Occurrence Report and Job prospects

[AviatoRN86]

Long time reader, rarely post.

I recently started working med-surg (9/15) in a well known magnet facility in Ny. The place looks nice but the ugliness inside is deplorable sometimes:

-Nurse bullying

-Bullied by those the bullying was reported to

-Strong inter-nurse write up culture - not for things that would cause harm - that I agree would merit one but for things like putting date and time but not initials on a label

-Poor scheduling

-Public humiliation acceptable

-Customer service over nursing care at the risk of disciplinary action

-Good ratios but bordering on overwhelming work loads (needy, confused, pretty highly acute patients, back to back admissions)

At work I stay positive and do my best work despite all of this.

I recently suffered a medical emergency on duty and after taking a brief break on the advice of a manager I told. realized I had to go to the ER.

A week later I was approached by my main mgr about how "erratic" my behavior was (I had chest pain), I was "pacing and blasting music" (untrue - I have ear buds that I use on break, I walked out of the break room because I was scared) and that I left narcs in a pt room (in a locked med cabinet) and questioned on why I didn't give report (did - before break) and why I didn't tell someone I couldn't do the work (told my ANM as soon as I felt the pain and we even took my vitals together).

My word against theirs- I feel I can't win.

Policy/Procedure=pull the narc and give it right away. I believe what happened was I was called away mid task for an higher priority issue and put the narc (tramadol) in the locked cabinet for fear of dropping it if I carried it around. Intending to come back and administer as ordered. The chest pain worsened and seemed to spread and I was rushed to the ED.

I offered to chart, tie up any loose ends when I was more stable and the work up was done and was told "not to worry" about it. I was d/ced in the AM, and went home.

I agree and own the fact that yes I violated policy and procedure regarding the narc. A fellow nurse wrote an "occurrence" report about it that I'm told would stay in my file. I was never explained the implications of this report, nor was I ever asked to sign anything. I requested a copy of the report but have yet to see it. It is my one and only "occurrence"

I want to transfer off this unit and to a different one within the same facility because of the toxicity, and I am not doing well with night shift despite trying all the "night tricks", BP is up etc.

Management types: Would this usually affect one's transfer eligibility? I tried to ask the ANM and didn't get a full answer - only that she would write a good review....

Really stressed about this. Any guidance would help before I try to speak to management again.

Thank you.

[dishes, BSN, RN]

What is the job market like in your area? How long on average does it take a nurse to move into a new position? Unless there is a severe shortage of nurses, it isn't reasonable for you to expect you will be first in line to be offered an internal transfer. If the reason you want the transfer is because you do not like the culture of your current unit, you will be seen as a problem employee and overlooked. For now, suggest you work on your ability to manage stress and apply for external jobs that do not include night shifts.

[AviatoRN86]

I've been managing the culture pretty well I don't believe they're aware of my strong opinion of the culture since orientation I've stayed pretty quiet about it to avoid being a "problem". The main reason to transfer would be to get a day position, a better culture would be an awesome bonus...but I was worried if the occurance report would hurt my chances of transfer or not.

[dishes, BSN, RN]

I don't think one occurrence report is a barrier, it had to be written and you accepted responsibility. If you have two or more further occurrences you may risk being terminated, but one occurrence in which the patient was not harmed and the employee accepted responsibility is seen as following procedure and remediation so the employee doesn't make the mistake again.

[AviatoRN86]

Thank you for your time, dishes! I really did learn from it - the importance of just following policy and procedure and avoiding short cuts in the future.

[FurBabyMom, MSN, RN]

I don't know the facility you work in. I know in my facility (Magnet, academic facility) - being written up is not the end of it.

I submit incident reports ALL the time about things. Patients without adequate site markings arriving in the OR, policies not followed 100% (physicians refusing the x-ray in the case of an incorrect count), etc. I don't write incident reports about other nurses. I have written them about events - patients brought to the OR without a nameband, or with a slider board still under them on the stretcher. Perhaps the nurses in those other units were spoken to about the situations - who knows. I know that within my department, most of the time we do not get written up or punished over what we report.

Based on the OP's comments about things to learn and take away from the situation, it seems like you've drawn the conclusions you need to. You may have done something wrong but you've learned, changed and and growing. Personally it would bother me more if you never learned or grew from mistakes.

Also - most facilities the "write up" stays in your file perhaps for forever but only counts against you for 6-12 months. We have a point based disciplinary action system and without other transgressions things fall off (ex you'd leave written warning after 6-12 months if you don't have another event requiring formal discipline).