So let me start with last shift. One of the assistant managers told me she had to speak to me regarding my ''documentation'' so now I'm thinking what now? Over the last few months I've made it a habit to have excellent documentation and even in my last evaluation which was 2 weeks ago they said my documentation was good.
So getting right to it. She wanted to give me a verbal warning because during her ''chart review'' she found that a second set of cardiac enzymes was not drawn on a patient. Ok understandable. So I asked did the patient decompensate? No she said, the patient was fine, but she still needed to basically write me up about this. And might I add I had this patient a week ago. I had to stop and think and comb through the chart to remember who this patient was and what she was here for.
Then the second complaint was that I did not do my double charting. Yes they want us to double chart. They want us to chart in one computer system, then re-chart in another computer software system after the patient is admitted, and although I did two complete and spot on assessments of the patient within 10 hours (patient was completely stable) I still deserved to be reprimanded because I did not do my ''double charting" as I call it.
Now I already received a ''verbal warning'' because once again during a ''chart review'' the manager said I had no focused assessment of the patient, which was wrong. She failed to read the entire chart and looked over where I documented my focused assessment, but she was still able to ''get me'' on the write up because the patient was under ICU evaluation. Mind you the patient (who was to be an ICU eval because she vomited a small amount of blood twice at home, none on my time, completely hemo stable, and A&O) This occured during shift change and the patient had become an ICU eval literally 45-60 minutes prior to shift change and I was scrambling around trying to make sure she was on fluids, med drips etc.. but I had stopped to give report, therefore I was not able to placed the patient of the monitor, BUT a full report was endorsed to the evening nurse.
So on this second write up I'd just had enough. This time I had to have my delegate present. The delegate was peeved. She said do you know how many times this happens? You might as well write everyone up! She said she knew plenty of nurses that committed the same mistake and where was their write up, why weren't they sitting in the office as well?
It seems as though they love ''reviewing my charts'' and finding anything to bring up to me.
Now I understand being warned for something, but both patients NEVER decompensated, both were actually completely stable.
To be honest I just feel so terrible. I work in a crazy busy level 1 ER, where we get up to 14 patients sometimes, some of them being critical, intubated, hypotensive. Literally every shift I give 110%. I can understand if the patients decompensated, I'd take fully responsibility,but honestly I feel as though since I'm not a favorite of theirs, they try to ''get me'' you know?
This is the same place who gave new grad nurses (myself being one) only 2 weeks of unit training before throwing us on our own. I NEVER had anything major happen to a patient that was directly my fault, I've never suffered from the big mistakes a new grad can make working in a high pressure area, but yet it's as if they can still find something to slap in my face.
I am appauled at the way management treats there own nurses here. You get no credit, no respect, but if you do anything wrong, BAAM, like lightning they catch you. What kind of environment is this to work in?
I'm seeing more and more who they want to succeed and who they are trying to tear down. Nurses come and go here often.
I just cannot believe they are really picking at straws. No other of the new grads I started with have had verbal warnings for this type of stuff. Favoritism is big there.
The managers literally snoop around and pick on nurses, what is wrong, was wasn't done, etc...
I am more floored than anything, I cannot believe this.
My issue is not with discipline alone, my issue is when people tell me that they know plenty of people who haven't been written up for the same issue. I understand the discipline, but if you you really want to run a unit, discipline everyone who deserves to be disciplined. Life's not fair, and I am an adult, so the insinuations that I am a child need to end.
We all can learn a thing or two, or do a thing or two better on each shift, no nurse is perfect, no nurse is a machine. No that won't hold up in court, but it's the reality of it. Staff morale and fairness is important to running a successful unit, and if you are frequently bringing up what someone is doing wrong, how is that beneficial to you or your staff? I know for sure I'm not the only one with this issue where I work.
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it doesn't matter if some people never document at all! just show up and do nothing, sit at the desk eating donuts. if you miss one little thing, they can fault you for that. the key is to never miss anything. Bringing up what people do wrong is how you get them to change it. I think i understand your thought process. when i have had shifts from hell, and get an email about not documenting something trivial to pt care, it does annoy me. but you just have to suck it up as part of the game. trying to fight it only makes it worse, i suppose.
I understand what you're saying although I think this is a bit different from my situations in that the patient was not harmed, which is my FIRST priority. But I definitely understand the example you gave.
When some steps are missed, this is pure luck that the patient does well.
Quite simply- if you feel you are REALLY doing all you can to cover ALL bases with your patients, then go. If you can learn from these write ups and become even better, then do so. :)
If there wasn't a crowd watching your write up, you don't really know who else the manager has spoken to about "them" patients.
