Occurrence Reports (Incident Reports)

[diane227, LPN, RN]

I just wanted to talk to you guys for a moment about this subject because I think that it is something that is frightening to everyone when they are a student and a new nurse. When you hear the term "written up" or "incident report" immediately your sphincter tone is so tight that you could not put a nail up there with a jackhammer. So let me sum it up for you.

Occurrence report is the proper name for these reports. They are meant to report incidents that are outside normal operating procedures that may have an impact on patient care and safety. They are also used to report employee injury and in some cases employee behavior issues. When you know that as error has occurred inform your charge nurse at once and go ahead and write your report. If you have made a medication error, write up the occurrence report yourself and turn it in to your manager. When you make an error, report your own errors. If you have someone going around threatening to "write you up" just let them and don't worry about it. Most managers are smart enough to know vindictive behavior when they see it.

The important thing about occurrence reports is that they help the manager track trends in operations that are not working well. If a manager gets repeated reports that you are not able to provide a certain level of care to a patient because a certain item of equipment was not available, then he/she can take action on that issue and try to make a case for getting the unit the equipment needed.

It is not about placing blame on anyone. In my 31 years of nursing, most often what I have found in my investigations is that most problems occur because we have a system problem not a person problem. But I would never know that if no one told me. Any time an error occurs the manager should always take time to look at the process along with the person(s) involved.

And remember, if you have a concern, you don't have to use a form to report it. You can write it on anything and give it to your manager. If you are uncomfortable with the form, don't use it. Or if you fear that the charge nurse will not pass the form on to the manager, then do it yourself. Take a proactive approach and do not allow anyone to bully you. Sometimes you have to learn to work around the system to get what you need. When I have an issue with an employee (I am the 3-11 charge nurse on my floor) I send my manager an email. I only write occurrence reports usually when it involves another department of when we have a fall, a medication error etc.

So put the incident report anxiety to rest and don't worry about it. Use it as a tool. Report your own errors before someone else does and keep your manager informed. Remember, these reports can assist you with getting what you need in the long run if you have a manager that advocates for his/ her staff.