Incident report- retaliation

[ICRN2008, BSN, RN]

I had to write up an incident report last night on a med error involving the 2 nurses before me (as well as myself to some degree). I gave report back to the day nurse this morning, and I let her know about the incident report as a courtesy (so that she wouldn't be blind-sided if she was approached about it today). This nurse got really mad and basically insinuated that I had probably cost her her job. Apparently, she already has some issues and had been warned that if she had another incident she would be let go. I felt horrible, of course, but at the same time I'm not going to lie (on my charting or verbally) in order to save someone else's hide. IMO we all make mistakes, and as adults we have to own up to them and learn from them.

I have had to write up incident reports in the laboratory before, and I have never run into this kind of response from another "professional". Based on this nurse's behavior, I am now concerned that she is going to go back through my charting from last night and try to find something to "catch" me with to retaliate.

I know that I wasn't wrong to write up the incident, because that is part of my job and I am unwilling to lie. However, I am wondering that if in my attempt to be nice and give this nurse a heads-up I unwittingly created a worse situation for myself.

I'm just worried and feeling bad in general. Any encouragement would be appreciated. TIA.

[BBFRN, BSN, PhD]

Give your manager a heads up on what is going on ASAP. Email it, so it'll be in writing. Follow your gut on this, and if you can, try to follow other nurses for a while, so she won't have any reason to be looking at your charting.

[EmmaG, RN]

However, I am wondering that if in my attempt to be nice and give this nurse a heads-up I unwittingly created a worse situation for myself.

Possibly, but any manager worth a damn will see through any attempts at retaliation.

Apparently, she already has some issues and had been warned that if she had another incident she would be let go.

That's not your fault; don't allow her to project that onto you.

However, stay alert. If she's not willing to take responsibility for her own actions and instead blames others, her retaliation could go beyond the workplace. Not trying to scare you, but there are some crazy people out there.

[llg, PhD, RN]

I agree. Work with your manager on this. She may be able to alter your schedule or assignments to give you some protection until she has time to deal with the other nurse. You'll also want your manager to have a record of the situation in case something develops in the future. If anyone else witnessed the other nurse's reaction, I would also get them to write down what happened -- just in case.

[FireStarterRN, BSN, RN]

I hate this sort of stuff. Yes, some nurses do practise tit for tat in these cases. She probably feels cornered because she's been repeatedly flubbing up. Maybe she can't handle the job but still has bills to pay. But watch out, she might have allies at work who will join in in persecuting you. This does happen.

[NursingAgainstdaOdds]

I agree with the posters above - just get it in writing so your manager knows what is going on.

[Cosper123]

This nurse got really mad and basically insinuated that I had probably cost her her job. Apparently, she already has some issues and had been warned that if she had another incident she would be let go. I felt horrible, of course, but at the same time I'm not going to lie (on my charting or verbally) in order to save someone else's hide. IMO we all make mistakes, and as adults we have to own up to them and learn from them.

Firstly you did the right thing. You shouldn't have felt horrible, AT ALL, as you did the right thing. If this person cannot hold themselves accountable as a professional (and more importantly...an adult...), then that is not your fault.

As stated above, give your manager a heads up on the convo, and let them know everything you posted here.

Don't let this person drag you down. You are not responsible for their mistakes, nor should they deflect blame onto you like a child. Heck, you even went above and beyond in giving them a heads up. Kudos for your morals and values, it sounds like this 'person' could learn a lot from you.

[SuesquatchRN, BSN, RN]

Stop worrying about things that haven't happened.

Tell you manager about her reaction and then let it go.

If she tries to find a problem with your work she tries. She will or won't. If you haven't been screwing up big time left and right it won't matter.

[montieICURN]

Incident reports are not supposed to be punitive. They are supposed to notify risk management that an error occurred so they can prepare for a law suit in case harm was caused to the patient. Was any harm caused? If not, don't worry about it.

If it involved a "high alert medication", and a "near miss" (at causing harm), it may lead to a root cause analysis which is a really BIG deal. If you want to read more about that dreaded process, check out www.jointcommision.org

This nurse was unprofessional, and obviously your manager knows her well if she is on her last leg. I'm sure your manager will see through any retaliation, as Emanuel G stated. NOT YOUR PROBLEM!! You have to report errors as you find them, or YOU could be written up. Also, you did the right thing by giving her a head's up. Don't let her reaction keep you from doing that in the future.

[Jo Dirt]

I don't know how serious the medication error was (of course, they are all serious, but was this Reglan or Morphine?) but in the future (because I am going to assume it wasn't anything that would actually cause harm to the patient) be sure what you find fault with and write up reports on is serious enough to cause the grief and trouble and possibly loss of job to your co-worker who has a family to care for and bills to pay.

I can't assume you are like this but I have seen nurses who want to build themselves up against others and they gleefully grab that write up report or incident form and fill it out over things that don't make a dimes worth of difference in the bigger scheme of things, they just do it because they think it makes them look good.

I gave a patient the wrong medication once, and being a new nurse it scared me to death and I thought it was really going to harm the patient. I ran to my supervisor and told her what happened. She could have pulled out all the paper work and gone through the drama routine of running to the patient's room, etc. But she didn't. She told me to watch his VS and monitor him the rest of the shift and if I noted any changes to call the doctor and tell him what happened.

The only time I have seen a med error serious enough to bring it to the person's attention was when I was working private duty and the patient was supposed to get 60u insulin in the am and 20u in the pm and a nurse mixed it up and gave it the other way around and caused the patient's sugar levels to be out of whack for a day. I mentioned it to her and she reacted how I thought she would (I can do no wrong kind of thing) but it never happened again.

Technically, though, there isn't anything she can do to retaliate against you. Any supervisor with half a brain will see right through that.

[CaLLaCoDe, BSN, RN]

one thing i can add to this blog is that incident reports should be done as a last resort. i mean if you see something done wrong point it out verbally first. don't just go about writing the person up post haste, that is inconsiderate and rude to boot!

[leslie :-D]

agree w/the others.

notify nm (in writing) of conversation.

keep copy for yourself.

try not to be paranoid, but do be more aware of your environment.

go about your business.

you acted professionally and admiringly.

and do not feel badly.

you're not the one w/the "issues".

leslie