Yes I have learned from them mistakes, but the fact that no other nurse I started with has this issue makes me suspicious. Also the fact that I and other nurses have seen other nurses make this mistake and we know they haven't been disciplined over it.
I don't understand I am an excellent worker, I work well, do not complain, and have no major incidents. Like I said I can understand if the patients decompensated, I would have appreciated if I was brought aside and advised certain things instead of paperwork going in my file.
One thing I wholeheardedly disagree with is the double documenting, that is where mistakes arise.
Have you ****** someone off unintentionally? A boss or a butt kissing coworker? That usually explains it..nursing is chock full of spiteful, immature people, many of them in the leadership role. Sounds bitter, but I get so tired of seeing the rotten people flourish and get away with stuff, while the decent people get grief over the littlest things.
I know taking ownership for our mistakes is important but in the OR, favoritism is very hard to hide. And it's never the good workers either, that are the favorites. No, it's the loudmouth tech who is a moron to boot who is the favorite, despite the fact that most of the docs can't stand her and she doesn't have a clue. The joke is that she must have some serious blackmail material on the guy who runs the board, lol. I'd say it was something more naughty but she's kind of a crusty old thing.
Sorry, your post touched a nerve;). Loudmouth has been especially obnoxious lately. I think the short staffing you describe and the shortened orientation time is a big problem too. Moving quickly is fine, but not at the expense of patient safety. If you are overwhelmed in your current environment, maybe a change is in order. You have to look after your patients and yourself. There are a lot of problems in nursing, no doubt. It is rife with unfairness and maladjusted people. But, if we choose to practice in this job, we have to kind of accept these things, to a point.
I can believe that maybe you are being targeted a little. I too have seen more experienced nurses make some whoppers of mistakes and get no repurcussions. This isnt fair but thats how it works, unortunately. You really have two choices here. If you want to keep this particular job, you'll have to tow their line. If you think there's something more to it, and you don't feel safe in your practice, then start looking for a job where you feel more secure and maybe will get a longer orientation. Good luck!
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
have you ****** someone off unintentionally? a boss or a butt kissing coworker? that usually explains it..nursing is chock full of spiteful, immature people, many of them in the leadership role. sounds bitter, but i get so tired of seeing the rotten people flourish and get away with stuff, while the decent people get grief over the littlest things.
i know taking ownership for our mistakes is important but in the or, favoritism is very hard to hide. and it's never the good workers either, that are the favorites. no, it's the loudmouth tech who is a moron to boot who is the favorite, despite the fact that most of the docs can't stand her and she doesn't have a clue. the joke is that she must have some serious blackmail material on the guy who runs the board, lol. i'd say it was something more naughty but she's kind of a crusty old thing.
sorry, your post touched a nerve;). loudmouth has been especially obnoxious lately. i think the short staffing you describe and the shortened orientation time is a big problem too. moving quickly is fine, but not at the expense of patient safety. if you are overwhelmed in your current environment, maybe a change is in order. you have to look after your patients and yourself. there are a lot of problems in nursing, no doubt. it is rife with unfairness and maladjusted people. but, if we choose to practice in this job, we have to kind of accept these things, to a point.
i can believe that maybe you are being targeted a little. i too have seen more experienced nurses make some whoppers of mistakes and get no repurcussions. this isnt fair but thats how it works, unortunately. you really have two choices here. if you want to keep this particular job, you'll have to tow their line. if you think there's something more to it, and you don't feel safe in your practice, then start looking for a job where you feel more secure and maybe will get a longer orientation. good luck!
wow! hate nurses much?
life is full of rotton, unfair, maladjusted people and some of them are nurses. some of them are even posting on this board. life isn't fair, and no one sane ever promised it would be.
i also can believe that the op is being targeted "a little." i think it has to do with attitude more than race or with favoritism.
over the years, i've seen nurses make many mistakes -- some serious, some not. some serious with great good luck of not injuring the patient. some not serious with the great bad luck of seriously injuring someone. sometimes there are serious consequences to the nurse, sometimes not. from what i've seen, the attitude of the nurse involved is one of the biggest predictors of consequences to the nurse . . . not severity of the mistake, and not patient outcome.
years ago, there was a new grad whom i'll call laura working with a brand new preceptor i'll call linda. laura wasn't one of our stronger new grads, linda wasn't an experienced -- or even very good -- preceptor. nevertheless after a couple of false starts, laura was considered good enough to come off orientation. on her very first night shift alone, she gave 5 mg. of digoxin rather than 5 mg. of diltiazem. it was an emergency situation and laura didn't have time to look up the drug in our two foot thick formulary . . . .she asked a senior nurse what the appropriate dose of the drug would be. the senior nurse either thought she was asking about the usual dose of diltiazem, wasn't sure which drug she was asking about, or didn't know and didn't want to look stupid. laura took her advice.the patient died.
