Your funniest "are you serious?!?!" MIDAS report

Sour Lemon · Sep 22, 2016

Recently our manager told us to stop putting in frivolous Midas reports and that it goes into corporate.

That's the best way to report frivolous things if you feel the need to report them. Personally, I can't be bothered unless the situation is DEADLY-serious. Some people sit down at the end of a shift and write them out like Christmas cards. Good for them, I guess. I would rather go home and sleep.

offlabel · Sep 22, 2016

Got midas'd once for not wearing gloves while intubating someone in the OR. By an nurse from the outside observing.

offlabel · Sep 22, 2016

How could they see you had no gloves? (I assume you must have had them on, at least to protect yourself).
Some people's children /shaking my head (the reporter, not the reportee).

Oh...haha....no...outside as in was not an OR nurse. I didn't have gloves on (as is a good practice)...I had a senior moment or something...but a midas? Just silly.

roser13, ASN, RN · Sep 23, 2016

Despite the misleading title, I think this thread is not meant to be about Midas reports necessarily. I think it's meant to ask for the moments when management makes jaw-dropping statements or requests.

Pepper The Cat, BSN, RN · Sep 23, 2016

What is a MIDAS report?

i have never heard of the term

Sour Lemon · Sep 23, 2016

What is a MIDAS report?
i have never heard of the term

It's an incident report.

TiffyRN, BSN, PhD · Sep 23, 2016

I'm not sure but it might be that MIDAS is an internal reporting system for the OP's employer. It's my understanding that the lawyers try to change the name of these reporting systems off and on in an attempt to keep them from legal discovery. As in the plaintiff's lawyers ask for "incident reports". Defendant replies, sorry, we don't have anything called and "incident report". The game will continue until the plaintiff guesses what the defendant hospital's incident reporting system is called. "Oh, can we have all your MIDAS reports?".

Just a guess, maybe I'm off target.

HouTx, BSN, MSN, EdD · Sep 23, 2016

This is probably going to be a really unpopular opinion

It is important to report 'near misses' as well as actual adverse incidents.... because THAT is where the real improvements come from. Serious events always get a lot of attention, especially "never events" and sentinel events. But those are usually about finding about what happened and taking corrective actions after the fact.

The 'near miss' information provides information about bad processes or systems... things like nurses skipping steps in order to cope with higher workloads; or inaccurate sponge counts because there aren't enough veteran OR nurses left to hold the line against impatient surgeons. Maybe nothing bad has happened yet, but it's probably only a matter of time until it does.

So, yeah, I would definitely take appropriate action if I saw someone doing an sterile procedure without gloves or other adequate safeguards. I hope you would too.

Twinmom06, ASN, APN · Sep 23, 2016

I only ever MIDAS'ed someone once - for knowingly administering 30 units of Lantus at HS, with a BG of 85 (which was the highest it had been that day) and she told me she didn't feel like calling the doc to find out to hold it or not. 2am BG was 32.

djh123 · Sep 24, 2016

Yet another acronym I've never heard of... but there were Midas muffler places where I used to live. :^)

nutella, MSN, RN · Sep 24, 2016

This is probably going to be a really unpopular opinion
It is important to report 'near misses' as well as actual adverse incidents.... because THAT is where the real improvements come from. Serious events always get a lot of attention, especially "never events" and sentinel events. But those are usually about finding about what happened and taking corrective actions after the fact.
The 'near miss' information provides information about bad processes or systems... things like nurses skipping steps in order to cope with higher workloads; or inaccurate sponge counts because there aren't enough veteran OR nurses left to hold the line against impatient surgeons. Maybe nothing bad has happened yet, but it's probably only a matter of time until it does.
So, yeah, I would definitely take appropriate action if I saw someone doing an sterile procedure without gloves or other adequate safeguards. I hope you would too.

I agree with your statement all the way - investigating near misses and adverse events provide the opportunity to look at the system that is in place with the goal to create or improve a system that will be able to prevent near misses/ adverse events/ sentinel events because human's nature is to make errors. And it is also an opportunity to intervene if it turns out that the system in place is working but the employee is willfully not compliant (example "I do not like precaution gown because they make me sweat" as opposed to "there were no gowns on the floor, I would have to get them from a different floor but the patient had to go to the bathroom").

However, the goal to improve the system and practice is not always achieved for a variety of reasons, for example:

- Punitive culture in which employees are not encouraged to report those mistakes

- The system gets swamped with "revenge" motivated reports to "pay back" another employee leading to huge amounts of reports and it can be hard to find out which ones are the ones needing attention. A report that states that patient got a stool softener medication 40 minutes after the ordered time is obviously different from "the patient needed narcan " or "patient had the wron ID bracelet attached".

- The reporting system itself could be at fault because of the way it is designed, taking too long to use, or not user friendly and so on

- General culture of under - reporting, which often goes back to the punitive culture and mistrust in leadership but can also be based on "not wanting to alienate coworkers" .

The questionable part with the OP post is that leadership on the unit seems motivated to cut back on the numbers of reports to corporate because it also directly says something about the general performance and leadership. Employees usually need to be encouraged to submit reports. If there are concerns about using the system appropriately, the manager need to educate employees about how and when to use the reporting system. Just telling employees to stop putting in reports because it goes to corporate does not make any sense and it encourages behavior that works against the culture of safety that we need.