Overwhelmed.

[sjhaz63]

I'm facing a write up for the first time. I have worked on the same floor for 5 plus years and while we constantly work over-ratio and without reasonable breaks, yesterday I actually had the appropriate number of patients. Two very confused patients, one whom was combative and assaulting the numerous staff members throughout the morning, a bleeder whom I was pumping blood into, a newly diagnosed cancer patient (diffused mets) and her bereaved family too. I could hardly get out of combative's room and when I did it was too dash and try and care for my bleeder and relieve the bone pain in my CA pt. IV begins leaking in bleeder, second confused patient pulls out his line...the dr we all dread has 3/4 of my assignment. Now, it's time to discharge a patient I glance through his discharge orders-nothing about antibiotics at STR. I double check with the case manager and also confirm his OP dialysis is set up. She confirms no need for PICC to remain. I remove it for discharge.

Well, despite that he was being treated for renal issues and no infection IV antibiotics were in fact sent to the STR. I discovered this while giving report to the receiving nurse. I got a new PICC inserted and sent him out later than scheduled. I contacted patients wife to explain reason for delay and she was apologizing to me for leaving. The family had quit taking calls because they could not deal with combative patient anymore. Today a family member calls my manager to complain. She calls me at home to find out what happened. Yes, I made the mistake. Im sure it will result in a write up. Do I just sign it? I've not dealt with write ups previously. Just asking for input.

[Pangea Reunited, ASN, RN]

I would sign it, but I'd be irritated. Yes, it was a mistake ...but in the grand scheme of things, not a huge one. It was corrected and the patient is no worse for it. If my employer saw fit to write me up, I'd be looking for another job. Now, if it's something that happens on a weekly basis, that's a different story.

[Marisette, BSN, RN]

I don't understand the write up if you corrected your mistake and no harm came to the patient. Sounds like you work a very busy medical surgical floor. An apology is an order for the patient that was inconvenienced. But why give a write up to a experienced nurse who has not made mistakes in 5 years. You should add an explanation to the document if you sign. I don't think I would sign it.

[40thEditionRN]

Not looking to foment your feelings of irritation, but i feel like your manager should have had your back a little more. Sounds like there was a miscommunication and you're taking the fall for it? She could have tried to smooth the ruffled feathers, and then checked in with you. I don't see the need for the write-up.

[40thEditionRN]

Just to add, though, maybe you won't get written up? Was the call from your manager punitive in nature?

[sjhaz63]

Thanks for the feed back. The call was to clarify events but ended with the statement 'we should not have put the patient through the ordeal of a second PICC'. Manager is not one to use any form of emotion in conversation so there was no way to know. I've heard nothing so far. There have been lots of little write ups of co-workers recently so could just be paranoia on my part. We will see.