after the patient died, laura called the manager herself to report the mistake and it's consequences. she was waiting in the manager's office at 6 am when shelly showed up. she told her all about the mistake, the events leading up to it and her own part in the problem, never minimizing or excusing her own part in the debacle, and never attempting to lie the blame anywhere but at her own feet. she owned the mistake, took her punishment, did her penances and worked with a cadre of senior nurses -- myself included -- who all knew she killed a patient her first night off of orientation. that could not have been easy. she's still working there, now as an np and she's one of the best nps i've ever seen. it took her years to work up the confidence to go back to school for advanced practice, but she's excellent.
linda, the former preceptor started that fateful morning after the incident by seeking to cover her butt at the expense of anyone else she could drag into the debacle. "they shouldn't have been so harsh with laura," she announced at lunch one day. amid shocked stares and disbelieving silence, one brave soul stepped in and said "she killed a patient."
"she only killed one," was linda's retort. to which the question was "how many patients should she have to kill before she goes back on orientation?"
linda is still there, at the bedside, and she's convinced that she's being targeted because everyone is so jealous of her beauty. that was in the early 90s. there are younger and more beautiful nurses there by now. she never did take any responsibiltiy for the incident. she wasn't there, of course, but since she wasn't there she wouldn't have needed to cover her butt by flinging blame in every direction.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
have you ****** someone off unintentionally? a boss or a butt kissing coworker? that usually explains it..nursing is chock full of spiteful, immature people, many of them in the leadership role. sounds bitter, but i get so tired of seeing the rotten people flourish and get away with stuff, while the decent people get grief over the littlest things.
i can believe that maybe you are being targeted a little. i too have seen more experienced nurses make some whoppers of mistakes and get no repurcussions. this isnt fair but thats how it works, unortunately. you really have two choices here. if you want to keep this particular job, you'll have to tow their line. if you think there's something more to it, and you don't feel safe in your practice, then start looking for a job where you feel more secure and maybe will get a longer orientation. good luck!
perhaps my last post wasn't clear enough. i have seen experienced nurses make whoppers of mistakes and you won't necessarily see the repercussions. an experienced nurse who makes a whopping error and immediately recognizes it, admits it, then sets about to mitigate the damage to the best of her ability probably isn't going to be publiclly flogged. especially if she self-reports the mistake and makes it clear to her managaer that she did it, she accepts responsibility for doing it, she is sure it will never happen again and even if the patient was just fine afterward, she knows what could have happened.
contrast that with the nurse who either doesn't recognize the mistake she made or won't admit it until someone doing chart audits came across it and pointed it out. then she has all sorts of things to say -- "no one told me to draw a second set of enzymes," "i hadda give report rather than put her on the monitor." "i already did that, but you didn't look well enough to find it." "i shouldn't have to double chart, anyway." "but nothing happened to the patient."
which of those two do you think understands the mistake and the potential consequences and owns it? which of those two can you trust not to make the same mistake in the future? and which one to you want to bi#ch slap into next sunday?
perhaps my last post wasn't clear enough. i have seen experienced nurses make whoppers of mistakes and you won't necessarily see the repercussions. an experienced nurse who makes a whopping error and immediately recognizes it, admits it, then sets about to mitigate the damage to the best of her ability probably isn't going to be publiclly flogged. especially if she self-reports the mistake and makes it clear to her managaer that she did it, she accepts responsibility for doing it, she is sure it will never happen again and even if the patient was just fine afterward, she knows what could have happened.
contrast that with the nurse who either doesn't recognize the mistake she made or won't admit it until someone doing chart audits came across it and pointed it out. then she has all sorts of things to say -- "no one told me to draw a second set of enzymes," "i hadda give report rather than put her on the monitor." "i already did that, but you didn't look well enough to find it." "i shouldn't have to double chart, anyway." "but nothing happened to the patient."
which of those two do you think understands the mistake and the potential consequences and owns it? which of those two can you trust not to make the same mistake in the future? and which one to you want to bi#ch slap into next sunday?
ruby, i have respect for you on many fronts, but i disagree with you on this. there is a strong undercurrent of "mean girl" behavior in nursing. it may very well be present in other fields but we're not talking about other fields, we're talking about nursing.
the op made a mistake, no doubt about it. but, i have noticed that on this board, if someone has less than the magic number of years of experience, their posts are open to attack. ironic too, because it reflects the issue in nursing. namely, that if you are new, you are seen as not only second class as a nurse, but as a human being. they can have a legitimate complaint but they have to be "hazed" first before its considered valid.
and sorry, but i think your comment about ***** slapping someone is inappropriate and unprofessional. now, i know that might tick some people off because i don't have as much experience as others, oh well.
we'll just have to agree to disagree because we have vastly different opinions on this and have both been vocal about them. and i don't hate nurses or nursing. i hate catty, high school behavior and nursing is full of it sadly.
