Incident report happy nurse

[ohbet]

When do you right up an incident report?

Lets say the patient was not harmed and it is the first time the error has been made,should an incident report be done or should you discuss it with the nurse who made the error?

Some Nurses seem to be incident report happy.

[hoolahan, ASN, RN]

I always discuss it with the nurse first. I rarely ever write anyone up. There would have to be harm done for me to write someone up.

I once was working agency in a local hospital. A new nurse was asked to prep for a swan insertion in CCU. She had no idea what to do, thier employee. No one from their staff would take the time to explain how to do the set-up. So, I showed her how to run it through, and explained how to zero the lines and how she would have to re-zero and cal once the lines were conncted. She wanted to play with the mintor, so I handed her the little package of dead-enders and told her she needed to cover the ends when she was done. I was done with my shift and it was time for me to give report, so I left her. Imagine my surprise when the next day, the sup from the agency calls and tells me I was written up for not covering the ports with dead-enders. I just LMAO! Is that my horrible crime? I asked. I explained what happened, but the write up had to stand. Next time I worked, I marched right up to that bit*hy head nurse and told her exactly what I thought of her little write-up. She never wrote me up again, in fact I think she was farid of me. Yes, be afarid, be very afraid ! :roll

Some people get a sense of ower and control by writing people up, I don't know why. Others have told me they think I am wrong for not writing people up more often, but I just can't be bothered with any more paperwork. Once I wrote upo the lab, and the damn incident report kept coming back with request for more info, more info. I asked the charge nurse what I should do, I couldn't figure out what the DON wanted. She said, Honestly? I rip them up and throw them out. They never follow up and ask about it again. So I did, and they didn't. Go figure!

[live4today, RN]

I agree with you, Hoolahan. Unless a patient suffered harm in some way, I would always pull that nurse aside and kindly "school" her on what was done incorrectly, and show her how to do it properly.

Having worked with soooooo many different nurse agencies in the past, I often found errors when reporting to work at the various hospitals I floated to. I found wrong IV solutions hung on patients more times than I can count on all my fingers and toes.

I preferred to do "walking rounds" when receiving report from the "off going" nurse, and I offered to do the same for the "oncoming" nurse replacing me. This helped to "correct" any errors (i.e. wrong IVFs hung, etc.) with the "offgoing" nurse before she got away. I've even had one staff nurse BEG me not to write her up for hanging D5/NS with 40K on the wrong patient. The only reason I did not write her up was because she had grabbed the wrong IV solution at the end of her shift, and hung it on the patient in the bed next to the patient who should have gotten that IVF. There couldn't have been more than 50cc administered to that patient as the IV bag still read 1000cc. I told her how I understood the pressure the staff nurses were under, but to stop and take a deep breath and take notice of the medications and IVFs she grabbed so she wouldn't hang them on the wrong patient, or administer the wrong med to the wrong patient. I told her how giving K+ to the wrong patient could seriously effect their health if given enough of it, and to be more careful in those areas. She thanked me a dozen times over and promised to not do it again. She never did with me, but....

We all make errors in judgment and in giving meds or hanging IVFs. Just school the nurse in what was done incorrectly, and report the nurse who continuously repeats the same mistakes, and report those who have done something that can cause serious harm to the patient.

[fergus51]

Incident reports or unusual occurence reports aren't all about blame at our hospital. Our nurse managers like to get them so they can see where to make improvements. Like our medication system which was completely revamped after the same error happened twice. It hasn't happened since. Without the incident reports it would probably never have happened.

[NurseDennie, BSN, RN]

Hi. Most - I guess ALL of the incident reports about me were BY me. Mostly I was Covering My A&&. For instance - I was drawing up demerol into a syringe, and dropped the full syringe with needle still uncapped. It kind of scratched my skin and darted into the carpet in the hallway. I grabbed another nurse REALLY quickly (she'd seen it happen) and filled out an incident report with her name, made HER witness the narc waste, and then went to employee health and asked them for a blood test. The nurse there looked at my scratch and declined to test.

I can think of other incident reports I've filled out, and they were pretty much all along the same lines. If I had to do an incident report, I never mentioned anybody else's name. What time *I* got there, and what *I* found.

For a while, we were sending incident report after incident report on the lab. The admin was trying some new staffing and hours, down there, and they wanted a report for every time we could come up with one. We did, and staffing was restored.

Love

Dennie

[night owl]

I'm with you fergus. How do you improve the quality of care if you don't have anything to go by? I'm all for the incident report, but not for the blaming, for the improvement!

[thisnurse]

new nurse somehow got in the habit of carrying around a tablet in her pocket so she could write ppl up. (she was being groomed for the tattle-tale position)

one of the cna's suggest she might want to rethink that tablet thing.

[mattcastens]

Originally posted by night owl

I'm with you fergus. How do you improve the quality of care if you don't have anything to go by? I'm all for the incident report, but not for the blaming, for the improvement!

I'd have to agree here, but i think it depends on your hospital culture. Where I work, no one is offended by an incident report, and much improvement has come of them from faster lab and pharmacy times to better staffing on the night shift. There is one nurse in particular who seems to be incident report happy, but we all (NM included) have learned to take them with a grain of salt.

[P_RN, ADN, RN]

Once a "brilliant" decorator came up with a color scheme for our unit. Beige walls, tan paint, Brown carpet in all the patient rooms was the "highlight" of the scheme.

Now picture that same carpet 9 years later....in patient rooms, a la betadine, Number 2, Number 1, emesis, shoes, food........

Well TPTB said there was no money for renovations. Patients were actually refusing to stay or even check in these nasty looking rooms.

OK an incident report on EVERY refusal as well as EVERY inadvertant "accident" and within about a month.....guess what?

Renovation. Nice polished white floors, carpet in the halls...that really was easy on the feet, pretty walls, pictures.....

P

[CANRN, MSN, RN]

Incident or "unusual occurance" reports are useful and PRN's post clearly points that out! LOL

They truly are intended mostly for 'education' but there are a few over zealous nurses who believe they are for discipline and take them way too seriously! That's what is sad.

[Jenny P]

Get this one! A doctor FORCED another (newbie) nurse to write an incident report on me because I'd hung a 250 bag of NS on a pt. and ran it at 25cc/hr from 2AM til 8AM because I didn't call him about it! The pt. was supposed to be on tube feedings at 40/hr, but they hadn't been able to get the tube in on the previus evening shift, and the day shift nurse had d/c'ed the maint.IV because the bag was empty (no specific order to d/c it) and the T.F. were beginning. By 2AM, he was so dry his tongue was fissured (his only other fluids were Dopa and Dobut running at a total of 25cc/hr); he was a renal pt. who was scheduled to be dialized at 10AM that morning. I'd talked it over w/ my charge nurse and we decided that the small volume wouldn't hurt and the MD wouldn't want to be called for such a trivial request.

Believe me, this doc is called at night for the most inane things now! The other nurse was in tears when she told me about it. And the NM couldn't understand why the doc was such a jerk either.

[Heather56]

I agree that incident reports can be very usefull in getting things done. On my ward we had been having alot of trouble with a head injured patient who was waiting to go to rehab. This pt. was very manipulative and becoming more and more agressive with staff. We would call security and he would be an angel as long as they were there. Finally one weekend we filled out incident reports on every verbal and physical aggressive move he made and our manager arrived Monday morning to 16 reports on her desk. The patient was moved to the rehab unit by 2pm that afternoon!