I am a new RN, and I have been working on a med-surg floor for 8 months now, and up until this point things have been going well. Yesterday we had students on our floor, and I love having a student because I was one just a short time ago, but I had 4 nursing students on my cart, plus 7 patients to take care of, as well as a doctor coming in to do a bone marrow biopsy on one of my patients that I had to assist with, plus a new admission! Needless to say, I worked my tail off all day without even breaking for breakfast or lunch. Things were hectic but everything was given and done on time. Well, I came in this morning to find out that the night nurse who had my patients wrote me up because I forgot to give the ordered Phenergan to the patient before the biopsy. I did give the dilaudid which sedated the patient more than enough and she slept through the whole procedure. I spoke with my manager and she said that she saw how hectic it was for me, and not to worry about it, but I am shocked that this nurse who wasn't even there took it upon herself to write me up, and now this goes on my record. I love my patients, and it eats me up inside when I forget something, I admit my mistake, but should one nurse be allowed to write up another one without consulting the boss first? I've been crying all afternoon about this, and feel like I need to quit, the incompetence that I feel is immeasurable.:urgycld:
It does not go on your record. Only a charge nurse or a nurse manager can "write you up" and have it go permanently in your file.
She wrote an incident report to report a med error, not the same thing as a write up that goes in your file.
Some people are proud of saying "I wrote that nurse up" when they merely filled out an incident report. NOT THE SAME THING. You've discussed this with your manager, so relax about it.
You made a med error, learn from it, vindictive or petty as the nurse might have been if you look at it objectively the nurse was not wrong. What if you made a major error because it was busy and hectic? Be thankful it wasn't a big one and take pause to take a deep breath and move on.
I feel your pain, I really do. I know exactly how it feels to give 110%, not get breaks and work like a dog, only to make a mistake and be berated for it. It hurts. However, it reminds us that no matter how busy and hectic is gets, we must never let our guard down and be diligent. If ever called before the BON for a med error, trust me on this, they don't care one bit "that I'm a new grad, with a horribly busy assignment, and students distacting me......etc.etc.."
I disagree. It isn't the reporter's job to sort out what happened. Think of the "write-up" as question presented to the unit manager. The manager is the one who should get the whole story and decide what, if any, further action is warranted.
I agree. The reporting nurse merely reports "medication "x" was not given. Or whatever it is, stated factually without judgements, just the facts.
This is the first step in "sorting it out" and getting the whole story. But it's not the reporters job to figure it all out.
If this was a true incident report, a name should not be listed. The manager would have addressed this issue with the nurse, and drop it. Maybe this is what actually happened...
If this was a 'write up" as the author first indicated, that is a different beast. I have (and I am sure many of you have ) worked in places where nurses love to write up another nurse, as it gives them complete happiness to do so. This is the part I don't understand. If a nurse has time to "write up" another nurse, then the nurse that writes up another has too much free time on their hands or hospital must is overstaffed and there is nothing else to do for a patient. Or, they wouldn't have the time to be so childish.
I've never written up a nurse. (Have written up a doctor!) I feel that's unprofessional and it's best to talk with the nurse and if no results talk to the manager. I agree, it was probably a med error by omission that was written up. Try to relax.
Our incident reports require the name of the writer as well as any witnesses to the incident and anyone involved. That allows for further investigation and evaluation.
It does not go on your record. Only a charge nurse or a nurse manager can "write you up" and have it go permanently in your file.
Some people are proud of saying "I wrote that nurse up" when they merely filled out an incident report. NOT THE SAME THING. You've discussed this with your manager, so relax about it.
I honestly believe there is nothing more horrible than being written up. I believe it can be a useful way of highlighting errors but that it has been abused by many, as a personal petty vendettas.
Being written up can create an atmosphere of dread and fear, plus resentment. It is a powerful tool which does have it's place in hospitals but only if it is used effectively.
We live in a society where we are presumed innocent until proven guilty-Unless of course you are an RN in a hospital.
If Phenergan was ordered and you did not give it, then you went against the doctor's order. This is not within your scope of practice. If you did not give the Phenergan because of too much sedation, then you should have told the doctor the situation and allowed him to decide whether or not you should give it. If you did not give it because you forgot, you should have notified the doctor that you forgot to give the med but that the patient was very comfy with the Dilaudid. You could then have documented that the Phenergan was not given, doctor notified, no further orders.
