Occurence reporting to punish other nurses

[sistrmoon]

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?

[sistrmoon, BSN, RN]

This is probably a symptom of a management problem because they always want to know everyone involved and it's often treated as punitive.

[sadiemae1123]

While there's a lot of talk from management that occurrence reports aren't supposed to be considered punitive, their actions never really seem to back it up. I've heard about plenty of nurses being disciplined because of an incident, and experienced it myself, but I can't say that I've ever heard a manager or administrator taking responsibility for the error and changing the system that allowed the error to occur.

[bubblymom373]

I agree with chevyv, I would rather fix the mistake. Granted after fixing it I will talk with the nurse involved and tell what I had found. If the mistake is repeated and by the same nurse yeah then it is written up. I figure she at least had fair warning. Lets face it mistakes happen.

[I love my cat!]

Reporting the "errors" of others seems to be a trait stemming from a feeling of little to no control or respect. Reporting someone and watching the aftermath from such a report can be very empowering for some. The problem with non-stop reporting is that it can come back to bite. When coworkers realize who is responsible for so many reports, all eyes focus on that person.

It can turn really ugly.

[Lev, MSN, RN, NP]

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.

Why would anyone make effort to go out of their way and potentially put patients' lives in danger all to make someone look bad? So ridiculous!

[applesxoranges, 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:)

Well, I was thinking "more experienced" when I said it. Unfortunately, it is the ones that have been nurses for over 10 years that are being catty about this stuff. It goes through cycles where someone gets a bug and then all departments are acting like two year olds. It is ridiculous between the ER and ICU. Radiology was ridiculous too at a point. It was so bad that all shifts started having to fill out these sheets that were checked off to make sure that all this unnecessary crap was done and then sent to the manager. We found out later that it was due to a day feud between radiology and day shift writing each other up (we were really puzzled by it on nights because we were not experiencing the same write up phase).

[mmc51264, BSN, MSN, RN]

Some of this sounds like a hostile work environment.

I am the first one to write a safety report on a mistake that I have made and I will only do it on another if it something that is truly an unsafe situation. Missed dosed of vanc, stuff like that.

[wooh, BSN, RN]

While there's a lot of talk from management that occurrence reports aren't supposed to be considered punitive, their actions never really seem to back it up. I've heard about plenty of nurses being disciplined because of an incident, and experienced it myself, but I can't say that I've ever heard a manager or administrator taking responsibility for the error and changing the system that allowed the error to occur.

That's why when it's a system error, and I bother to do a report, I tell exactly WHY it's a system error and what system change is needed to fix it. (Or at least id the break in the system.) I make it very clear in the report that it's not a person, so they have to at least read it before they go and try to blame one person.

[suanna]

I've worked in that type of toxic enviornment, and I know it is no fun. We solved a lot of the "write up" mentality by establishing a required Qmos staff meeting for each shift (later it became elective but was scheduled when the most possible staff could be on the unit.) At the end of the required management agenda there was always the offer from our director "so tell me what issues and problems have been happening this last mos" We also reviewed solutions and provided feedback for problems that were reported the previous mos. The rules- you reported problems, not people. ie: "we keep finding outdated IVs hanging on our patients when we get report at 07:00- we spend half the morning hanging new drips, IVs, tubing before we can even start out patient assessments". The staff then would brainstorm as to why this was happeneing and how we could correct it without blaming of punishing one person or group. This kind of open communication goes a long way to solving the problem you describe. If requires a real commitment from management to facillitate the communication and promote only professional problem solving, but in my opinion it was worth every hour of those staff meetings.

[xoemmylouox, ASN, RN]

I've worked in that type of toxic enviornment, and I know it is no fun. We solved a lot of the "write up" mentality by establishing a required Qmos staff meeting for each shift (later it became elective but was scheduled when the most possible staff could be on the unit.) At the end of the required management agenda there was always the offer from our director "so tell me what issues and problems have been happening this last mos" We also reviewed solutions and provided feedback for problems that were reported the previous mos. The rules- you reported problems, not people. ie: "we keep finding outdated IVs hanging on our patients when we get report at 07:00- we spend half the morning hanging new drips, IVs, tubing before we can even start out patient assessments". The staff then would brainstorm as to why this was happeneing and how we could correct it without blaming of punishing one person or group. This kind of open communication goes a long way to solving the problem you describe. If requires a real commitment from management to facillitate the communication and promote only professional problem solving, but in my opinion it was worth every hour of those staff meetings.

That is how these things SHOULD be handled. My employer encourages you and tells you it's your duty to report other staff memebers.. Of course the actual problems are never solved this way. Luckily only a handful of staff have the time to be chronic "reporters" so you just avoid them as much as possible. Good luck to the OP.

[sistrmoon, BSN, RN]

I've worked in that type of toxic enviornment and I know it is no fun. We solved a lot of the "write up" mentality by establishing a required Qmos staff meeting for each shift (later it became elective but was scheduled when the most possible staff could be on the unit.) At the end of the required management agenda there was always the offer from our director "so tell me what issues and problems have been happening this last mos" We also reviewed solutions and provided feedback for problems that were reported the previous mos. The rules- you reported problems, not people. ie: "we keep finding outdated IVs hanging on our patients when we get report at 07:00- we spend half the morning hanging new drips, IVs, tubing before we can even start out patient assessments". The staff then would brainstorm as to why this was happeneing and how we could correct it without blaming of punishing one person or group. This kind of open communication goes a long way to solving the problem you describe. If requires a real commitment from management to facillitate the communication and promote only professional problem solving, but in my opinion it was worth every hour of those staff meetings.[/quote']

Well, I don't like this example because it targets night shift, and we already get the "you don't do anything all shift" mentality directed at us:p At my facility, tubing labeling is a problem across shifts for sure! They want us to do central line dressing changes on nights(which I do if the patient is amenable), but then we always get the "night shift is too noisy and not consolidating care enough to let the patient sleep" complaint. But I do like the idea of approaching it as a problem solving activity.

[sistrmoon, BSN, RN]

That's why when it's a system error and I bother to do a report, I tell exactly WHY it's a system error and what system change is needed to fix it. (Or at least id the break in the system.) I make it very clear in the report that it's not a person, so they have to at least read it before they go and try to blame one person.[/quote']

I absolutely report systems errors.,I had a big one recently where a heparin drip had been changed from rebolus to no rebolus by an ED pharmacist but the boluses weren't taken out of the system and the change wasn't communicated. So a bolus was indicated on my patient and I scanned it, gave it after a 2nd RN check but the main order had been changed to no rebolus. I'm trying to get pharmacy IT to change it so that the boluses drop out automatically when the main order is changed to no rebolus. As it currently stands, it has to be done manually.