I realize this is off topic but I'd like to ask an open question to those who are quick to perceive *experience bias* when an experienced nurse disagrees with a less-experienced nurse:
Do you not think that your own judgement, knowledge and skills will be vastly better after 10 or 20 years of experience? Why is it so hard to accept that those with more experience are very likely to know more than you do?
Specializes in Critical Care; Cardiac; Professional Development.
I am relatively new - been on the board for a few years, about to graduate. I have had a few "older" nurses jump my shizolla for things. I also made some pretty arrogant and mouthy posts when brand new that I cringe over now, mostly caused by me dragging my uninformed, inexperienced ideals all over the playground.
I don't see this bias really often. I do see people react a lot to the quality of the post and the thought that went into it (or lack thereof). And I do see people tired of answering the same 20 questions over and over again.
I recently posted what is probably going to seem like a VERY stupid question to me in a year or two. But I wanted input on it now. I was answered with very direct information - a few terse replies, but still very civil and most of them downright friendly. Since I don't think I am all that special, I suspect it was the sense of my genuinely wanting to learn that caused positive response (and by positive, I mean honest answers, not coddling). Undoubtedly my question strained the patience of the experienced nurses, but those who responded refrained from saying anything that made me feel stupid for asking. I recognized when I posted it that it would be prime hunting ground if someone took it that direction, but honestly didn't give that much thought. I had a question I needed input from experienced nurses on. And they gave me that.
My point is that I don't think a blanket statement of old vs new really applies. Not in my experience anyway.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
ruby, i have respect for you on many fronts, but i disagree with you on this. there is a strong undercurrent of "mean girl" behavior in nursing. it may very well be present in other fields but we're not talking about other fields, we're talking about nursing.
the op made a mistake, no doubt about it. but, i have noticed that on this board, if someone has less than the magic number of years of experience, their posts are open to attack. ironic too, because it reflects the issue in nursing. namely, that if you are new, you are seen as not only second class as a nurse, but as a human being. they can have a legitimate complaint but they have to be "hazed" first before its considered valid.
and sorry, but i think your comment about ***** slapping someone is inappropriate and unprofessional. now, i know that might tick some people off because i don't have as much experience as others, oh well.
we'll just have to agree to disagree because we have vastly different opinions on this and have both been vocal about them. and i don't hate nurses or nursing. i hate catty, high school behavior and nursing is full of it sadly.
there is a difference between behaviors -- clearly the nurse who recognizes that she made an error, owns up to it immediately, sets about mitigating the damage, self-reports and has a plan for doing better next time is a nurse -- regardless of length of experience -- who probably will not be publically flogged. the nurse who doesn't recognize her error until it is pointed out to her, makes excuses for having made the error, says it's not really a problem since nobody died and it ought to be ok anyway because everyone else does it . . . well is that the nurse you want taking care of your grandmother?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i am relatively new - been on the board for a few years, about to graduate. i have had a few "older" nurses jump my shizolla for things. i also made some pretty arrogant and mouthy posts when brand new that i cringe over now, mostly caused by me dragging my uninformed, inexperienced ideals all over the playground.
i don't see this bias really often. i do see people react a lot to the quality of the post and the thought that went into it (or lack thereof). and i do see people tired of answering the same 20 questions over and over again.
i recently posted what is probably going to seem like a very stupid question to me in a year or two. but i wanted input on it now. i was answered with very direct information - a few terse replies, but still very civil and most of them downright friendly. since i don't think i am all that special, i suspect it was the sense of my genuinely wanting to learn that caused positive response (and by positive, i mean honest answers, not coddling). undoubtedly my question strained the patience of the experienced nurses, but those who responded refrained from saying anything that made me feel stupid for asking. i recognized when i posted it that it would be prime hunting ground if someone took it that direction, but honestly didn't give that much thought. i had a question i needed input from experienced nurses on. and they gave me that.
my point is that i don't think a blanket statement of old vs new really applies. not in my experience anyway.
when an experienced nurse disagrees with a less-experienced nurse:
anotherone, BSN, RN
1,735 Posts
it doesn't matter if some people never document at all! just show up and do nothing, sit at the desk eating donuts. if you miss one little thing, they can fault you for that. the key is to never miss anything.
Bringing up what people do wrong is how you get them to change it. I think i understand your thought process. when i have had shifts from hell, and get an email about not documenting something trivial to pt care, it does annoy me. but you just have to suck it up as part of the game. trying to fight it only makes it worse, i suppose.