Everyone makes mistakes and it is horrible when the mistake is yours. But it is a mistake and any risk manager and attorney will tell you that any and all mistakes should be documented per hospital policy. This covers everyone. You need to separate yourself from feeling that you were picked on. You do seem to have had a lot of things going on but this does not mean that you did not make a mistake and should not be reported. In a good system, incident reports are used to fix system errors, not punish the person who committed the error unless it was an ongoing problem or horribly negligent. From what you describe, you had way too many patients and too many students for a newbie to be working trying to deal with all at once. The students should have had patients that were cared for by experienced nurses so that you only had to deal with the patients in your care - not babysit students too. This is a system error that needs to be corrected.
If you are conscientious in your duties, this isn't going to harm you. Take it as a learning experience. You need to know what your limitations are and work to prevent something similar from occurring again. I know that it is hard not to wonder if they are out to get you. So many nurses use incident reports to be vindictive that it can make you paranoid. Don't let it. Learn from it and go on. And when the shoe is on the other foot, you will know that it is your duty to report errors when you find them, even when it isn't the popular thing to do.
If more people wrote up incident reports on ALL of the errors and problems that occurred every day in every hospital - we might actually be able to show the public the purposely understaffing and under-training causes errors and deaths - not the actual persons involved. Few errors are the result of one person, they are a result of a terrible healthcare system.
I disagree that she did the right thing. Writing someone up is something that should be done only after ALL the information is obtained, and then if the situation warrants such an extreme measure then do it. The nurse never spoke to her to get that information. Writing someone up goes in that persons personel file and will be used against them on evaluations. If you are going to have such an effect on a co-workers professional life at least give them the courtesy of explaining the facts. It is not your "duty" to write people up.
I disagree that she did the right thing. Writing someone up is something that should be done only after ALL the information is obtained, and then if the situation warrants such an extreme measure then do it. The nurse never spoke to her to get that information. Writing someone up goes in that persons personel file and will be used against them on evaluations. If you are going to have such an effect on a co-workers professional life at least give them the courtesy of explaining the facts. It is not your "duty" to write people up.
There is a difference in a "Write up" (Read: Incident report as in for a med error in this situation) and a write up given by management as a reprimand for attendance, insubordination, etc.
There is a difference in a "Write up" (Read: Incident report as in for a med error in this situation) and a write up given by management as a reprimand for attendance, insubordination, etc.
My main point was regardless of whether it was an incident report or a write up the person doing the incident report or write up still should have all the information.To do this you need to speak to the person(s) involved. From reading the original post this person did not bother to obtain any information. She made an assumption and reacted to it. I learned a long time ago never assume anything in nursing. I find it disheartening to read that so many people think this nurse was right in writing this nurse up without speaking to her first.
We all make mistakes ,some mistakes do cause the patients their life or physical or psychological trauma ,but is this a mistake or you just didn,t give because the patient was sedated otherwise?
In that case,you had to assess the patient,s and report to the doctor your findings, then ask him whether or not to give the drug ordered.
If the doctor on the other hand said to give and you had any doubts then you call your supervisor to confirm your assessment or nicely ask the doctor to come and reassess the patients.
Did you discuss this with the immediate supervisor before with- helding the drug?
And I think the nurse should discuss with you before she wrote you up.I would ask for a transfer to avoid her by all means.
:urgycld:
Tweety, BSN, RN
36,517 Posts
It does not go on your record. Only a charge nurse or a nurse manager can "write you up" and have it go permanently in your file.
She wrote an incident report to report a med error, not the same thing as a write up that goes in your file.
Some people are proud of saying "I wrote that nurse up" when they merely filled out an incident report. NOT THE SAME THING. You've discussed this with your manager, so relax about it.
You made a med error, learn from it, vindictive or petty as the nurse might have been if you look at it objectively the nurse was not wrong. What if you made a major error because it was busy and hectic? Be thankful it wasn't a big one and take pause to take a deep breath and move on.
I feel your pain, I really do. I know exactly how it feels to give 110%, not get breaks and work like a dog, only to make a mistake and be berated for it. It hurts. However, it reminds us that no matter how busy and hectic is gets, we must never let our guard down and be diligent. If ever called before the BON for a med error, trust me on this, they don't care one bit "that I'm a new grad, with a horribly busy assignment, and students distacting me......etc.etc.."