Occurence reporting to punish other nurses

[sistrmoon, BSN, RN]

Several of us have noticed a trend amongst the newer nurses to write PSNs on piddly things and even exclaim with glee to their coworkers that they're "writing a PSN on that!"

I'd like to say management takes a non punitive approach to PSNs and uses it strictly as quality improvement, but that's not the case. I once tried to write one anonymously(because I was tired of it being turned back on me when I wrote one) and they apparently questioned everyone until they figured out who wrote it and then called me at home to question me about it and basically said we weren't allowed to submit anonymously.

I'd like to say management sees what's going on and discourages it, but yeah no. I'm not talking about legitimate occurrences that need to be reported. I'm talking about a pimple on someone's backside reported as a pressure ulcer the previous nurse didn't document. And the like.

It's turning into a very uncomfortable vindictive feel where no one has anyone else's back. Anyone else have this going on?

[Esme12, ASN, BSN, RN]

I have found that in a adversarial environment the best defense is a good offense. So there is a lot of finger pointing and report writing. I have found younger nurse particularly adept at this. I have found it's defense mechanism.

[VANurse2010]

I've met some new nurses who have quality reported IV tubing without date labeling. Now, I'm not condoning not labeling IV tubing, but a quality report? Get a life. Fortunately, the boss at that job rightfully looked at such shenanigans with suspicion.

[applesxoranges, BSN, RN]

One of the places I worked before I was a nurse, every department wrote a report out for every little thing. Radiology did it to the nurses because they felt like the day shift was writing out reports about them. The floor and ER had it bad too. It became very toxic. Although to be honest it was usually the older nurses that were doing it.

[sistrmoon, BSN, RN]

By the way, I didn't say anything about age. Just said "newer nurses." Those can be older or younger. But yes we do have one older experienced nurse who runs to the manager about everything:)

[sistrmoon, BSN, RN]

I've met some new nurses who have quality reported IV tubing without date labeling. Now I'm not condoning not labeling IV tubing, but a quality report? Get a life. Fortunately, the boss at that job rightfully looked at such shenanigans with suspicion.[/quote']

I don't get this. Just put up new tubing. This is one of those instances where you should just take care of the situation and move on.

[caliotter3]

At one place we had this problem, but it was confined to one individual. She actually would create med errors for other nurses then write them up. Eventually she got what she deserved.

[hope3456, ASN, RN]

I really have a difficult time with this because my mom raised me not to be a "tattle tail."

It does seem to be most prevalent among "newer" nurses, as well as nurses who have inferiority/control issues.

But also at issue is the managers who thrive on/encourage nurses to throw their coworkers under the bus over trivial matters.

[sadiemae1123]

When I was a new nurse and would find errors (like blood infusing for 6 hours, no filter on TPN, etc) I would ask my preceptor what to do. The response was always to write an incident report. Since this was my first real job ever I did as I was told. Later the same preceptor said everyone else on the unit thought I had been sent in as a mole to dig up dirt on people. I learned to just fix things and not mention it after that. It helped me with getting along with my coworkers, but obviously it's not the right solution for patient safety or quality control.

[chevyv, BSN, RN]

I would rather fix the mistake than write it up. I've seen many nurses take to writing incidents up but it never seems to occur to them to just fix the error if you can. I'm guess I'm kind of old school and would rather have my fellow nurses take me aside and tell me what they found that I had done or not done so I can make sure I'm on top of my game from that moment on. I'm not perfect and neither is anyone else. I will also learn a lot more from a coworker telling me I forgot to or did this instead of that rather than having to try to take the knives out of my back. Some people need to just grow up and that goes for the ones who are older as well.

[sistrmoon, BSN, RN]

When I was a new nurse and would find errors (like blood infusing for 6 hours no filter on TPN, etc) I would ask my preceptor what to do. The response was always to write an incident report. Since this was my first real job ever I did as I was told. Later the same preceptor said everyone else on the unit thought I had been sent in as a mole to dig up dirt on people. I learned to just fix things and not mention it after that. It helped me with getting along with my coworkers, but obviously it's not the right solution for patient safety or quality control.[/quote']

Please understand I'm not saying a PSN should never be written. I don't think they are for the most part used properly at my facility, but I do think they should still be done. The problem is judging when. I think when you have no or little experience, you are more apt to write up any mistake. I definitely let my coworkers know if I feel it is important. I've had varying degrees of receptiveness with this.

[klone, MSN, RN]

In my current role, I feel like I'm doing PSNs all the time. In reality, I've done maybe 6 in the 8 months I've been here. But I've done more PSNs in the past 8 months than I had in the 8 years previously. Mainly it's because I'm the charge nurse, so people always come to me with issues, and I'm the one that has to deal with them. They've always been serious issues, except the two times that I did PSNs on errors I made, and those I just did because you're supposed to (one was for a med error - I gave 250 mg Rocephin instead of 1g Rocephin, but then realized my error after the fact and gave her the other 750mg immediately). But the PSNs I have done, have been for serious stuff - huge blatant HIPAA violation (one patient's lab results were mailed to the wrong patient), egregious lab errors.

But anyway, yeah - I've submitted a lot of PSNs. They've never been about a specific individual, though (except in the cases of the PSNs on my own errors), and I've done them for the purpose of process improvement.

I really have no point with this post. It just got me thinking that I've done a lot of PSNs. And sometimes when I submit one, I wonder if the risk management department thinks "Oh my god, another one??"