ATTENDING physician.

If the surgeon wanted to tell you that you should have called him, then fine. But to write it up?! It's his ego, not your "incompetence."

[TweetiePieRN]

I am a little disturbed at some of the responses in this thread.

Nurses are professionals and as such, shouldn't use games as "paybacks".....

It is quite childish to "call the doc for every single thing - that'll teach him/her".

According to another post you posted...you are not a nurse nor a nursing student. No offense to you...BUT it is very easy for someone from the "outside" to say something like this and not understand what working as a nurse really is like. Granted, you may think that this is "childish", but walk in our shoes and then make a judgment call.

BTW...If you are not a nurse or nursing student, why are you visiting a forum called "Allnurses" (just curious).

[SmilingBluEyes]

Sweetie, live and learn. And then MOVE ON. Don't let this stymie you; we all have had our down times as new nurses----and even as not-so-new ones now.

[group_theory]

According to another post you posted...you are not a nurse nor a nursing student. No offense to you...BUT it is very easy for someone from the "outside" to say something like this and not understand what working as a nurse really is like. Granted, you may think that this is "childish", but walk in our shoes and then make a judgment call.

BTW...If you are not a nurse or nursing student, why are you visiting a forum called "Allnurses" (just curious).

Because I'm interested in what's going on in all aspect of healthcare - not only to understand what my colleagues are dealing with, but also the topics and issues that are important to them. This is why I visit various forums - to learn and understand, and sometimes to give my input.

You are correct in that I'm not a nurse or a nursing student. However, I do believe I'm not violating any TOS agreement. But if this board wishes to make this site exclusive for nurses, nursing students, and pre-nursing students ... then I'll abide by its decision and leave (it is your board, I'm just a visitor). But I still stand by my advice - retaliating is never an option and is "childish". It just exacerbates any animosity and can potentially turn a small fire into a conflagration.

[canoehead, BSN, RN]

I agree that someone without nursing experience doesn't have a clue about nursing.

I have to add to the discussion that for the number of times I've threatened to call every 10 minutes I've actually only done it to harass the doc into transferring the pt to ICU, not just to drive him/her nuts. If it was your relative would you want the harassing nurse, or the nurse who defers to the doc's order of "don't take any more vital signs until 6am" (True story)

After working in 5 hospitals and with hundreds of nurses I have not yet met the Q10 minute caller, but I have met lots of nurses who have kept calling because they were truly concerned. so maybe, maybe, MAYBE the poster was just joking

[Larry77, RN]

My own personal rule of thumb is, if it has absolutely nothing to do with the surgery done or to be done then call the PCP (if named, sometimes is not). 9/10 we call the on call surgeon. There is info passed to the on call doc about all the Pt's he is covering plus they have access to our computer charting system if they need to research the pt before answering any questions.

I also would not have been one of the nurses taking part in a "pay-back" scheme simply because it is not my style. If I have a problem with someone I will let that person know face to face not by trying to get retaliation.

[chadash]

According to another post you posted...you are not a nurse nor a nursing student. No offense to you...BUT it is very easy for someone from the "outside" to say something like this and not understand what working as a nurse really is like. Granted, you may think that this is "childish", but walk in our shoes and then make a judgment call.

BTW...If you are not a nurse or nursing student, why are you visiting a forum called "Allnurses" (just curious).

I am not a nurse or a nursing student myself, I can't speak for the poster that tweetie pie is answering.

I originally got on to allnurses because I was going to start nursing school, but life interrupted. I am a nursing assistant who works in home health at this time, and have found allnurses very instructive when facing the problems of what is appropriate, or what to do....I just need the info while working independently on private duty.

But I have felt akward being on an all nurses site. I also had never posted anywhere before this, and it is a little foreign to me.

Have been thinking I probably should not post. But the discussions are so interesting.

When you're hungry, sing; when you're hurt, laugh.

(Jewish aphorism quoted by Leo Rosten in The Joys of Yiddish)

[ZASHAGALKA, RN]

I also would not have been one of the nurses taking part in a "pay-back" scheme simply because it is not my style. If I have a problem with someone I will let that person know face to face not by trying to get retaliation.

Some of it is pay-back - maybe.

But mainly, I think it's about perspective - and respect. If some doc doesn't want to trust my judgment, then my take is to let him/her make all the decisions, day or night.

A good part of my job is managing things at night. I understand that the whole array of the resources of the 'day world' isn't at my fingertips. If I do my job well, docs don't have to be bothered unless necessary. And I'm good at it.

But if a doc wants to make an issue of the decisions I make in order to AVOID waking him/her up, then that doc cannot expect the luxury of sleep when those very decisions were designed to protect that sleep. A doc simply can't have it both ways.

It is an issue of respect. If a doc doesn't respect my judgment, that is fine. But it's not simply payback to then defer all those judgments to him/her.

A doc simply can't have it both ways.

And as far as a pt maybe suffering because a doc thinks the nurses are crying 'wolf' . . . If the doc doesn't trust us to watch the sheep, then I will call for every rustle of the leaves. But if he doesn't answer promptly to investigate, well he is a link in a chain of command. And I don't have any problem immediately calling his chief of staff to handle things for him, if necessary.

~faith,

Timothy.